A New Road to Relief from Knee Osteoarthritis

David Lent, M.D., FAOS, once saw two types of osteoarthritis patients who put themselves in the “grin and bear it” category. There was the patient in his 50s who had given up his active lifestyle due to knee pain because he felt he was too young to undergo a total knee replacement. Then, there was the older patient suffering from the disease who was either too frail or too ill to face the prospect of major surgery.

Now there’s another, less invasive option, and St. John’s Riverside Hospital is the first facility in the area to offer it.

Since this past summer, Dr. Lent has been performing a robot-assisted operation known as MAKOplasty, which is designed to relieve pain from knee joint osteoarthritis.

“After MAKOplasty, patients are able to resume normal activities much more rapidly than after a total knee replacement. They’re back to their jobs or their usual lifestyles within a couple of weeks rather than months.” — David Lent, M.D., FAOS, St. John’s Riverside Hospital

“Total knee replacement has long been an excellent operation, and many patients have had excellent results,” Dr. Lent says, “but the downside of total knee replacement as opposed to robotic partial knee replacement (PKR) is longer downtime, more extensive rehab — much of which is done as an inpatient — and the overall longer recovery time needed before returning to full activity.”

Robotic PKR (MAKOplasty) is an entirely different way of surgically treating osteoarthritis of the knee, targeting patients living with early- to mid-stage osteoarthritis that has not progressed to all three compartments of the knee.

In a total knee replacement, a 15-centimeter incision is made to remove the natural joint completely and replace it with an artificial implant. Powered by a robotic arm, MAKOplasty precisely removes and resurfaces only the diseased portion of the knee through a smaller than 6-centimeter incision, sparing healthy bone and surrounding tissue. An implant is then secured in the joint.

“What’s even more impressive is that we virtually plan the entire operation on a computer prior to surgery,” says Dr. Lent. “We take a preoperative CT scan that shows the damage, and we design an implant, allowing only a portion of the damaged bone to be removed. We make sure the operation works perfectly on the computer before beginning the procedure. We therefore know at the time we make our incision, the model we have designed will be nearly perfectly reproduced inside the knee.”

Dr. Lent says many of his patients go home the same day, whereas patients undergoing a total knee replacement typically remain in the hospital five or six days before being transferred to a rehabilitation facility. Instead, MAKOplasty patients are provided prescriptions to undergo physical therapy as outpatients.

In addition, because healthy bone is preserved, patients who undergo MAKOplasty are still candidates for total knee replacements later in life, if this becomes necessary.

However, Dr. Lent encourages patients to deal with osteoarthritis before it gets too advanced.

“It’s like a cavity,” he says. “If you let it go too long, there’s no choice but to remove the tooth. Same thing here — if you catch arthritis when it’s less severe or when it’s isolated to one part of the knee, you’re able to deal with it appropriately. Why wait in misery for a huge operation when you can get rid of your pain earlier with a much smaller operation?”

For more information about MAKOplasty at St. John’s Riverside Hospital, visit




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