MDNews

MAKOplasty Comes to Saint Anne’s Hospital




Fall River Hospital Becomes First in 
Massachusetts to Offer Robotic-Arm 
Partial Knee Resurfacing

Millions of people across the United States suffer from osteoarthritis of the knee, and for early- to mid-stage sufferers, the treatment options have historically been limited. Saint Anne’s Hospital in Fall River recently added a new service, which could just be the relief many people in the South Coast region are looking for.

Saint Anne’s Hospital is the first and only hospital in Massachusetts providing MAKOplasty, a robotic-arm partial knee resurfacing procedure. The hospital currently has five MAKOplasty-certified surgeons, with three more in the process of completing the specialized training. All are part of the Coastal Orthopaedics physician group in Fall River.

A common condition, knee osteoarthritis is generally caused by factors that can include previous knee injuries, overuse, genetics and obesity. Symptoms, such as pain, stiffness, limited motion and swelling, can range from mild to severe. Patients require physical exams, X-rays, MRIs or even arthroscopic surgery to obtain a full diagnosis.

Traditional treatments can be as simple as pain relievers or supplements, but surgery is sometimes required. For patients with the most advanced form of the disease, this can mean a total knee replacement, but that isn’t an answer for early- to mid-stage osteoarthritis.

“The best candidate for this procedure would be a patient with arthritic symptoms who is typically younger and active,” says Kevin Mabie, M.D., President of Coastal Orthopaedics. “Overall, it is estimated that 8% to 12% of people with knee osteoarthritis may be candidates for unicompartmental knee replacement. Far fewer than that actually undergo unicompartmental knee replacement.

“Orthopedic surgeons have shied away from other unicompartmental knee replacement procedures because results have been unpredictable,” explains 
Dr. Mabie. “MAKOplasty, however, allows for accurate and reproducible implantation.”

James Worthington, M.D., who also serves as Director of Orthopedic Rehabilitation at Sarah S. Brayton Nursing Center in Fall River and at Somerset Ridge Center in Somerset, agrees.

“This technique limits the surgery to replacing joint surfaces only in the area where patients need it without sacrificing other parts of the knee,” he says. “It doesn’t burn any bridges for them for future care, and it provides them an option they really didn’t have before.”

The procedure is powered by the RIO Robotic Arm Interactive Orthopedic System and covered by most Medicare-approved and private health insurance providers. The RIO system combines patient-specific, 3-D modeling for presurgical planning and provides surgeons with real-time visual, tactile and auditory feedback that allows for the best possible joint resurfacing and implant positioning.

“This is a quantum leap forward from what we’ve been able to do, and I think this kind of technology is going to revolutionize joint replacements down the road,” says Jerald Katz, M.D., a member of the medical staff at Saint Anne’s Hospital who formerly served as chair of the orthopedics department and is a clinical instructor at Tufts University School of Medicine. Dr. Katz was the first surgeon at the hospital to perform the procedure.

MAKOplasty works by resurfacing the damaged part of the knee and securing an implant in the joint, all without impacting healthy bone and surrounding tissue. It can be performed in the medial compartment, patellofemoral compartment or the lateral portion of the knee, and can be done as a bicompartmental procedure on both the medial and patellofemoral portions of the knee. Very little bone is taken out during the procedure.

The procedure is less invasive and less painful than a full knee replacement, and it relieves the pain of osteoarthritis while making the knee feel more natural. The procedure can be done in inpatient or outpatient settings, and its minimally invasive nature speeds up recovery times while shortening hospital stays. All of this means patients can get back to their normal lives much faster.

“This is a much smaller operation,” explains Dr. Mabie. “The intact part of the knee and its muscular structure isn’t really disrupted, and there is considerably less pain because the incision and exposure is less disruptive. Patients will also end up with knee function that is more like a normal knee. Total knee replacement patients with a very good outcome may get 120 degrees of flexion, but MAKOplasty can get very close to a normal range of motion.”

Saint Anne’s Hospital and its orthopedics care team are excited about bringing this robotic-arm technology to the market. Not only is it an innovative treatment option that is altering how surgeons can care for adults with early- to mid-stage osteoarthritis, but also it showcases how committed the hospital, its management team at Steward Health Care and area physicians are to providing state-of-the-art treatments and services to the region. The hospital was also recently designated as a Blue Distinction Center for Knee and Hip Replacement by Blue Cross Blue Shield of Massachusetts.

In fact, this is just the latest step forward in the ongoing rebirth of Saint Anne’s Hospital, which is part of the Caritas Christi health care system. In fall 2010, Steward Health Care, a unit of Cerberus Capital Management, acquired Caritas Christi and immediately began supporting improvement initiatives at Saint Anne’s Hospital. Just like the ongoing additions of a new emergency room and surgery wing, adding MAKOplasty is one step in reinventing this storied 105-year-old provider.

“This speaks volumes about the new owners of the hospital. They’ve made big financial commitments to the hospital by investing in this technology,” says Dr. Katz. “They are saying that they are committed to state-of-the-art procedures and have confidence in the kind of care the physicians can deliver to the community.”
The service has only been offered at Saint Anne’s since March, so getting the word out about the procedure and its benefits is one of the hospital’s most important continuing efforts. Part of that strategy includes hosting free “Meet MAKOplasty” events for the public where people can speak with MAKOplasty-trained surgeons and learn about osteoarthritis and the procedure.

“We’ve had a tremendous number of people attend those events and ask some excellent questions,” says Dr. Worthington. “We’ve also met with primary care doctors to make them aware of this service and its importance. We will continue to hold events inside and outside the hospital so the public and physician community know that this option is available.”

In the end, MAKOplasty is a new technology and improved method of performing a procedure that has been around for a long time. Not every patient is a good candidate for the procedure, and many will still need a total knee replacement, but the opportunity here is to positively impact many people who previously had no real solution to their pain while expanding Saint Anne’s Hospital’s reputation as one of the leading orthopedic care providers in the region.

“I recently saw the first patient who underwent the procedure,” says Dr. Katz. “He had both knees done, went home from the hospital in three days and is walking around with only a cane two weeks out. That is incredible. I see indications that this kind of technology will continue to advance and expand to all forms of hip and knee replacement, but right now, the people of the South Coast need to know that this surgery is available to them close to home.”

For more information on MAKOplasty at Saint Anne’s Hospital, please call (855) GO-2-MAKO (462-6256) or visit 
www.SaintAnnesHospital.org/MAKOplasty.


 


MD News May/June 2011, South of Boston


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