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Robotics-Assisted Orthopedic Surgery
Robotic-assisted orthopedic surgery has improved patient outcomes and recovery times. Dr. Deidre Blake, Orthopedic Surgeon and Medical Director of Cayuga Orthopedics, discusses how this new technology works.
Featuring:
Deidre Blake, MD
Deidre Blake, MD graduated from Wilkes University with a Bachelor of science degree, summa cum laude, biology major and chemistry minor. She finished medical school in the top 5 percent of her class, winning numerous awards and scholarships during medical school and while in her residency. In 2009 Blake was an American Orthopedic Academy resident in the Emerging Leaders Forum and she has been cited in Who’s Who of American Young Professionals. Blake has special interest and expertise in joint-revision surgery. Transcription:
Bill Klaproth (Host): If you’re suffering from a painful orthopedic condition requiring surgery, chances are you’ve heard of robotic-assisted orthopedic surgery. So what is it and how can it benefit you? Joining me right now is Dr. Deidre Blake, orthopedic surgeon and Medical Director of Cayuga Orthopedics. Dr. Blake, thanks for being here.
Dr. Deidre Blake (Guest): Hey Bill, thanks for having me.
Host: You bet, Dr. Blake, let’s jump into this. Can you explain more about robotics and the role it plays in orthopedic surgery?
Dr. Blake: Well as time goes on with orthopedics, we’re always striving to make reproducibly excellent results through all of our surgeries, so robotics has really come into play as an option for developing reproducible placements of hardware in total joint surgery and partial uni-compartment arthroplasty.
Host: So what are the main benefits then overall of robotic-assisted surgery versus traditional surgery?
Dr. Blake: Well the goal of using robotics is certainly to achieve the best alignment and positioning possible. I’m not going to say that you need robotics to achieve this, but it’s another tool that orthopedic surgeons can use if they have the robot at their health facility. One of the surgeries that I think it’s excellent for and best suited for is the partial knee replacement. Traditionally in the past, a large percentage of these have failed because of malalignment, and with the robotic surgery, like I said, you can get more reproducible, accurate placement of the implants so that they last longer for the patient.
Host: So with better alignment and positioning as you are mentioning, does this translate to smaller incision, minimally invasive, and better recovery times?
Dr. Blake: It does. There’s a spectrum, and it depends on which surgery you’re talking about. For the partial knee replacement with the appropriate surgical candidate, you can have more of a mini incision, and then with using the robotics to have accurate placement of the implants so that you can have better long term outcome so that the implant lasts longer in the person’s body, and it’s a longer time until they need a second surgery.
Host: So who’s a good candidate for robotic assisted orthopedic surgery?
Dr. Blake: I think the focus at Cayuga is going to be identifying people who are good candidates for partial knee replacements. So in the knee, there’s a medial compartment, a lateral compartment, and the patellofemoral compartment or the compartment around your kneecap. So there’s three different compartments. So traditionally we’ve been only offering the partial knee replacements to people that truly had osteoarthritic disease in one compartment. Studies have shown that if you have disease in more than one compartment, that you ought to have a total. So if the person’s a good candidate for the partial knee replacement, I think the robotics is a wonderful addition to our offerings here at Cayuga Orthopedics. For the total knees, I think that surgeons are doing an excellent job these days with accurate component placement. We also do use the mini incisions or minimally invasive techniques and we’ve been getting excellent results. There are two special groups that I think the robot would help immensely for total knees, and for that I think it would be people that have a prior trauma so some people can have deformity of their tibia or femur to begin with, so determining the accurate placements and angles becomes more complex and the robot can really help with this. As well as people who have had prior trauma and have hardware in place that can make it impossible to use the traditional jigs and instruments in a total knee, so the robot comes into play there and can help a great deal as well.
Host: So when you talk about this, Dr. Blake, you just mentioned the robot, can you help us understand this? How does this work? Do you stand behind a machine that uses robotic arms, which serve as your hands and eyes?
Dr. Blake: It is – no – that is not exactly how it works. It’s more of a computer assisted, robotic handheld device. So there’s the computer that helps you map out the patient’s specific anatomy intraoperatively, and those measurements and computer algorithms are determined because you put two pins in the femur and two pins in the tibia and actually map the patient’s anatomy intraoperatively, and there’s a robotic hand held device that helps you decide on the bone removal and implant positioning based off of all the computer assisted measurements and the decision of where to place the implants. The surgeon is doing the surgery, but the computer assisted navigation and the robotic hand held piece, the hope is that you get better alignment and positioning of the implant.
Host: This is really cool. So you were talking about mapping out the specific anatomy and computer assisted navigation, these are things you don’t have in traditional surgery, is that right?
Dr. Blake: Correct. These have been around for years and some of them, there are positives and negatives to anything. So some of them in past were very cumbersome systems, and some studies in the past have shown that the outcomes were about the same, so having the newer technology in the year 2019 is less cumbersome. These are small devices, small computers, small hand held robotic hand pieces that can be taken from one OR to the other. The ease of use is there and the technology has evolved, so we’re very lucky that Cayuga has invested in this to give us an additional tool to help our patients.
Host: So much more advanced. So we’ve been talking about partial knee replacement, whole knee replacement, so what are the most common types of orthopedic surgeries that would also benefit from the use of robotic assisted surgery?
Dr. Blake: At this point in time, the only ones I know of that are FDA approved are the total joints and partial joints. Now looking down the road into the future, it’s really up in the air. That is to be determined, but with the placement of the implants that takes place and is central to that part of the surgery for total joint arthroplasty, the robotics has become like I said an additional tool that you can use to give more offerings to your patient population.
Host: Right, that makes sense. So why did CMC/CMA what to bring robotics to Ithaca?
Dr. Blake: Well I think Cayuga Health System has invested a lot of resources into building this orthopedic program to be one of excellence and we have a lot of different specialties at this point. We have well trained excellent surgeons that are offering almost everything right here in town so people don’t have to travel, and so I think this is an additional option that will allow us to do more excellent partial joint replacement, partial knee replacement, and it’s another example of Cayuga Health System really backing the orthopedic department and helping us offer everything we can here in town to our Ithaca patients.
Host: So true and as we wrap up Dr. Blake, is there anything else we should know about robotic assisted orthopedic surgery?
Dr. Blake: I think that it’s a wonderful addition, it’s a wonderful resource to have. I think every patient has to talk to their doctors about what surgery is appropriate for them, and if you have a doctor that you trust and does these surgeries, I would listen to your doctor’s advice on what surgery is appropriate for you and whether robotics is the way to go.
Host: Great information, Dr. Blake, thank you so much for your time today. We appreciate it. For more information, please visit cayugahealthsystem.org/robotics, that’s cayugahealthsystem.org/robotics. This is To Your Health from Cayuga Medical Center, I’m Bill Klaproth, thanks for listening.
Bill Klaproth (Host): If you’re suffering from a painful orthopedic condition requiring surgery, chances are you’ve heard of robotic-assisted orthopedic surgery. So what is it and how can it benefit you? Joining me right now is Dr. Deidre Blake, orthopedic surgeon and Medical Director of Cayuga Orthopedics. Dr. Blake, thanks for being here.
Dr. Deidre Blake (Guest): Hey Bill, thanks for having me.
Host: You bet, Dr. Blake, let’s jump into this. Can you explain more about robotics and the role it plays in orthopedic surgery?
Dr. Blake: Well as time goes on with orthopedics, we’re always striving to make reproducibly excellent results through all of our surgeries, so robotics has really come into play as an option for developing reproducible placements of hardware in total joint surgery and partial uni-compartment arthroplasty.
Host: So what are the main benefits then overall of robotic-assisted surgery versus traditional surgery?
Dr. Blake: Well the goal of using robotics is certainly to achieve the best alignment and positioning possible. I’m not going to say that you need robotics to achieve this, but it’s another tool that orthopedic surgeons can use if they have the robot at their health facility. One of the surgeries that I think it’s excellent for and best suited for is the partial knee replacement. Traditionally in the past, a large percentage of these have failed because of malalignment, and with the robotic surgery, like I said, you can get more reproducible, accurate placement of the implants so that they last longer for the patient.
Host: So with better alignment and positioning as you are mentioning, does this translate to smaller incision, minimally invasive, and better recovery times?
Dr. Blake: It does. There’s a spectrum, and it depends on which surgery you’re talking about. For the partial knee replacement with the appropriate surgical candidate, you can have more of a mini incision, and then with using the robotics to have accurate placement of the implants so that you can have better long term outcome so that the implant lasts longer in the person’s body, and it’s a longer time until they need a second surgery.
Host: So who’s a good candidate for robotic assisted orthopedic surgery?
Dr. Blake: I think the focus at Cayuga is going to be identifying people who are good candidates for partial knee replacements. So in the knee, there’s a medial compartment, a lateral compartment, and the patellofemoral compartment or the compartment around your kneecap. So there’s three different compartments. So traditionally we’ve been only offering the partial knee replacements to people that truly had osteoarthritic disease in one compartment. Studies have shown that if you have disease in more than one compartment, that you ought to have a total. So if the person’s a good candidate for the partial knee replacement, I think the robotics is a wonderful addition to our offerings here at Cayuga Orthopedics. For the total knees, I think that surgeons are doing an excellent job these days with accurate component placement. We also do use the mini incisions or minimally invasive techniques and we’ve been getting excellent results. There are two special groups that I think the robot would help immensely for total knees, and for that I think it would be people that have a prior trauma so some people can have deformity of their tibia or femur to begin with, so determining the accurate placements and angles becomes more complex and the robot can really help with this. As well as people who have had prior trauma and have hardware in place that can make it impossible to use the traditional jigs and instruments in a total knee, so the robot comes into play there and can help a great deal as well.
Host: So when you talk about this, Dr. Blake, you just mentioned the robot, can you help us understand this? How does this work? Do you stand behind a machine that uses robotic arms, which serve as your hands and eyes?
Dr. Blake: It is – no – that is not exactly how it works. It’s more of a computer assisted, robotic handheld device. So there’s the computer that helps you map out the patient’s specific anatomy intraoperatively, and those measurements and computer algorithms are determined because you put two pins in the femur and two pins in the tibia and actually map the patient’s anatomy intraoperatively, and there’s a robotic hand held device that helps you decide on the bone removal and implant positioning based off of all the computer assisted measurements and the decision of where to place the implants. The surgeon is doing the surgery, but the computer assisted navigation and the robotic hand held piece, the hope is that you get better alignment and positioning of the implant.
Host: This is really cool. So you were talking about mapping out the specific anatomy and computer assisted navigation, these are things you don’t have in traditional surgery, is that right?
Dr. Blake: Correct. These have been around for years and some of them, there are positives and negatives to anything. So some of them in past were very cumbersome systems, and some studies in the past have shown that the outcomes were about the same, so having the newer technology in the year 2019 is less cumbersome. These are small devices, small computers, small hand held robotic hand pieces that can be taken from one OR to the other. The ease of use is there and the technology has evolved, so we’re very lucky that Cayuga has invested in this to give us an additional tool to help our patients.
Host: So much more advanced. So we’ve been talking about partial knee replacement, whole knee replacement, so what are the most common types of orthopedic surgeries that would also benefit from the use of robotic assisted surgery?
Dr. Blake: At this point in time, the only ones I know of that are FDA approved are the total joints and partial joints. Now looking down the road into the future, it’s really up in the air. That is to be determined, but with the placement of the implants that takes place and is central to that part of the surgery for total joint arthroplasty, the robotics has become like I said an additional tool that you can use to give more offerings to your patient population.
Host: Right, that makes sense. So why did CMC/CMA what to bring robotics to Ithaca?
Dr. Blake: Well I think Cayuga Health System has invested a lot of resources into building this orthopedic program to be one of excellence and we have a lot of different specialties at this point. We have well trained excellent surgeons that are offering almost everything right here in town so people don’t have to travel, and so I think this is an additional option that will allow us to do more excellent partial joint replacement, partial knee replacement, and it’s another example of Cayuga Health System really backing the orthopedic department and helping us offer everything we can here in town to our Ithaca patients.
Host: So true and as we wrap up Dr. Blake, is there anything else we should know about robotic assisted orthopedic surgery?
Dr. Blake: I think that it’s a wonderful addition, it’s a wonderful resource to have. I think every patient has to talk to their doctors about what surgery is appropriate for them, and if you have a doctor that you trust and does these surgeries, I would listen to your doctor’s advice on what surgery is appropriate for you and whether robotics is the way to go.
Host: Great information, Dr. Blake, thank you so much for your time today. We appreciate it. For more information, please visit cayugahealthsystem.org/robotics, that’s cayugahealthsystem.org/robotics. This is To Your Health from Cayuga Medical Center, I’m Bill Klaproth, thanks for listening.