Innovative Technology Enhances Joint Replacement Surgery Mako Robotic-Arm Assisted Surgery offers a higher level of customization and precision, which speeds healing and gets you back to the life you love.

Carol DeFazio postponed having knee replacement surgery for more than a decade. Her busy family, including her husband, son and daughter-in-law, and two grandsons, kept her in constant motion. But the pain was beginning to interfere with her life, waking her up at night and making it difficult to do the things she loved, including attending her grandsons' baseball games.

Carol and her husband, Jim, at a Pittsburgh Pirates game.

"Carol had progressed to painful bone-on-bone arthritis," said Michael McCollum, MD, an orthopaedic specialist at The University of Tennessee Medical Center, and Carol's physician. "She tried cortisone shots and arthritis medications and eventually decided that knee replacement was the best way to approach the problem."

In September, McCollum replaced Carol's left knee with the assistance of the Mako Robotic Arm, the latest in joint replacement technology.

McCollum is one of several physicians at University Orthopedic Surgeons practicing in the Advanced Orthopaedic Center at The University of Tennessee Medical Center. These surgeons use robotic arm technology to enhance hip and knee replacement surgeries. To date, McCollum; Brian Tonne, MD; William Oros, MD; and Philip McDowell, MD, have performed more than 250 robotic assisted hip and knee replacements.

They are the first in the region to offer all three robotic applications:

Knee Replacements: Mako vs. Manual

Mako Robotic-Arm Assisted Surgery differs from manual surgery in two ways: It allows physicians to create a pre-surgical plan and it gives them more control while they're operating.

Watch the video below as Brian Tonne, MD, introduces the Mako Robotic Arm.

Here’s how it works. Before surgery, the physician takes a CT scan of the knee. This results in a 3D image, which is uploaded to Mako's sophisticated software. The software assesses deformity, bone loss and anatomy, and lets the physician create a surgical plan.

During surgery, the surgeon guides the robotic arm cut the bone, following the pattern set during the planning phase.

McCollum, an orthopedic specialist with more than 20 years of experience, performed his first Mako knee replacement in January, and has since performed nearly 100 knee replacements using the machine. He appreciates the pre-planning and how the machine limits the cuts to specific boundaries based on the scan.

"In traditional manual knee and hip replacements," said McCollum, "we use a cutter, freehand, to perform the surgery. While we do imaging before the surgery, most of our decision-making about the best way to replace the joint is done during surgery."

For patients who have already had the joint replaced, or for those whose bodies don't follow the norm, manual surgery isn’t always an option and, if it is, it can come with challenges or complications. And for all patients, manual surgery can also mean larger incisions and longer healing times.

With Mako, incisions are smaller and healing times faster. Because the scan maps the surgery so precisely, it allows surgeons to minimize their incision and how much bone is removed. "The robot can remove sections of bone that are thinner than a credit card," said McCollum.

Plus, the robot will only let physicians cut in the correct plane, and it won't allow them to cut further than they determined during planning. As McCollum says, “It creates protective boundaries for our patients, and as a result, is safer and more accurate than manual surgery."

Carol said she’s thrilled with how easy recovery has been and how much better her knee feels. She’s so happy with the surgery that she's planning to get her right knee replaced using the Mako System.

When asked what she dreams about doing once her knee replacements are complete, Carol said,"My goal is to walk Walt Disney World with my family." But today, just two weeks after her knee replacement, she's looking forward to attending her grandson's baseball game, minus the usual arthritis pain.

The Advanced Orthopaedic Center, one of the medical center six Centers of Excellence, offers award-winning care for all types of orthopaedic issues. The staff works to deliver the most advanced skills, interventions, and treatments available in East Tennessee.

For more information on Mako Robotic-Arm Assisted Surgery or to schedule an orthopaedic consultation at the Advanced Orthopaedic Center, request information or call 865-305-8848.

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