What is a total knee replacement

The knee is the largest joint in the body and is central to nearly every routine activity. Three bones come together to form the knee joint:

• the lower end of the thighbone (the femur),
• the upper end of the shinbone (the tibia),
• and the kneecap (the patella) right above where the long bones meet.

Tough bands called ligaments help keep everything in place and stable.

A smooth, plastic like lining called cartilage covers the ends of the bones. Cartilage provides cushioning, keeps bones from rubbing together, and absorbs the shock of walking, running and jumping. Your body also produces a natural lubricating fluid called synovium that minimizes friction in the joint.

Questions to ask your doctor:

• 1. How often do you perform surgeries using Mako SmartRobotics™?
• 2. How long do knee implants usually last and what factors can impact their longevity?
• 3. What to expect in weeks prior to surgery?
• 4. Do I need a caregiver after the surgery and what do they need to know?

The AccuStop technology

With Mako Smart Robotics™, your surgeon can create a personalized surgical plan, and with the help of AccuStop™ technology, they are guided to accurately cut what’s planned for you, which for some patients can help preserve soft tissue and for others can help protect healthy bone

How does Mako SmartRoboticsTM and AccuStopTM technology work?

Personalized surgical plan

Before your surgery, your doctor will take a CT scan of your knee joint, which develops a 3D virtual model of your unique anatomy. This model helps your doctor see things they can’t typically see with an X-ray alone. The information provided by Mako helps your surgeon determine the desired size, placement and positioning of your implant. Throughout the procedure, Mako SmartRobotics™ provides real-time data to the surgeon so they can continuously assess the movement and tension of your new joint and adjust your surgical plan if needed.

Arthritic bone removal

In the operating room, your surgeon guides Mako’s robotic arm to remove arthritic bone and cartilage from the knee. AccuStop technology provides tactile resistance to help your surgeon stay within the boundaries defined in your surgical plan and accurately cut what’s planned for you,which could protect your healthy bone.

Implant placement and range-of-motion assessment

With the removal of the diseased bone, your implant is placed into the knee joint. Once your implant is successfully placed, it’s off to the recovery room to begin the journey towards strengthening your new joint.

Your knee pain

Each patient is unique, and can experience knee pain for different reasons. One common cause of knee pain is osteoarthritis (OA). OA is sometimes called degenerative arthritis because it is a “wearing out” condition involving the breakdown of cartilage in the joints.

Another common cause of knee pain is rheumatoid arthritis (RA). RA produces chemical changes in the lining of the joints, or synovium, that causes it to become thickened and inflamed. In turn, the synovial fluid destroys cartilage.

When cartilage wears away, the bones rub against each other, causing pain and stiffness, limiting your ability to move and work.

Total knee replacement is a surgical procedure where a diseased or damaged joint is replaced with an artificial joint called an implant. Made of metal alloys and high-grade plastics, the implant is designed to mimic a normal, healthy knee.

Mako SmartRobotics™ transforms how total knee replacement procedures are done by integrating 3D CT-based planning software and AccuStop™ haptic technology

Time to take on

References

1. Mahoney O, Kinsey T, Sodhi N, et al. Improved Component Placement Accuracy with Robotic-Arm Assisted Total Knee Arthroplasty. J Knee Surg.
2022;35(3):337-344. doi:10.1055/s-0040-1715571

2. Kayani B, Konan S, Pietrzak JRT, Haddad FS. Iatrogenic bone and soft tissue trauma in robotic-arm assisted total knee arthroplasty compared with conventional jig-based total knee arthroplasty: a prospective cohort study and validation of a new classification system. J Arthroplasty. 2018;33(8):2496-2501. doi:10.1016/j. arth.2018.03.042

3. Hozack WJ. Multicentre analysis of outcomes after robotic-arm assisted total knee arthroplasty. Bone Joint J:Orthop Proc. 2018;100-B(Supp_12):38.

4. Bhimani SJ, Bhimani R, Smith A, Eccles C, Smith L, Malkani A. Roboticassisted total knee arthroplasty demonstrates decreased postoperative pain and opioid usage compared to conventional total knee arthroplasty. Bone Joint Open. 2020;1(2):8-12. doi:10.1302/2046-3758.12.BJO-2019-0004.R1

5. Marecek GS, Schafer MF. Driving after orthopaedic surgery. J Am Acad Orthop Surg. 2013;21(11):696-706. doi: 10.5435/JAAOS-21-11-696.

6. Foran JRH. Activities after knee replacement. OrthoInfo. Accessed February 25, 2019. https://orthoinfo.aaos.org/en/recovery/activities-after-kneereplacement/

Important information

Knee replacement: Knee replacement is intended for use in individuals with joint disease resulting from degenerative, rheumatoid and post-traumatic arthritis, and for moderate deformity of the knee. Knee replacement surgery is not appropriate for patients with certain types of infections, any mental or neuromuscular disorder which would create an unacceptable risk of prosthesis instability, prosthesis fixation failure or complications in postoperative care, compromised bone stock, skeletal immaturity, severe instability of the joint, or excessive body weight.

As with any surgery, knee replacement surgery has serious risks which include, but are not limited to, pain, infection, bone fracture, peripheral neuropathies (nerve damage), circulatory compromise (including deep vein thrombosis (blood clots in the legs)), genitourinary disorders (including kidney failure), gastrointestinal disorders (including paralytic ileus (loss of intestinal digestive movement)), vascular disorders (including thrombus (blood clots), blood loss, or changes in blood pressure or heart rhythm), bronchopulmonary disorders (including emboli, stroke or pneumonia), heart attack, and death.

Implant related risks which may lead to a revision include dislocation, loosening, fracture, nerve damage, heterotopic bone formation (abnormal bone growth in tissue), wear of the implant, metal and/or foreign body sensitivity, soft tissue imbalance, osteolysis (localized progressive bone loss), and reaction to particle debris. Knee implants may not provide the same feel or performance characteristics experienced with a normal healthy joint.

This information is solely intended for patients who have been booked for a Mako robotic-arm assisted surgery by their surgeon. The information presented is for educational purposes only. Stryker is not dispensing medical advice. Speak to your doctor to decide which treatment is appropriate for you. Individual results vary and not all patients will return to the same activity level. The lifetime of any joint replacement is limited and varies with each individual.Your doctor will counsel you about how to best maintain your activities in order to potentially prolong the lifetime of the device. Such strategies include not engaging in high-impact activities, such as running, as well as maintaining a healthy weight. It is important to closely follow your doctor’s instructions regarding post-surgery activity, treatment and follow-up care.

Stryker Corporation or its other divisions or other corporate affiliated entities own, use or have applied for the following trademarks or service marks: AccuStop, Mako, SmartRobotics, Stryker. All other trademarks are trademarks of their respective owners or holders.