Robotic Knee Surgery
Gwo-Chin Lee MD discusses robotic knee surgery. He shares how Penn has designed its new robotic joint replacement program and why Penn has decided now is the right time to add this option to its array of surgeries. He describes the robots they’re using at Penn Orthopaedic Surgery and the advantages for patients and the surgeon.
Featuring:
Gwo-Chin Lee, MD
Dr. Gwo-Chin Lee is a Professor of Orthopaedic Surgery at the Penn Medicine Presbyterian Medical Center of Philadelphia. He attended medical school at the Baylor College of Medicine. He completed is residency at Mayo Clinic and his fellowship at Beth Israel Deaconess Medical Center. Dr. Lee is board certified in Orthopaedic Surgery Transcription:
Melanie Cole: Welcome to the podcast series from the specialists at Penn Medicine. I'm Melanie Cole. And today, we're discussing the robotic joint replacement program at Penn Medicine. Joining me is Dr. Gwo-Chin Lee. He's a professor of orthopedic surgery at the Penn Presbyterian Medical Center of Philadelphia.
Dr. Lee, it's a pleasure to have you join us today. Robotic technology has really been around for a while, but why has Penn now decided that the time is right to add this option to its armamentarium of therapies?
Dr. Gwo Chin Lee: Good afternoon. Thank you for having me.. Well, Penn has always been very responsible and always struck a good balance when it comes to the adoption of new technologies. Many of us who were interested in robotic technology were involved very early on and follow its development closely over the years. And only once when the technology had been sophisticated and developed enough what we felt as a group, that it was sufficiently reliable to provide care for our patients, that's when we decided to pull the trigger to introduce it to Penn in most of our patients.
Melanie Cole: So describe the robot you're using at Penn Medicine. We've heard about a few different kinds and the types of surgery that you're performing with the robot
Dr. Gwo Chin Lee: Well, we have a couple of robotic platforms here at Penn. We have the Mako system and the NAVIO system. They both have been shown to be effective, reliable, and reproducible performing hip and knee surgeries in orthopedics the Mako is a robotic arm, which assists the surgeons in making the cuts or bone preparations necessary for hip and knee replacements. While the NAVIO is a robotic bur system that allows the surgeons to make the necessary resections in knees.
The Mako is also capable of performing hip replacement procedures. The main difference is that the Mako requires the use of a preoperative CT scan that more accurately defines the surgeon's needs and anatomy at the time of surgery while the NAVIO system is what we call image-less guidance system where the surgeon maps the knee or the hip at the time of surgery in order to get a 3D model of a knee to perform the surgery.
Melanie Cole: Speak about patient selection for us, Dr. Lee, if you would. Is everyone a candidate for robotic knee surgery and/or hip if you like, do these things have any contraindications for certain people?
Dr. Gwo Chin Lee: Well, you know, most patients can be potential candidates for robotic knee surgeries and even hip surgeries. There are certainly a few conditions that may preclude the utilization of this technology. Like for example, if someone is claustrophobic and cannot get into a CAT scan, then obviously, that person can not use the Mako system, for example. If there's a significant, hardware that could potentially preclude the placement or accurate imaging and registration of the joints, then obviously that could be a barrier to these robotic systems.
The good news is that basically we view a robot, you know, like many enabling technologies as tools that allows us to be better surgeons to provide better care. And we try to pick the best technology to suit the patient's specific condition to try to achieve the best possible outcomes.
Melanie Cole: While we're talking about the best possible outcomes, tell us about some of the advantages of these types of knee surgery with the robots. Tell us a little bit about the benefits to the surgeon and what you're finding are some of the most exciting reasons for you to use them.
Dr. Gwo Chin Lee: Yeah, that's a great question. Certainly robotic replacement platforms are tremendously powerful instruments that can improve the precision of joint replacement surgery. It allows surgeons to plan the procedure before making any cuts and quantify in real time any adjustments that are made to the bone and its impact on like ligaments and the joint balance.
I think we believe that this increase in precision will improve the consistency in our ability to hit certain technical goals, whatever they may be in terms of target, alignment and balance for our patients. And hopefully, this will translate into lower complications, recovery and patient satisfaction.
Melanie Cole: Well, certainly. So now, tell us what kinds of research are you planning? What are some of your goals at Penn Medicine?
Dr. Gwo Chin Lee: One of the most exciting things about having access to robotic platforms is the ability to do exciting new research using these technologies. In knees, we can use it to define the optimal ligament balances and ligament alignments that will make the patient's knee function better as opposed to a standard cookie cutter resection on patients that currently are being done today, individualizing total joint replacements in order to potentially improve patient satisfaction.
In the hip, we can use it to study the optimal component positioning in order to minimize problems such as impingement and even joint dislocation. My hope of course is that we can participate in this fertile area research by using these tools to define new targets in terms of ligament alignment, balance, and component, position, and be active in shaping the next generation of hip and knee replacements.
Melanie Cole: What would you like to tell other providers as we wrap up about the Penn Medicine Orthopedic Surgery's new robotic joint replacement program, and when you feel it's important that they refer?
Dr. Gwo Chin Lee: Well, I think the addition of the robotic program to Penn is it completes our ability to provide the entire gamut of care and truly brings us into the forefront in areas of joint replacement surgeries. It truly allows us to say that we are using the most advanced techniques, the most advanced instrumentation, the most advanced implants.
It certainly does not replace the experience that has been going on with joint replacements here at Penn. It certainly allows us more flexibility in offering our patients tools that we feel may enhance recovery, may improve patient satisfaction, but does not replace the expertise that has been used to perform excellent joint replacement surgeries over the past 50 years or so.
We feel that we can take great care of our patients. We feel that we can provide the balance in choosing the appropriate technologies to use at the appropriate time for our patients that have hip and knee problems.
Melanie Cole: Great information. Thank you so much, Dr. Lee, for joining us today. To refer a patient to Dr. Lee or one of the other Robotic Joint Replacement surgeons at Penn Orthopaedics, please visit our website at www.pennmedicine.org/refer.
That wraps up this episode from the specialists at Penn Medicine. Please remember to subscribe, rate and review this podcast and all the other Penn Medicine podcasts. I'm Melanie Cole.
Melanie Cole: Welcome to the podcast series from the specialists at Penn Medicine. I'm Melanie Cole. And today, we're discussing the robotic joint replacement program at Penn Medicine. Joining me is Dr. Gwo-Chin Lee. He's a professor of orthopedic surgery at the Penn Presbyterian Medical Center of Philadelphia.
Dr. Lee, it's a pleasure to have you join us today. Robotic technology has really been around for a while, but why has Penn now decided that the time is right to add this option to its armamentarium of therapies?
Dr. Gwo Chin Lee: Good afternoon. Thank you for having me.. Well, Penn has always been very responsible and always struck a good balance when it comes to the adoption of new technologies. Many of us who were interested in robotic technology were involved very early on and follow its development closely over the years. And only once when the technology had been sophisticated and developed enough what we felt as a group, that it was sufficiently reliable to provide care for our patients, that's when we decided to pull the trigger to introduce it to Penn in most of our patients.
Melanie Cole: So describe the robot you're using at Penn Medicine. We've heard about a few different kinds and the types of surgery that you're performing with the robot
Dr. Gwo Chin Lee: Well, we have a couple of robotic platforms here at Penn. We have the Mako system and the NAVIO system. They both have been shown to be effective, reliable, and reproducible performing hip and knee surgeries in orthopedics the Mako is a robotic arm, which assists the surgeons in making the cuts or bone preparations necessary for hip and knee replacements. While the NAVIO is a robotic bur system that allows the surgeons to make the necessary resections in knees.
The Mako is also capable of performing hip replacement procedures. The main difference is that the Mako requires the use of a preoperative CT scan that more accurately defines the surgeon's needs and anatomy at the time of surgery while the NAVIO system is what we call image-less guidance system where the surgeon maps the knee or the hip at the time of surgery in order to get a 3D model of a knee to perform the surgery.
Melanie Cole: Speak about patient selection for us, Dr. Lee, if you would. Is everyone a candidate for robotic knee surgery and/or hip if you like, do these things have any contraindications for certain people?
Dr. Gwo Chin Lee: Well, you know, most patients can be potential candidates for robotic knee surgeries and even hip surgeries. There are certainly a few conditions that may preclude the utilization of this technology. Like for example, if someone is claustrophobic and cannot get into a CAT scan, then obviously, that person can not use the Mako system, for example. If there's a significant, hardware that could potentially preclude the placement or accurate imaging and registration of the joints, then obviously that could be a barrier to these robotic systems.
The good news is that basically we view a robot, you know, like many enabling technologies as tools that allows us to be better surgeons to provide better care. And we try to pick the best technology to suit the patient's specific condition to try to achieve the best possible outcomes.
Melanie Cole: While we're talking about the best possible outcomes, tell us about some of the advantages of these types of knee surgery with the robots. Tell us a little bit about the benefits to the surgeon and what you're finding are some of the most exciting reasons for you to use them.
Dr. Gwo Chin Lee: Yeah, that's a great question. Certainly robotic replacement platforms are tremendously powerful instruments that can improve the precision of joint replacement surgery. It allows surgeons to plan the procedure before making any cuts and quantify in real time any adjustments that are made to the bone and its impact on like ligaments and the joint balance.
I think we believe that this increase in precision will improve the consistency in our ability to hit certain technical goals, whatever they may be in terms of target, alignment and balance for our patients. And hopefully, this will translate into lower complications, recovery and patient satisfaction.
Melanie Cole: Well, certainly. So now, tell us what kinds of research are you planning? What are some of your goals at Penn Medicine?
Dr. Gwo Chin Lee: One of the most exciting things about having access to robotic platforms is the ability to do exciting new research using these technologies. In knees, we can use it to define the optimal ligament balances and ligament alignments that will make the patient's knee function better as opposed to a standard cookie cutter resection on patients that currently are being done today, individualizing total joint replacements in order to potentially improve patient satisfaction.
In the hip, we can use it to study the optimal component positioning in order to minimize problems such as impingement and even joint dislocation. My hope of course is that we can participate in this fertile area research by using these tools to define new targets in terms of ligament alignment, balance, and component, position, and be active in shaping the next generation of hip and knee replacements.
Melanie Cole: What would you like to tell other providers as we wrap up about the Penn Medicine Orthopedic Surgery's new robotic joint replacement program, and when you feel it's important that they refer?
Dr. Gwo Chin Lee: Well, I think the addition of the robotic program to Penn is it completes our ability to provide the entire gamut of care and truly brings us into the forefront in areas of joint replacement surgeries. It truly allows us to say that we are using the most advanced techniques, the most advanced instrumentation, the most advanced implants.
It certainly does not replace the experience that has been going on with joint replacements here at Penn. It certainly allows us more flexibility in offering our patients tools that we feel may enhance recovery, may improve patient satisfaction, but does not replace the expertise that has been used to perform excellent joint replacement surgeries over the past 50 years or so.
We feel that we can take great care of our patients. We feel that we can provide the balance in choosing the appropriate technologies to use at the appropriate time for our patients that have hip and knee problems.
Melanie Cole: Great information. Thank you so much, Dr. Lee, for joining us today. To refer a patient to Dr. Lee or one of the other Robotic Joint Replacement surgeons at Penn Orthopaedics, please visit our website at www.pennmedicine.org/refer.
That wraps up this episode from the specialists at Penn Medicine. Please remember to subscribe, rate and review this podcast and all the other Penn Medicine podcasts. I'm Melanie Cole.