Mako surgical robot at Providence St. Mary increases knee replacement options and precision

People preparing for knee replacement surgery often have many questions. At Providence St. Mary Medical Center, those questions may now include “Is the robot doing my surgery?” 

Surgeons at Providence St. Mary Medical Center are now using a Mako surgical robot for knee replacement procedures. The robot doesn’t perform the surgery. The surgery still lies in the skilled hands of orthopedic surgeons, as it always has.

The robot increases the precision of the procedure by combining CT scans and 3D modeling of the knee with robotic guidance, assisting the surgeons to plan and execute a very precise joint replacement to fit each knee’s exact shape.

“It’s a really good tool,” said Dr. Michael Priddy, orthopedic surgeon at Providence Medical Group in Walla Walla. “The precision can lead to a more balanced knee, which can give you a more normal feel.”

Mako knee replacements can be performed minimally invasively, through an incision around the same size as a traditional knee replacement.

Many patients even can go home the same day, Dr. Priddy noted, although at Providence St. Mary, hospital stays remain an option when appropriate for the patient’s needs.

Mako has bought an additional benefit as well – the ability for some patients to receive knee replacements that don’t require surgical cement, Dr. Priddy said.

Fast-drying surgical cement is commonly used in knee replacements to bind the implant to the bone. The implant is firmly in place by the conclusion of the surgery. This may remain the best option for patients who are older, have osteoporosis or other issues affecting the quality of their bone. However, the cement can weaken over the span of 10 to 20 years, and another surgery may be required to revise the joint.

For younger patients who have strong, healthy bones, there is another option enabled by Mako: Cementless knee replacements, also called press-fit knee replacements. Press-fit knee replacements have a rough, porous surface. As the patient heals, the new bone grows into spaces in the implant, holding it strongly in place. No cement is needed, so the risk of cement weakening is eliminated. It is thought that press-fit replacements may last longer and form a more permanent bond with the patient’s bones than cemented implants.

“I think one of the best things is that people don’t have to leave town to for this kind of technology now,” Dr. Priddy said. “We can do it here. The Mako is great technology and is very promising.”

What to expect from a Mako knee replacement procedure

Your primary care provider will refer you to an orthopedic surgeon for an assessment to determine if you are a candidate for knee replacement surgery. This generally occurs after more conservative approaches such as physical therapy and medications are no longer able to relieve your knee pain, and it interferes with your mobility and desired lifestyle. If you are a good candidate for knee replacement, the surgeon will discuss the type of replacement appropriate for you, then refer you for a CT scan of your knee.

Highly advanced software takes your CT scan and creates a 3D model of your knee, helping the surgeon create a precise, personalized preoperative plan. That 3D model is then uploaded into the Mako. As the surgeon guides the robotic arm during surgery, following the plan he or she created, the Mako helps ensure the precision of the procedure.

Your surgeon will advise whether it would be appropriate for you to go home the same day as the procedure or spend a short time recovering in the hospital based on your health, age and other factors.