Stryker’s Mako Makes CNOS Surgeon a Robotic Convert
B
R IAN J O H N SO N , M D, an
the cuts. That means you cut less soft
robotic partial knee replacements
orthopaedic surgeon with
tissue and disrupt less of the knee.”
are lasting as long as total knees
CNOS in Dakota Dunes, says
The system lets the surgeon
for the first time ever, giving more
he was never anxious to jump
overlay a series of
patients a shot at a “forgotten
on the robotic “bandwagon”. During
checkpoints with
knee” —a joint so strong, flex-
his residency 14 years ago, Johnson
CT
to
ible, and pain-free that the
took part in a study comparing
ensure precise
patient can simply forget that
robotic surgery to traditional instru-
placement of the
it was ever a problem.
mentation for knee replacement.
array and ultra
“With the robotic partial
fine tuning of the
knee, a lot more people end up
joint position.
with a forgotten knee,” says
“Back then, the tech was clunky and it took a long time,” he says.
images
“Most importantly, it didn’t affect the
“How many
Johnson. “The key is to get the
outcomes for patients. So I had a
humans can take
baseplate as big as you can
healthy sense of skepticism for a long
a pin and draw a
time.”
perfect circle a thousand times in a
ACL. The robot helps you do that. It
without compromising the
Johnson was also unmoved by
row? No one can, but the robot can,”
can also simulate how the forces
studies conducted by robot manu-
says Johnson. “It allows you to imple-
are going to go through the knee in
facturers in recent years showing
ment exactly what’s in your mind. It
that particular patient, so you can
a clinical benefit. It was not until
will not allow you to deviate from
adjust by just a few millimeters.”
the independent Australian Ortho-
your own plan.”
Johnson is hopeful that this
paedic Association National Joint
Johnson says the result is a safer,
level of precision will also make a
Replacement Registry (AOANJRR)
more precise operation, and a bal-
big difference for total knees, too,
released its own data in 2017 that
anced, stable joint. This precision is
but the data is not in yet. In the
he decided to take a more serious
especially critical with partial knees,
meantime, he is working with
look at the robotic approach to knee
which tend to have a higher failure
Stryker to help develop a robotic
replacement.
rate than total knees. The data shows
procedure for the shoulder joint. ❖
“The Australian Registry is the best in the world and is completely independent,” says Johnson. “Their data showed a clear difference. Not a hint of a difference, but a clear superiority for robotic-guided partial knee replacement.” After seeing the Mako Robotic Arm Assisted Surgery system firsthand, and evaluating the independent research, Johnson says he was determined to help bring it to Siouxland. “The biggest advantage is that it allows you to balance the knee more cut,” explains Johnson who has offered robotic knee surgery at CNOS for about a year. “Traditionally, you would make the cut and then adjust the soft tissue to balance it. Now you can balance it before you even make
November 2020
Photo courtesy Stryker
precisely before you even make a
19
