Monday, Feb. 16, 2015


Integrating robotics into surgery

A little over five years ago, my partners and I invested in a new robotic technology called MAKOplasty.

Since that time, I have completed over 500 MAKOplasty procedures and have committed a great deal of my practice to this technology.

MAKOplasty is a partial knee replacement procedure that is optimal for patients with early to mid-stage osteoarthritis. MAKOplasty uses a surgeon-interactive robotic arm (RIO- Robotic Arm Interactive Orthopedic System) that has a high speed surgical burr that allows the surgeon to only remove the diseased portion of your knee, while salvaging the healthy bone and tissue surrounding it. It can be performed on one or two of the three compartments of the knee. If all three compartments of the knee are damaged, you are more likely a candidate for a total knee replacement. Robots and surgeons have a bit in common. Both strive for precision, accuracy and consistent results.

MAKOplasty is a “semi-active” robot and allows my strengths and abilities as an orthopedic surgeon to merge with visualization technology. Because no two knees are the same, MAKOplasty technology allows me to customize your surgery to your unique anatomy. Prior to your surgery, a computed tomography is taken of your knee and from that image the robot (RIO system), creates a 3D anatomical model. Before your surgery, I review your CT scan and pre-surgical work-ups to create your preoperative plan. On the day of your surgery, your surgical plan and CT image are loaded into the RIO, and it creates a personalized image of your leg optimizing the alignment and placement of your implant. In the operating room, I place sensors on the tibia and femur that sync with the RIO system and coordinate with your individualized surgical plan. From this point, you and the computer are linked, and the robot comes into play. The robotic arm feels “weightless” as I begin cutting, unless I exceed the surgical boundaries determined by your preoperative plan; if I “color outside of the lines,” the robot will become rigid and not allow me to progress. The surgery usually takes an hour to an hour and a half. The incisions made during this procedure tend to be smaller, which also accounts for minimal blood loss. Most of my patients spend one night in the hospital and are up and moving one to two hours after their surgery.

Simply said, my patients’ results, shorter hospital stays, quicker recovery times and a return to an active lifestyle.

Some of my patients have recently just begun to experience knee pain in their 70s and 80s, and others have had early onset osteoarthritis in their 40s and 50s, due to an increased level of activity.

When patients come to me in clinic and have concerns about increasing knee pain, we look at options-non surgical and surgical. If a patient is a candidate for MAKOplasty, I feel like it is an obvious choice. Every patient’s recovery is relative to their health and their commitment to recovery, but I have consistently seen my 500 plus MAKOplasty patients make significant strides toward regaining their quality life in a shorter time span. One of my patients is a loyal LSU Tiger fan, but his knee pain was preventing him from heading down to Baton Rouge to enjoy the game. After missing a good part of the season fearing the stadium steps at Death Valley, he came to see me. We determined he was an excellent candidate for MAKOplasty. He had the surgery on Thursday and the following Thursday was heading down to Baton

Rouge for the game. Another one of my patients, a third-grade teacher who was having great difficulty keeping up with her active students, but was worried surgery would involve a lengthy recovery time. When we determined that she was a good candidate for MAKOplasty, she had her first MAKOplasty procedure during Spring Break, returning to work afterward and her other knee (also MAKOplasty) completed during Summer Break. By next fall, she was excited and ready for her new third-grade class. These are just a couple of relatable stories. I can’t tell you by looking at you whether MAKOplasty is the right choice for you, but I can tell you it’s worth researching. I believe that robotics and orthopedic surgery are a dynamic combination: an orthopedic surgeon’s skill and experience, paired with innovation. Currently, I am exploring opportunities to further my use of robotics in my practice while performing total hip and total knee replacements.

Dr. Steven Atchison joined Orthopedic Specialists of Louisiana in 1999. Atchison specializes in disorders of the knee and hip and performed the very first MAKOplasty surgery in Louisiana at Specialists Hospital Shreveport in July of 2010.


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