Mistakes are usually not encouraged in school, but as Animas High School students took turns using a robotic arm to grind away the surface of a model knee joint, surgeons encouraged them to take off more “bone” than planned.
When the students tried to press too hard or move outside of the designated area, the MAKOplasty Robotic Arm Interactive Orthopedic System stopped turning.
“It won’t let you color outside the lines,” said Dr. Gareth Hammond, an orthopedic surgeon at Animas Surgical Hospital.
The device emits and receives infrared light that tracks the surgeons’ resurfacing of the bone in real time on a screen, said Colleen Roarty, a clinical launch and products specialist for MAKO Surgical Corp., which sells the robot.
Rather than watching the arm as they worked, the students and surgeons watched the screen, showing the golf ball-like pattern of their grinding. With the robotic assistance, the accuracy of the cut is ensured within 2 millimeters of a surgeon’s plan.
The hospital recently purchased the robotic arm for partial knee replacements and total hip replacements because it allows surgeons to ensure better joint alignment for patients after surgery, Hammond said.
The robot system allows surgeons to create a 3-D model of the knee with CT scans ahead of time. Using the digital model, surgeons can adjust the thickness and alignment of a potential implant to create the best range of motion, Roarty said.
In partial knee replacements, the implants replace a piece of the knee that has been worn away or destroyed, commonly by osteoarthritis, said Dr. Brinceton Phipps, an orthopedic surgeon at ASH.
The robot’s imaging is far more accurate than the traditional method of planning the surgery using X-rays and CT images, Phipps said.
During traditional knee surgery, surgeons drill a hole into the femur and insert a rod into it to gauge the alignment of the joint, Phipps said.
For hip replacements, the robot is used to resurface the socket of the hip’s ball-and-socket joint. This method can help a replacement feel more natural and decreases the risk of dislocation later, Phipps said.
Now that they have an alternative, surgeons at the hospital expect to use the MAKOplasty robotic arm about three to five times a week. But patients will not pay more for a surgery aided by the robot, which generally costs more than $1 million.
The students, impressed by the technology, raised questions about whether fully automated surgery is on the horizon.
“There’s no way in the near future you’re going to see fully robotic surgery,” Hammond said.
One of the main problems is the imaging, which isn’t perfect, Phipps said. Patients also don’t trust robots to execute surgery on their own yet, he said.
Students also were curious about using similar technology in soft-tissue surgeries. While there are robots that assist in many branches of medicine, the type of imaging used by the MAKOplasty robot is specific to work with bone, because it can’t sense soft tissue.
But the applications for the technology are limitless for orthopedic surgeries, Hammond said.
The next step for the MAKOplasty robot is likely full-knee replacements, Phipps said.
The MAKOplasty robot was approved by the Food and Drug Administration in 2008, and there are about 270 of them in use, Roarty said. There are only three in Colorado, and the closest one is in Aspen.
The hospital is looking to dub the robot with a worthy nickname, and some of the students submitted suggestions.
Keely Savage suggested “Ed.”
“With something this modern, it should be a classic name,” she said.
Savage has had 13 surgeries for her trochlear dysplasia, a knee disorder, and she has been inspired by her experience to pursue a career in medicine.
Her friend Hannah Langford was similarly inspired by a knee surgery after one of her tendons tore off a chunk of bone in an accident.
They joked about feeling a kinship with the robot.
“All the metal we have in us, we’re just partial robots,” Savage said.
mshinn@durangoherald.com
