Lifewatch: Knee Osteoarthritis

WILMINGTON -- More than 10 million Americans have osteoarthritis of the knee, a painful condition that causes swelling, stiffness, and loss of mobility.

A new robot is making a smaller incision and getting patients back on their feet more quickly.  Right now the procedure is for patients who need partial knee resurfacing, but it should be available for the entire knee in a few years.

Judy Turner has no problem keeping up with her Girl Scouts.  For the past 26 years she has been camping, hiking, and biking with them.

But for the last year, painful osteoarthritis in her knee made it difficult.

"It got really hard. I mean I couldn't, certainly couldn't run and walking, I was always afraid I was going to trip," said Turner.

She was sick of the pain and sought help.  She had a partial knee resurfacing performed by a robot.

"It acts like new cartilage. It works very well. It alleviates the pain, the swelling, the deformity and really can cure the symptoms of arthritis," said Orthopedic Surgeon Richard Levitt, MD.

Using a small, three to four inch incision, the Mako made exact cuts in the bone and tissue, then placed an implant to cushion the bones by replacing missing cartilage.  All of this was done more precisely than a doctor's hands.

"The more precisely the implant is put in the knee, the better the results and the longer the implant will last," said Dr. Levitt.

According to Dr. Levitt, with this technique, the implant should last at least 10 to 15 years.

And because the incision is smaller and the surgery is less invasive, recovery time is faster than traditional surgery.  Judy was back on her feet the day after her surgery.

"I was surprised. I didn't think I would be walking that quickly, though he told me I would."


Richard Levitt, M.D.

Orthopaedic Institute of South Florida

(786) 308-3350

MAKO Surgical Corp.

TOPIC:  ROBOTIC KNEE REPAIR (Courtesy: Ivanhoe and the Orthopaedic Institute of S. Florida)

BACKGROUND: In our joints where our bones meet is a substance called cartilage.  It cushions our bones where they rub together, providing a smooth surface for bones to move along.

Arthritis is what happens when the cartilage wears away and the bones touch each other directly.

Osteoarthritis is a term for arthritis due to wear-and-tear or injury. Because it most often results from years of use, it is a condition that usually arises in middle age. Unfortunately, almost everyone has some form of osteoarthritis by age 70.

Being overweight or obese is also a risk factor for osteoarthritis.

According to the American Academy of Orthopaedic Surgeons, osteoarthritis of the knee is one of five leading causes of disability in elderly men and women.

The risk of disability from the condition is as great as that from cardiovascular disease. Doctors don't know what causes joint cartilage to wear away.

Medicine, physical therapy and anesthetic injections can help treat pain caused by osteoarthritis. However, for about one in four patients with osteoarthritis of the knees, surgery is needed to treat the condition.

SURGERY: Not all osteoarthritis of the knee is created equal. For many patients, decay of the cartilage occurs on just one side of the knee. Surgery for this condition is called partial knee resurfacing.

Traditional surgery for this condition can involve a substantial incision, pain and several weeks of recovery.

MAKOplasty is a new, partial knee resurfacing procedure performed by a robot.

The small robotic tool allows the surgeon to make a small, three to four inch incision in the patient's knee.

Before surgery, the entire procedure is mapped and planned by a computer. The computer will make exact cuts in the tissue and bones, no bigger than necessary.

"The machine is pre-programmed to only cut the bone a certain depth, a certain width, a certain length -- precisely, exactly the way we would want it," Richard Levitt, M.D., orthopedic surgeon at Doctors Hospital in Miami, Fla., told Ivanhoe.

"It eliminates some of the guesswork, some of what we say, the 'eyeballing' that can be done in the time of surgery." Then, an implant is placed in to cushion the bones. Dr. Levitt says the more precisely the implant is placed in the knee, the better the results and the longer the implant will last.

RECOVERY TIME: A smaller incision means less blood loss, reduced pain and faster recovery time.

Most patients are on their feet walking again the day after surgery. Within a week of surgery, most patients are able to drive a car again.

As with most orthopedic procedures, physical therapy is necessary for some patients.

Reported by Kristy Ondo