Total Knee Replacement Gets Robotic Assistance

Sylvia and Kenny Brown on a recent cruise to the Bahamas after having robotic-assisted knee replacement surgery.

A decade ago Herman Botero, DO, then a fourth-year resident at Hospital for Special Surgery in New York City, watched in awe as the orthopedic surgeon he was working with maneuvered a new surgical robot during a joint replacement surgery.

“When I first saw it, I was impressed with the technology. I thought it was cool,” said Dr. Botero, now an orthopedic surgeon at Parkwest Medical Center. “Ten years later, I still think the technology is cool and possibly, with further improvements in the technology and further research, may play a significant role in joint replacement surgery.”

While robotic-assisted surgery has been used in partial knee replacement since its 2009 introduction, it was not until 2016 that improved functionality enabled surgeons to use it for total knee replacements. Parkwest began offering robotic-assisted surgery for total knee replacements in January.

It is the precision that the robot provided during patient Sylvia Brown’s January 2018 total knee replacement that continues to impress Dr. Botero. That’s because the system utilizes a CT-based 3D modeling of the bone anatomy to create a personalized surgical plan and identify the implant size, orientation and alignment based on each patient’s unique bone anatomy.

“The robot enables surgeons to virtually modify the surgical plan intra-operatively and assists in executing bone resections,” added Dr. Botero. “This increases the accuracy by which the implants are placed in total knee replacements.”

Mrs. Brown was likewise impressed. “Dr. Botero assured me that the robot could get a more precise cut and fit of my knee than practically anybody could,” she said recently. “He made me feel pretty good about it. It was a little scary at first, especially when they talked about how they would do it. It makes you wonder, but at that point I was in so much pain, I was ready to get it done.”

Mrs. Brown, who had undergone arthroscopic surgery on her left knee nearly 30 years earlier, said her knee had reached the point that putting weight on the leg was unbearable. She still maintained a fair range of motion, but steroid injections no longer worked because of bone-on-bone osteoarthritis in the knee. For her, total knee replacement was the best way to go.

While robotic-assisted total knee replacement surgery is not considered “minimally invasive,” Dr. Botero believes it can offer an advantage over traditional knee replacement in certain cases.

All Mrs. Brown knows is that after a few weeks of physical therapy, her knee is stronger. “I’ve got feeling in it just like my other knee. It feels the same as the other knee,” she added. “It’s not 100 percent yet, but it will be in a few more months. But just by looking at my knee, you wouldn’t know that I even had surgery if it weren’t for the scar, and it’s not bad. Dr. Botero is great! He is absolutely wonderful. Bedside manners, everything. I would recommend him and his staff to anybody. Everybody there was nice and everybody at Parkwest was very nice.”

She says she’s leaving soon on her first cruise with her husband and grandchildren. “It’s just a short cruise to the Bahamas, but I’ll give it a workout then. It’ll be interesting if I can keep up with my grandkids. So we’re going to test it out.”