For one to arrive at the solution of joint replacement surgery, it means that there are no non-invasive ways to deal with the joint problem and the pain it causes. This happens because the articular surfaces have been damaged and the destruction of the bone covering these surfaces has begun.
This for the knee translates into acute pain, stiffness, cramping (the so-called “crack”), reduced mobility resulting in poor psychology and quality of life for the affected person.
Something similar happens with the hip. The symptoms are severe pain in the area that radiates down to the knee, trouble walking which, in turn, becomes a problem in the lower back and the other hip due to muscle atrophy, and again poor psychology and quality of life.
“So, when a person with any of the above problems proceeds with the corresponding arthroplasty, he expects a complete or at least a large degree of relief from them. And indeed on post-operative x-rays, the ones that check the outcome after a successful conventional arthroplasty, things can look good.
The reality of the patients, however, shows that 12% of those who undergo conventional hip arthroplasty and 20% of patients who undergo conventional knee arthroplasty state that they are not satisfied with the operation they underwent”, emphasizes the Mr. Dionysios HissasDirector of Robotic Orthopedic Surgery at Metropolitan HospitalInternational Instructor in the Mako system and head of SEGAS Sports Medicine Center.
These rates have been an essential cause for the development of robotic orthopedics and the creation of systems such as Mako, the world’s most advanced orthopedic robot. A system in which what Steve Jobs (the founder of Apple) once said seems to apply: “Somewhere along comes a revolutionary product and it changes everything.”
What does this particular system do?
Mako is the only orthopedic robot based on personalized CT-based planning of the operating room and has the software to allow the surgeon to perform 3D preoperative planning, robotically assisted bone preparation to receive implants, and robotically controlled implant placement resulting in high accuracy, reduction of complications and long-lasting results.
The step by step process
Computed tomography consists of a series of X-rays-slices, which are taken at different angles and allow the surgeon to see the elements of the patient’s anatomy that cannot be seen with a simple X-ray. Then, based on the axial information, a virtual, 3D model of the area as it is is composed.
This model is “loaded” into the Mako system software and used to create the patient’s personal pre-operative planning model that allows sizing and simulation of implant placement. If necessary, the surgeon modifies this model in favor of a better fit of the anatomical elements and the stability of the area.
During the operation the surgeon creates “guides” on the bone, which “transmit” the exact anatomy to the system. This more accurately correlates the actual anatomy of the area with the preoperative planning model and ensures that the procedure proceeds as planned.
Once this correlation occurs, the surgeon is now able to apply it to the 3D model of the area that has been created with the CT scan, so the surgeon (and the robotic arm) now has a guide which allows the bone to be prepared, i.e. it sees the exact amount it needs to remove to place the implant and places it in the exact location it has planned with an accuracy of 0.2 millimeters.
A precision unimaginable to the human eye and the human hand, which makes the difference by intervening at the critical point and size of the damage, allowing the combination that has established the system worldwide: “know more, cut less”.
The results of the operation
Less destruction of bone and soft tissue, less postoperative pain, less need for opioid analgesics, fewer physical therapy sessions, and less hospital stay.
What do the numbers show?
• There are currently more than 1,000 systems installed worldwide in more than 28 countries, in the most recognized arthroplasty centers internationally.
• More than 200,000 operations have been performed, while in 2018 alone 76,000 operations were performed worldwide.
• There are over 100 publications in the most authoritative international medical journals and over 250 active studies, documenting the advanced nature of the Mako system, which is FDA & CE mark approved for all 3 arthroplasty procedures.
• Studies comparing the results of different treatments show that robotic arthroplasty with the Mako system has a success rate of 99% compared to 68% of the classic method.
It is worth noting that this particular system is used exclusively by orthopedic doctors trained and certified for its use.
Metropolitan Hospital: First with 1,533 operations
“The Metropolitan Hospital is by far the first in Greece with 7 years of experience and 1,533 Mako operations, and is an international Center of Excellence for this technique. Of these procedures, 43% involved total hip arthroplasty, 9.3% unicompartmental knee replacement, and 47.7% total knee arthroplasty. Finally, in addition to the Metropolitan Hospital, the same system has also been installed at HYGEIA, which is also a member of the HHG Group and has approximately 500 operations”, concludes Mr. Hissas.
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