Shannon Medical Center | Health Beat | Fall 2020

Fall 2020 3 Orthopedics S hannon Orthopedic Center is now offering innovative methods of robotic- assisted surgery for total and partial knee and total hip replacement proce- dures.The new procedures are designed to enhance the accuracy and precision of the overall surgery so patients experience less pain and recovery time while achieving better function and mobility in the joint. Shannon orthopedic surgeons Stacy Beaty, MD; Barrett Bowlin, MD; and Caleb Vosburg, MD, have completed specific trainings and begun operating on patients using the Mako and Rosa robotic-assisted systems. “Shannon has been in the process of imple- menting this technology for about a year now,” Dr. Bowlin says. “We’re very excited they are here now and available as options for our patients to utilize here in San Angelo instead of traveling to have it done.” INCREASED ACCURACY The use of robotics in joint replacement surgery increases the surgeon’s ability to accurately place implants and decreases the chance of revision surgery.The robots are not autonomous and do not do the surgery themselves.Their main pur- pose is to guide the surgeon and provide cus- tomized imagery of the patient’s anatomy while setting safe barriers to prevent errors in the cut- ting process. “Your surgeon is still in control and making Training staff demonstrate a customized bone model created by Mako instruments to deliver more precise place- ment of a knee implant. This results in more natural movement and feel for the patient. The Mako robotic arm is equipped with a bone-cutting blade, which is activated as the surgeon pulls the trigger on the handle. The robotic guides help surgeons per- form cuts with improved accuracy within millimeters. Robotic-assisted orthopedic surgeries now available at Shannon decisions while performing the operation,” Dr. Vosburg says. “Robotic-assisted surgical systems are ultimately guided by a certified sur- geon and are used to facilitate the procedure. If either system detects the blade is even slightly close to cutting tissue that is not meant to be cut, it will immediately stop and prevent it from going further.” The Mako and Rosa robots are designed to provide more accurate ligament balancing and implant placement, precise bone cuts, and cus- tomized alignment for each patient during the procedure. Patients having an operation done with the Mako will be required to have a CT scan of their joint prior to surgery; this allows the provider to use a three-dimensional (3-D) virtual model of their unique anatomy on screen during the implantation, as well as gives the surgeon an accurate representation of how much tension is on the knee or hip. “Mako gives us real-time feedback during the operation,” Dr. Beaty says. “This technology provides an extra level of artificial intelligence for better guides with the same implants we had already been using. Surgeons make the decisions, but the robot makes the cuts in a safe, efficient way. It’s as precise as anything I’ve ever seen.” A CUSTOMIZED APPROACH During an operation with a Mako robot, the sur- geon will prepare the bone for implant based off the customized CT scan and mapped-out points taken with special tools.The Mako system allows for the surgeon to make adjustments as needed before guiding them within the pre-defined area. “I completed robotic-assisted operations dur- ing my residency in Oklahoma,” Dr. Bowlin says. “The accuracy and ease of operation it provides is outstanding. Our goal is always to give our patients the best outcome possible, and I would recommend this method as the preferred op- tion. It takes what we’ve provided here and made it better.” The Rosa Knee System uses 2-D x-ray to 3-D bone model imaging in replacement of a CT scan. Unlike the Mako, the Rosa instruments are not attached to the robotic arm, and the pre- operative planning technology helps reduce in- strumentation in the operating room.This system also has patient-specific data with dynamic data tracking during the operation. “Knee replacement performed with the robot still uses the same implants and post-operative rehabilitation protocols,” Dr. Vosburg says. “The benefit is that it allows more accurate implant placement, ligament balancing and a higher per- centage of good outcomes with higher patient satisfaction.” Shannon is excited to now offer these robot- assisted knee and hip surgeries to our patients. For more information, or to schedule an appoint- ment with an orthopedic surgeon, please call Shannon Orthopedic Center at 325-481-2292 .