Robotic knee replacement surgery involves the use of computer assistance to plan and execute knee replacement surgery with the utmost precision and accuracy. Dr Gomez still performs all aspects of the surgery such as the incision, surgical approach and wound closure. The mako robotic arm, which is controlled and operated by Dr Gomez at all times, is used for assistance during bone cuts and implant insertion.
The first step is patient-specific surgical planning. Before surgery, a CT scan of your knee is taken to develop a 3D virtual model of your unique joint. Dr Gomez uses this model to evaluate your bone structure, disease severity, joint alignment and even the surrounding bone and tissue, so he can determine the optimal size, placement and alignment of your implant.
During the operation specific points are marked out on the patients bone so the robot and computer can match these to those planned on the CT.
The range of motion (ROM) and balancing (tension) of the knee is then assessed in both extension (knee straight) and flexion (knee bent to 90 degrees).
The aim of a knee replacement is to create equal tension on both the inside (medial) and outside (lateral) compartments of the knee in both flexion and extension. This means the entire joint will be under equal tension throughout the full arc of motion. We know that TKR’s function best and last longest under these optimal conditions. With the use of the Mako robot Dr Gomez is able to receive real time feedback regarding the balancing of your knee and make real time corrections to the size and position of the prostheses during the surgery to correct the tension in your knee until it is perfect. This balancing process all occurs before a single bone cut is undertaken.
Once the optimal balancing is achieved, that data is programmed into the mako robot. The mako robotic arm is then used by Dr Gomez to make the desired bone cuts in order to execute the plan Dr Gomez has created. A virtual boundary (haptic) provides tactile resistance to help Dr Gomez stay within the boundaries defined in your surgical plan.
Trial prostheses are then inserted and the knee range of motion and balancing again assessed prior to the implantation of the definitive prosthetic components.