More than 15 million Americans suffer from osteoarthritis, according to the American Academy of Orthopaedic Surgeons. This disease, also known as wear-and-tear arthritis, affects the cartilage in joints and may cause pain, stiffness, swelling and a limited range of motion in the knees and hips.
If you have osteoarthritis, surgery to replace or resurface joints becomes an option if your quality of life is greatly diminished by the disease and you have difficulty carrying out activities of daily living.
Listen as Dr. Ramon Soriano, MD, Orthopedic Surgeon and member of the Medical Staff at Doctors Hospital of Laredo discusses how surgeons at Doctors Hospital use Mako™ robotic-arm assisted surgery for knee replacement (knee resurfacing) to improve the quality of life for knee pain sufferers.
Mako™ Robotic-Arm Technology for Knee Pain
Featured Speaker:
Learn more about Ramon Soriano, MD
Ramon Soriano, MD
Ramon Soriano, MD is an Orthopedic Surgeon and a member of the medical staff at Doctors Hospital of Laredo.Learn more about Ramon Soriano, MD
Transcription:
Mako™ Robotic-Arm Technology for Knee Pain
Melanie Cole (Host): More than 15 million Americans suffer from osteoarthritis according to the American Academy of Orthopedic Surgeons. This disease can affect the cartilage and joints and may cause pain, stiffness, swelling and a limited range of motion in the knees and hips. Surgery to replace or resurface joints becomes an option if your quality of life is greatly diminished by the disease or you have difficulty carrying out activities of daily living. My guest today is Dr. Ramon Soriano. He's an orthopedic surgeon, chief of the department of surgery, and a member of the medical staff at Doctors Hospital of Laredo. Welcome to the show, Dr. Soriano. So, when is it that somebody who experiences knee problems -- and we all get them -- when is it that those knee problems require a trip to the doctor to see what's going on?
Dr. Ramon Soriano (Guest): Usually, when it's been going on for quite a while, and you've been treated by your family physician with painkillers and non-steroidal anti-inflammatory medications and modifications of your activities of daily living and these don't work anymore, then it's probably time to see the orthopedic specialist.
Melanie: People get nervous; they hear, "okay, I'm going to see an orthopedic man or woman, and they're going to want to do surgery or a knee replacement," but there are so many other options today including partial knee replacements and resurfacing. So, explain a little bit about some of these other options that may not be requiring a full knee replacement.
Dr. Soriano: Yes, one of the options that we have is doing a partial knee replacement. In this particular procedure, only the damaged part of the knee joint is replaced, and this may help to minimize the trauma to the healthy bones and tissues.
Melanie: So, what does that mean for somebody when they hear partial knee, and it minimizes the trauma? What are you doing exactly?
Dr. Soriano: In other words, we are only replacing the particular parts that are diseased. Let's say only the inner half or the outer half is diseased then we can concentrate on that, and we would leave the normal parts untouched.
Melanie: Explain a little bit about the knee. So, you say there are parts that you can affect and parts that you can't, and there's three major compartments. So, how are they divided up? Give us a little physiology lesson.
Dr. Soriano: Sure. In terms of anatomy, we have three compartments. You have the middle compartment which is the inner compartment, that's the area between the femur and the tibia, and then you have the lateral compartment which is the outside and then you have the patellofemoral joint which is the articulation between the kneecap or the patella together with the femur. So, those are the three compartments that we would refer to.
Melanie: Which one is most oftenly affected by osteoarthritis wear and tear?
Dr. Soriano: Usually, it's the middle compartment.
Melanie: Ok, so if people are coming to see you, and there is this resurfacing, new robotic arm technology for knee pain. Explain about Mako technology and what you're doing there at Doctors Hospital of Laredo.
Dr. Soriano: In terms of surgical procedures for a diseased knee -- since the majority of these knees involve all three compartments -- the majority of these cases will still be a complete knee replacement or total knee replacement. However, about 10 to 15 percent of the osteoarthritis that we see would be eligible for a partial knee replacement. The technology that we have at Doctors Hospital involves the Mako robot which is robotic-assisted surgery during the performance of a partial knee replacement.
Melanie: And how does that work? What are the benefits for the patient?
Dr. Soriano: Well, this is how it works. It all begins with a CT scan of the affected joint and from the CT scan we are able to generate a three-dimensional virtual model of your particular knee, and then this is loaded into the Mako system, and the software is used to create your personalized preoperative plan. So, all the surgery is based on the virtual model based on the 3D CT scan which we would acquire prior to the surgery.
Melanie: That's cool. So, it's very personalized if somebody is smaller or larger then this is going to really personalize it for them. Does it help with giving the knee a natural range of motion, doctor?
Dr. Soriano: It absolutely does, but more importantly, this type of robot-assisted surgery, it provides more accurate placement and alignment of the implant.
Melanie: So how long is something like this? If you have a partial knee -- you have this resurfacing. You have a partial knee replacement, unicompartmental. How long does this last? Is it something that might have to be redone or then might lead to a full knee replacement down the line?
Dr. Soriano: It might sometimes lead to a full knee replacement when the other compartments that have not been replaced will progress to osteoarthritic knees, but these have been found to last from 20 to 30 years without any complications.
Melanie: Wow. Are there certain people who are not candidates -- if they have rheumatoid arthritis or if it's something along those lines, are there people who really are not good candidates for a partial knee replacement?
Dr. Soriano: Yes. Certainly there are. Patients who have had infections to the knees. Patient who have had neuromuscular disorders or have any mental conditions that would preclude physical therapy for these patients or when there is loss of bone, or what we would say compromised bone stock, severe instability of the knee or excessive body weight -- these are considered contraindications to performing a partial knee resurfacing procedure.
Melanie: And wrap up a little bit about Makoplasty, and its benefits for the partial knee replacement as far as the ligaments that are remaining intact and the muscle. People like to hear Dr. Soriano, that you're not going to have to cut any muscle or that there's going to be a natural knee range of motion after this, and it's extremely a high accuracy of anatomic placement. Kind of wrap it up for us with this Makoplasty.
Dr. Soriano: Absolutely. The accuracy is what really distinguishes the robot system from doing it free- hand or by guides which go into the bone. The extra accuracy and alignment that the implant has is much, much better with the Mako system. Not only that, in the operating room, the Mako system allows us to adjust -- make adjustments to our preoperative plan during the actual surgery so we can really, really put the implant in the best position, and so this will result in a better and longer lasting replacement procedure.
Melanie: Absolutely fascinating. And why should they come to Doctors Hospital of Laredo for their care?
Dr. Soriano: At Doctors Hospital we have a team of nurses, physical therapists, occupational therapists who will set goals for the patient before, during, and after surgery to get the patients back on the move and at the same time we will be closely monitoring your condition and your progress.
Melanie: Thank you so much for being with us today. You're listening to Doctors Hospital Health News with Doctors Hospital of Laredo. For more information, you can go to ichoosedoctorshospital.com. That's ichoosedoctorshospital.com. Physicians are independent practitioners who are not employees or agents of Doctors Hospital of Laredo. The hospital shall not be liable for actions or treatments provided by physicians. Doctors Hospital of Laredo is directly or indirectly owned by a partnership that includes physician owners including certain members of the hospital medical staff. This is Melanie Cole, thanks so much for listening.
Mako™ Robotic-Arm Technology for Knee Pain
Melanie Cole (Host): More than 15 million Americans suffer from osteoarthritis according to the American Academy of Orthopedic Surgeons. This disease can affect the cartilage and joints and may cause pain, stiffness, swelling and a limited range of motion in the knees and hips. Surgery to replace or resurface joints becomes an option if your quality of life is greatly diminished by the disease or you have difficulty carrying out activities of daily living. My guest today is Dr. Ramon Soriano. He's an orthopedic surgeon, chief of the department of surgery, and a member of the medical staff at Doctors Hospital of Laredo. Welcome to the show, Dr. Soriano. So, when is it that somebody who experiences knee problems -- and we all get them -- when is it that those knee problems require a trip to the doctor to see what's going on?
Dr. Ramon Soriano (Guest): Usually, when it's been going on for quite a while, and you've been treated by your family physician with painkillers and non-steroidal anti-inflammatory medications and modifications of your activities of daily living and these don't work anymore, then it's probably time to see the orthopedic specialist.
Melanie: People get nervous; they hear, "okay, I'm going to see an orthopedic man or woman, and they're going to want to do surgery or a knee replacement," but there are so many other options today including partial knee replacements and resurfacing. So, explain a little bit about some of these other options that may not be requiring a full knee replacement.
Dr. Soriano: Yes, one of the options that we have is doing a partial knee replacement. In this particular procedure, only the damaged part of the knee joint is replaced, and this may help to minimize the trauma to the healthy bones and tissues.
Melanie: So, what does that mean for somebody when they hear partial knee, and it minimizes the trauma? What are you doing exactly?
Dr. Soriano: In other words, we are only replacing the particular parts that are diseased. Let's say only the inner half or the outer half is diseased then we can concentrate on that, and we would leave the normal parts untouched.
Melanie: Explain a little bit about the knee. So, you say there are parts that you can affect and parts that you can't, and there's three major compartments. So, how are they divided up? Give us a little physiology lesson.
Dr. Soriano: Sure. In terms of anatomy, we have three compartments. You have the middle compartment which is the inner compartment, that's the area between the femur and the tibia, and then you have the lateral compartment which is the outside and then you have the patellofemoral joint which is the articulation between the kneecap or the patella together with the femur. So, those are the three compartments that we would refer to.
Melanie: Which one is most oftenly affected by osteoarthritis wear and tear?
Dr. Soriano: Usually, it's the middle compartment.
Melanie: Ok, so if people are coming to see you, and there is this resurfacing, new robotic arm technology for knee pain. Explain about Mako technology and what you're doing there at Doctors Hospital of Laredo.
Dr. Soriano: In terms of surgical procedures for a diseased knee -- since the majority of these knees involve all three compartments -- the majority of these cases will still be a complete knee replacement or total knee replacement. However, about 10 to 15 percent of the osteoarthritis that we see would be eligible for a partial knee replacement. The technology that we have at Doctors Hospital involves the Mako robot which is robotic-assisted surgery during the performance of a partial knee replacement.
Melanie: And how does that work? What are the benefits for the patient?
Dr. Soriano: Well, this is how it works. It all begins with a CT scan of the affected joint and from the CT scan we are able to generate a three-dimensional virtual model of your particular knee, and then this is loaded into the Mako system, and the software is used to create your personalized preoperative plan. So, all the surgery is based on the virtual model based on the 3D CT scan which we would acquire prior to the surgery.
Melanie: That's cool. So, it's very personalized if somebody is smaller or larger then this is going to really personalize it for them. Does it help with giving the knee a natural range of motion, doctor?
Dr. Soriano: It absolutely does, but more importantly, this type of robot-assisted surgery, it provides more accurate placement and alignment of the implant.
Melanie: So how long is something like this? If you have a partial knee -- you have this resurfacing. You have a partial knee replacement, unicompartmental. How long does this last? Is it something that might have to be redone or then might lead to a full knee replacement down the line?
Dr. Soriano: It might sometimes lead to a full knee replacement when the other compartments that have not been replaced will progress to osteoarthritic knees, but these have been found to last from 20 to 30 years without any complications.
Melanie: Wow. Are there certain people who are not candidates -- if they have rheumatoid arthritis or if it's something along those lines, are there people who really are not good candidates for a partial knee replacement?
Dr. Soriano: Yes. Certainly there are. Patients who have had infections to the knees. Patient who have had neuromuscular disorders or have any mental conditions that would preclude physical therapy for these patients or when there is loss of bone, or what we would say compromised bone stock, severe instability of the knee or excessive body weight -- these are considered contraindications to performing a partial knee resurfacing procedure.
Melanie: And wrap up a little bit about Makoplasty, and its benefits for the partial knee replacement as far as the ligaments that are remaining intact and the muscle. People like to hear Dr. Soriano, that you're not going to have to cut any muscle or that there's going to be a natural knee range of motion after this, and it's extremely a high accuracy of anatomic placement. Kind of wrap it up for us with this Makoplasty.
Dr. Soriano: Absolutely. The accuracy is what really distinguishes the robot system from doing it free- hand or by guides which go into the bone. The extra accuracy and alignment that the implant has is much, much better with the Mako system. Not only that, in the operating room, the Mako system allows us to adjust -- make adjustments to our preoperative plan during the actual surgery so we can really, really put the implant in the best position, and so this will result in a better and longer lasting replacement procedure.
Melanie: Absolutely fascinating. And why should they come to Doctors Hospital of Laredo for their care?
Dr. Soriano: At Doctors Hospital we have a team of nurses, physical therapists, occupational therapists who will set goals for the patient before, during, and after surgery to get the patients back on the move and at the same time we will be closely monitoring your condition and your progress.
Melanie: Thank you so much for being with us today. You're listening to Doctors Hospital Health News with Doctors Hospital of Laredo. For more information, you can go to ichoosedoctorshospital.com. That's ichoosedoctorshospital.com. Physicians are independent practitioners who are not employees or agents of Doctors Hospital of Laredo. The hospital shall not be liable for actions or treatments provided by physicians. Doctors Hospital of Laredo is directly or indirectly owned by a partnership that includes physician owners including certain members of the hospital medical staff. This is Melanie Cole, thanks so much for listening.