When your knees start to weaken, the pain tends to play havoc with your active lifestyle. A knee replacement operation can help get you back to normal, but many people choose to avoid surgery, fearing the possibility of a painful recovery period or, even worse, that the replacement eventually will fail and another surgery will be necessary.
It doesn’t have to be that way – and it isn’t at the Lowcountry Orthopaedics outpatient surgery center in Summerville, where Richard Zimlich, M.D., uses a robotic system to aid with knee replacement. Dr. Zimlich is a board-certified orthopedic surgeon who specializes in joint replacement of the hip and knee, including total replacement and revisions of existing joint replacements.
As the name suggests, with knee replacement surgery, the worn parts of the joint are removed and replaced with duplicates made of metal alloys, high-grade plastics and polymers. In instances where only a part of the knee is impaired, a surgeon might opt to replace only the damaged part of the joint.
Lowcountry Orthopaedics uses the Stryker Mako robotic system, the method preferred on many Mayo Clinic campuses across the United States. Using a CT scan, the system creates a 3D model of the knee, giving orthopedic surgeons a clear picture of the size of the bones and exactly where the ligaments are attached. The model helps the surgeon select the exact size of the replacement, balance the ligaments with the proper tension and provide the best motion possible for the new knee.
The surgery involves using a robotic arm controlled by the surgeon to remove the correct amount of bone. The implants are then placed in the ideal position to maximize ligament balance and motion.
“Manually, you can do a good job with a knee replacement, especially if you are well-trained, but this system increases the precision to such a degree that it can’t be duplicated manually,” Dr. Zimlich said.
Every knee is different, and robotic-assisted surgery allows a knee replacement to be tailored like a fine suit to each individual patient. The better aligned the new joint is, the less likely it is to cause pain or deteriorate quickly.
“When we give a patient a more naturally-fitting and balanced knee, we can see a faster and less-painful recovery,” Dr. Zimlich said.
In addition to the Stryker Mako system, Dr. Zimlich uses a cementless attachment method that allows the bone to fuse into the replacement, creating a more permanent fit and reducing the chance of the replacement failing. The materials used in modern knee replacements have been shown in simulators to last for 40 years, which means there is little chance that the replacement will eventually have to be replaced. Indeed, patients who undergo this type of surgery report an extremely high rate of satisfaction and an early return to an active lifestyle.
Some hospitals offer the advantages of robotic-assisted knee-replacement surgery, but Lowcountry Orthopaedics was the first freestanding surgical center in South Carolina to do so and is still the only one in the Charleston area.
By James Rada Jr.
