New robotic arm device for early to mid-stage osteoarthritis

A robotic arm device developed to assist orthopedic surgeons with performing partial knee replacement surgery for early to mid-stage osteoarthritis is now available at NewYork-Presbyterian Hospital/Columbia University Medical Center. The technology was approved by the FDA in 2005, and to date nearly 5,000 cases have been performed in the U.S.

"Robotic technology is particularly well-suited to partial knee replacement surgery, which requires a high degree of precision. This device is making it possible to treat patients early and with more precision in order to more quickly and effectively eliminate their pain and get their lives back on track," says Dr. William Macaulay, director of the Center for Hip and Knee Replacement at NewYork-Presbyterian Hospital/Columbia University Medical Center and the Nas S. Eftekhar Professor of Clinical Orthopaedic Surgery and chief of the Division of Adult Reconstructive Surgery of the Hip and Knee at Columbia University College of Physicians and Surgeons.

According to a report by the Journal of the American Medical Association, more than 10 million adults in the United States suffer with osteoarthritis of the knee, which is characterized by the breakdown and eventual loss of cushioning joint cartilage. The result is debilitating pain while standing or walking short distances, climbing up or going down stairs, or getting in and out of a chair.

Surgical treatment is either a total knee replacement or, less commonly, partial knee replacement for patients whose damaged cartilage is restricted to one or more areas. Both procedures alleviate the problem by removing the damaged areas of cartilage and replacing these surfaces with an implant.

Total knee replacement is an invasive surgery and requires extensive rehabilitation. But some surgeons shy away from the partial replacement procedure because good outcomes depend on positioning and aligning the implants precisely.

According to Dr. Macaulay, the robotic arm gives the surgeon a pre-surgical plan that details the technique for bone preparation and customized implant positioning using a CT scan of the patient's knee. During the procedure, the system creates a three-dimensional virtual view of the patient's bone surface and correlates the image to the pre-programmed surgical plan. As the surgeon uses the robotic arm, its tactile, acoustic and visual feedback limits the bone preparation to the diseased areas and provides for optimal implant positioning and placement.

"Patients report being without pain and are comfortable with the feel of their partially reconstructed knee. The potential advantages are a shorter hospital stay, typically one to three days, as well as a quicker overall recovery," says Dr. Macaulay. "In most cases, patients can walk soon after surgery, drive a car within two weeks and return to regular daily activities shortly thereafter."

Typical surgical candidates experience knee pain with activity, usually on the inner knee, under the kneecap or the outer knee; knee pain or stiffness when activities are initiated from a sitting position; and have failed to respond to non-surgical treatments or non-steroidal anti-inflammatory medication such as ibuprofen.

The robotic arm being used at NewYork-Presbyterian/Columbia is the RIO® Robotic Arm Interactive Orthopedic System by MAKO Surgical Corp.

For more information about robotic partial knee replacement surgery at NewYork-Presbyterian Hospital/Columbia, patients may call (866) NYP-NEWS.