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Seniors Series: New joint replacement procedures at San Ramon Regional

Innovative robot technology enables more personalized surgeries

San Ramon Regional Medical Center is now offering new cutting-edge technology for knee and hip replacement surgeries with the Mako robotic arm assisted surgery, which hospital staff say will greatly improve patient care.

Developed by Stryker Corporation -- an international medical technology company -- the Mako System enables surgeons at SRRMC to create personalized surgical plans for patients in need of knee and hip replacement surgery, providing knee alignment for a variety of different body types.

"The Mako partial knee is a great option for patients in their 80s and 90s," said Dr. Thomas Peatman, an orthopedic surgeon at the medical center. "Some patients in that age group do not want the recovery of a full knee, even a robotic-assisted one. When they learn about the robotic partial knee they find it is a simple rehab.

"I have a patient in their 90s who was walking well at their nine-day post-op,ā€¯ he continued. "So the Mako has options for a variety of patients of all ages."

The Mako System is designed to enable surgeons to create CT-based 3D modeling of bone anatomy, identifying implant size, orientation and alignment based on each patient's "unique anatomy." The application offers knee and hip replacement surgery as a treatment option meant to relieve pain caused by joint degeneration due to osteoarthritis, a type of arthritis that develops from the repeated flexing of tissue, wearing down the ends of bones.

SRRMC officials said the need for advances in surgical technology and strategies is growing: as the average age of U.S. residents continues to rise, so will the need for knee replacement surgery.

By the year 2030 total knee replacement surgeries are expected to increase by a total of 673%, but today approximately 30% of patients are dissatisfied after "conventional" knee surgery, according to a 2013 article published by the scientific journal PLOS ONE. Hospital staff say that new methods made possible by Mako will give surgeons a more predictable and accurate surgical experience.

"During surgery, the physician can validate that plan and make any necessary adjustments while guiding the robotic-arm to execute that plan. It's exciting to be able to offer this transformative technology across the joint replacement service line to perform total knee, total hip and partial knee replacements," Peatman said.

The recovery time is about the same as for a conventional knee replacement surgery.

"There really is no difference in recovery time, usually four to six weeks," said Debbie Miller, physician liaison and nurse manager for orthopedics at SRRMC. "But the life longevity of the joint replacement has been shown to improve with the robotic-assisted surgery. Most of our knee replacement patients go home the day after their surgery, if not the same day of their surgery."

Peatman said that in his experience patients who have received the Mako System seem to have less "post-operative stiffness and ligament soreness" after a procedure. He added that while satisfaction always varies, it appears to be more consistently favorable with the Mako.

The real advantage of the Mako comes down to its enabling surgeons to complete procedures with a great increase in precision accuracy. This accuracy not only results in higher quality knee replacements and lower need for future surgeries but also happier patients.

"Certainly, patients are much happier to know that they shouldn't need a revision/replacement as quickly, if at all, when they have a Mako assisted knee replacement. This is due mostly in part by the precise measurements which causes less wear on the components," Miller said.

SRRMC currently has five orthopedic surgeons that are qualified to use the Mako and more have shown interests in receiving training to becoming qualified, according to Miller.

"We are proud to offer this highly advanced robotic technology in our area," said Ann Lucena, CEO of San Ramon Regional Medical Center. "This addition to our orthopedic services further demonstrates our commitment to provide the community with outstanding healthcare."

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