Answers for our patients

All about hip and knee robotic orthopaedic surgery

What is robotic prosthetic surgery?

The robotic prosthetic surgery is the most advanced mini-invasive procedure to position hip and knee prostheses. It is called ‘Makoplasty’ because is performed with help of Mako Rio robot and a specific software. Both assist the surgeon and support him to choose before and after operation.

What does computerized system do?

Before operation, through a three-dimensional computer-assisted tomography (TAC), the software elaborates a limb electronic model. During operation it receives data on the articulation form from implanted transmitters, the cartilage thickness and ligament tension. With these it defines surgical instructions to position the prosthesis in a perfect way, monitoring in real time the parameters indicating its correct working.

How does robot operate?

The surgeon drives the robotic arm and cleaves articulation by a cutter, creating a high precision osseous compartment, in which the prosthesis will be positioned. After correct working verification of test implant, the definitive prosthesis is laid.

Which are the Makoplasty benefits?

It allows to reduce drastically the mistakes of prosthesis placement, the consequent complications, pain and rehabilitation time. Particularly, it permits to preserve the healthy bone tissue and surrounding soft tissues, thanks to the precision (the margin of error is less than 1mm) and minimum traumatism of robotic arm cutter.

What diseases can be treated?

The Clinic uses the robot for hip operations and for total and partial knee replacement. Since November 2017 this procedure is used for all degenerative joint diseases. Just rare cases needing particular prosthetic solutions remain excluded.

What are the risks with Makoplasty?

The robotic surgery reduces postoperative pain, minimizing complications and accelerating the rehabilitation time of patient. Thanks to Mako Rio Robot is possible to avoid  troubles of dysmetria and dislocation in hip operations and achieve a perfect ligament balancing in knee operations.

Which kind of anesthesia is used?

A light sedation and peripheral anesthesia are generally administered. In the postoperative the anesthetic liquid is injected in a small subcutaneous catheter to reach directly the affected area, covering it during the following 12-14 hours: the patient doesn’t feel pain and starts moving again the articulation swiftly.

How long is the operation?

From a minimum of one hour to a maximum of one hour and a half. The duration depends on patient’s conditions, weight (a marked overweight can extend the time) and joint wear.

How long is the postoperative admission?

In 75% of partial knee prosthesis implants the hospital stay comes down to two days average, but in case of total knee prosthesis the patient can go home in the course of four/five days. For hip operations, the discharges take place within the first week. Just in particular cases admission up to suture removal (about two weeks) is requested.

When does the rehabilitation start?

Already during operation day the patients are invited to perform exercises of in-bed active mobilization. The rehabilitation starts the day after operation both for hip and for knee. Under physiotherapists’ guidance the patient starts a physical exercise programme that continues at home autonomously, except cases requesting specific physiotherapy. The patient can start walking again in the first 24 hours, generally without need of analgesic drugs.

Who can undergo this operation?

The (partial or total) robotic replacement operation can be carried out also on 90-years-old patients or patients less than 30-years-old, improving their quality of life. By traditional surgery the operable age band instead went from 60-years-old to 80-years-old.

When the Makoplasty cannot be used?

If the patient’s limb is very deformed, the ligaments are insufficient or extremely compromised, the robotic procedure is not yet feasible. In these cases types of prosthesis that don’t exploit the patient’s ligaments must be considered.

How much does Makoplasty operation cost?

Can be performed through the Italian Healthcare System (SSN)?

The operation can be carried out both by SSN (Italian Healthcare System – Servizio Sanitario Nazionale) cover and in private by rates fixed with insurance companies or directly with patients.