Robot-assisted partial knee replacement leads to patient's quick recovery

Carl Adams was cutting down trees and hauling logs in his yard last year when his knee began to hurt.

A fit 72-year-old, he spent much of his time outdoors, doing yardwork, golfing and walking his German Shepherd. He had never had knee problems before. Cortisone shots helped right away, but the effects didn’t last long. Adams likely needed surgery, his doctor said.

Though Adams and his wife live in Michigan City, Indiana, he knew where he wanted to go.

“Our family has had several major operations at the University of Chicago, and every contact we have had with the university has been outstanding,” he said. “It’s unfortunate when you need surgery, but if you have to do it, it should be with the best that you can get.”

Orthopaedic surgeon Aravind Athiviraham, MD, told Adams about a fairly new type of procedure: robotic arm-assisted partial knee replacement surgery.

The approach, called Mako partial knee resurfacing, uses advanced robotic arm-assisted technology to resurface areas of the knee while sparing healthy bone and ligaments. Before the surgery, patients undergo a CT scan. That information is then inputted into software, which helps determine the size of the implant, where it should go and how much bone needs to be cut. Surgeons then use the robotic arm to shape the bone before placing the implant where the bone used to be.

“The accuracy is great,” said Athiviraham, who cares for patients with athletic and overuse injuries. “It removes less bone and allows us to put the replacement components in accurately.”

Before the robot-assisted technique, surgeons needed to resurface the bone manually, which generally resulted in more bone being removed and a longer recovery period. The more of the “natural” knee that is kept generally means a quicker recovery and better outcome.

Adams, who had both arthritis and ligament damage, was eligible for the partial-knee replacement because the damage was limited to just one of the knee’s three compartments. Damage in more than one compartment generally requires a full knee replacement, where more bone is removed and a larger implant is inserted.

The robotic aspect of the surgery was “really cool,” Adams said. “Everyone really took the time to explain exactly what would happen with the operation.”

Adams began physical therapy not long after the procedure, which was in October 2018. Less than a month later, he was walking without a limp. By Thanksgiving, he was back to 100 percent, he said. And a year later, he had his last follow-up visit with Athiviraham, and got the all clear.

“Now, I can’t even tell that it happened,” Adams said. “My knee feels absolutely normal. I can do everything I did before. Even the scar is almost invisible.”

That’s the advantage of the robot-assisted surgery, Athiviraham said. “You have smaller incisions, and it removes less bone, which helps with patient recovery.” The robot-assisted surgery can also be used for full knee replacements, but its effects are particularly shown in patients with partial knee replacements.

“It’s an exciting surgery we offer that not a lot of other medical centers have access to,” Athiviraham said.