Robotic Partial and Total Knee Replacement

Prosthetic surgery at the forefront of operations without errors

Since November 2017 this procedure (Mako Rio System) can be used in all knee degenerative pathologies thanks to its extension to Triathlon Stryker total knee prosthesis.

Before this date the robot could be used just in pathologies interesting a part of knee (unicompartmental arthritis), applying prosthetic components that replaced only partially the knee. In this way almost all the knee degenerative pathologies can be treated, taking advantage of Mako robot. Only rare cases needing particular prosthetic solutions remain excluded.

How is the operation performed?

The (partial and total) robotic knee replacement consists in using the system as support for surgeon’s choices and work during the implant application.

First of all, it creates a three-dimensional knee electronic model on the basis of preoperative TAC; this model, with the information transmitted by sensors positioned on knee during operation, is used to elaborate correct surgical instructions useful for positioning precisely the prosthesis and balancing it in a perfect way.

Secondly the robotic arm permits surgeon to create a high precision osseous compartment, in which the prosthesis will be positioned.

Why to use the robotic surgical procedure

The orthopaedic robotic surgery allows to reduce greatly the placement errors of knee prosthesis from which most of  breakdowns and complications derive. Indeed the robotic procedure permits to know for sure the correct prosthesis placement while applying it, not when it’s done.

Thanks to Makoplasty, the limits of partial prosthetic surgery have widened, both in age indications and band.

In cases in which once the prosthesis was discouraged, for example in anterior cruciate ligament insufficiency, now can be applied an unicompartmental one. In cases of complete absence of ligament it can be reconstructed at the same time of prosthesis implant, precisely thanks to the great system precision. If wear of patellofemoral articulation coexists, is possible to replace as well this compartment (bicompartmental) by the same robotic surgical procedure and during the same operation.

Therefore the total knee replacement implant can be restricted only in cases of generalized articular wear (around 50% of cases).

Benefits for Patients

The partial knee replacement (partial Makoplasty) features various advantages for patient. As above, the Rio robot permits an absolute precision in the prosthesis placement, favouring the success of operation. At the same time it consents to spare the healthy bone tissue and respect the surrounding soft tissues (capsule, ligaments, muscles) thanks to minimal traumatism of robotic arm cutter.

Therefore the patients operated by knee Makoplasty at Clinica San Francesco have rehabilitation times more rapid than the traditionally operated ones. Being a minimally invasive procedure, the thigh tourniquet may not be used during operation, that is keeping a constant circulation during it, with huge benefits for the compression post-operative pain and for patients suffering limb arterial and venous diseases.

In most cases the patient can start again walking in the first 24 hours, generally without need of analgesic drugs; the return to work and relational life occur within a few weeks. In about 70% of cases the rehabilitation stay is not necessary (Fast Track or rapid discharge), but is sufficient a gym programme during the post-operative under physiotherapists guidance, to continue at home autonomously. The use of crutches is suggested just in the first days after operation.

The total knee prosthesis benefits from all advantages of mini-invasivity, perfect ligament balancing, precision and reproducibility of surgical wave, connected to the system. The robotic procedure, thanks to mini-invasivity and perfect ligament balancing, also consents a return to sport activity, although with some limitations.