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Knee And Hip Replacement Goes Robotic

Dr. Hogan.jpg
Todd Bookman

It’s been two weeks since Bonnie Parker had her hip replaced.

She is 50, petite, a tattoo artist. So she’s no stranger to pain, but says the past few years have been really tough.

“I watched my mother suffer from arthritis, and she sat down one day and never got back up. And I found myself sitting down more and more and not getting up, and I thought, ‘No, I can’t do this.’"

After non-surgical solutions failed to help, Parker spoke with her doctor, and decided to try a new robot-assisted procedure: something called MAKOplasty.

Sort Of Like A Video Game

Inside of Lakes Region General Hospital, Doctor Jeremy Hogan is maneuvering a robotic arm that’s got, basically, a small drill as its finger. The entire machine is about the size of a shopping cart.

The arm itself isn’t remote controlled: Hogan’s hand actually moves the appendage.

"The device doesn't think. It doesn't walk in and do the surgery by itself. It only does what we tell it."

He demonstrates on a plastic knee, with fragments flying in every direction.

“Hopefully I did a reasonably good job here. (beep) It said I passed, so that’s good.”

Hip and partial knee replacements involve cutting away damaged bone and replacing it with an artificial joint, usually a metal alloy.

During a MAKOplasty surgery, the robotic arm is connected to a 3-D scan of the joint and an infra-red camera. By watching a screen, Doctor Hogan can remove the exact amount of bone. The drill turns itself off if he goes too far.

Then he can place the implant with improved accuracy.

“The device doesn’t think. It doesn’t walk in and do the surgery by itself. It only does what we tell it. Ultimately its success is based on a good operative plan, but it does allow us to execute the plan we’ve designed with a very high level of precision.”

To within a fraction of a millimeter. Better, Hogan says, than most surgeons can do with just their eyes.

That can reduce recovery time, and the risk of future complications.

Good news for patients, and Lakes Region General Hospital hopes good for business.

Marketing The Machine

"It is sort of like a 60-year old divorced man buying a red Ferrari to lure dates. It might work, but it might also be a very expensive boondoggle."

Joanne Lamphere is a consultant with Health Management Associates, which works with hospitals around the country.

“If they invest in a winner, it can attract top doctors. They can attract a higher volume of patient.”

Specifically older patients who, if they have a good experience, may return for future procedures.

Lakes Region invested just under a $1 million in the robot. But by being the only hospital north of Boston with the technology, it hopes to market itself as the ‘go to’ place for knee and hip work in the region. And it’s doing just that, with brochures and traveling information sessions.

Lamphere says there is a risk, though.

“It is sort of like a 60-year old divorced man buying a red Ferrari to lure dates. It might work, but it might also be a very expensive boondoggle.”

She says it is too soon to know. Robotic technology has come into mainstream use within just the past decade or so. Only 150 hospitals are currently using MAKOplasty, which is produced by a firm in Florida.

The most popular surgical robot, the Da Vinci system, has sold more than 2,500 worldwide.

But there are numerous lawsuits currently pending against its manufacturer, claiming injuries and complications.

Time Will Tell

"Everything I felt with the arthritis is like magically gone."

Dr. Sherry Glied of Columbia University researches robotics in health care. She says all the machines are tested for safety, but unlike a new prescription drug, they aren’t confirmed to be more effective.

“People are really excited about robots, and they look cool, but we really don’t know if they work any better, and they might even work worse.”

For Bonnie Parker, the short-term results of her MAKOplasty surgery are anything but inferior.

“Everything I felt with the arthritis is like magically gone.”

Dr. Jeremy Hogan looks over her x-rays and says her new hip is positioned right where he wants it.

Lakes Region General Hospital hopes it’s also positioned to benefit from its new device.

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