Local joint surgery gets Mako makeover

Friday, March 17, 2017
Surgeons at Lakes Regional Healthcare have been using the Mako surgical robot since October of last year. The robot assists surgeons in both total hip replacements and partial knee replacements. In the near future, additional programs may expand the robots functions to assisting in total knee replacements. The staff at LRH is considering the purchase of expanded software for the robot this year. (Photo submitted)

SPIRIT LAKE — Lake Regional Healthcare providers are keeping up with technological advances in the surgical field — even if it means a latex-covered hand isn't holding tools to guide the procedure.

The Spirit Lake-based hospital purchased a Mako surgical robot in October of last year. LRH President and CEO Jason Harrington said the number of surgeries performed with the Mako have already exceeded the facility’s projections. The robot is capable of assisting surgeons in total hip and partial knee replacement procedures. The Mako provides an added level of accuracy for the surgeons as they place hip and knee implants.

“Lakes Regional Healthcare has a long history of providing high quality orthopedic services in addition to other specialties. That history, along with a strong desire by our local orthopedic surgeons to ensure we are providing state-of-the-art treatments, really drove the decision,” Harrington said of the purchase.

Because LRH is the first provider in the region to offer the technology as a surgical option, Harrington said the hospital has received referrals from more than 100 miles away. Partial knee replacements, which require less recovery time, have become an option for a good number of patients because of the Mako.

“It provided another treatment option, in partial knee replacements, that was not available to any patients in our service area and we felt it important — given the desire of younger orthopedic patients to recover more quickly and possibly avoid a total knee replacement,” Harrington said.

Dr. John Leupold of Northwest Iowa Bone, Joint and Sports Surgeons, expressed enthusiasm for the new service and said he has been impressed with the early results. He estimated patients will be in recovery from a total knee replacement for six months after a three-night stay in the hospital. Comparatively, he estimated a partial knee replacement would require a six-week recovery after a single night in the hospital. Leupold typically performed full replacement surgeries, prior to the Mako's arrival.

“We had the ability to do partial replacements for a long time but they’re very difficult to do and do accurately,” Leupold said.

With the ability to efficiently perform partial knee replacements, patient recovery times have decreased.

“We have received feedback from a number of partial knee patients who were amazed at how quickly they were able to return to normal activities and start to enjoy activities they had discontinued,” Harrington said.

The Mako’s ability to render a virtual model of each patient’s unique anatomy by use of a CT scan is one of the features that sets the system apart as a surgical tool, according to Leupold.

“The magic is really the software. It can’t do anything without me running it,” Leupold said.

The virtual model is used to determine which implant will best serve the patient’s needs. As such, a detailed surgical plan is developed prior to the surgery. The Mako is also able to track the surgeon’s tools as they remove bone for the implant.

“If I try to go too far or too deep, it won’t let me. I always tell people it keeps me between the ditches so to speak. I’m coloring inside the lines,” Leupold said, estimating the robot’s tracking is accurate to within 1 millimeter.

He compared the joint surgeries to carpentry in that two pieces may fit, yet still contain variances and a margin of error. He added that, because joint implants are mechanical systems, inaccuracies can cause loose implants or decreased joint movement.

“The robot dials in on that accuracy,” Leupold said.

The surgeon also says additional programming applications are being developed for the Mako robot, including an application for total knee replacement. He expects that these new applications will be featured at medical and surgical trade shows in the coming months. Harrington confirmed LRH is evaluating the purchase of a total replacement application for the Mako at some point this year.

Though Leupold was unsure how the new application may impact the patient pool of Northwest Iowa Bone, Joint and Sports Surgeons, he said the new software may benefit cases involving unusual formations on or near a joint.

“We’re excited to at least have that option available,” Leupold said.

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