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The implantation of a knee endoprosthesis is a successful operation. Nevertheless, up to 15% of patients are not completely satisfied with the result. In order to achieve a high level of satisfaction, an individually customised bony implantation of the prosthesis should be carried out, taking into account the patient’s individual anatomical conditions and ligament tension.
The Mako robotic technique supports the surgeon by combining 3-dimensional bone CT data with intraoperatively recorded soft tissue tension and robotic arm-assisted saw cuts.
Prosthesis planning has been a core competence of the ECOM® medical partnership for years. We have our own whole-leg X-ray and have been planning prosthesis implantation with the digital planning tool mediCAD for years.
This has already made it possible to achieve increasingly greater precision in the implantation of knee endoprostheses and to gain valuable clinical experience regarding the desired individual target values of different prosthesis positioning, depending on the existing leg axis and soft tissue guidance.
The Mako technology robotic arm-assisted surgical procedure for implanting partial and full prostheses in the knee joint optimises this even further in three areas:
1. first, a computer tomography (hip, knee and ankle joint) is performed and a three-dimensional virtual model of the knee joint to be operated on is created. Based on this, we create a preliminary plan of how the knee implant of the appropriate size can best be placed on the bone surface.
CT sections and 3D model of the bony anatomy for surgical planning (Stryker)
Planning the positioning of the prosthesis in the 3D model (Stryker)
2 The second step takes place during the operation. Here, the three-dimensional knee model is transferred to the real knee joint. Firstly, transmitters are temporarily attached to the thigh and lower leg. The surface of the knee joint is precisely recorded using a fine tactile instrument. To do this, 40 points are scanned on the surface of the thigh bone and the lower leg bone. The operation is only continued if a match is achieved with a deviation of less than 0.5 mm.
3. in a third step, the tension of the ligaments of the knee joint, the capsule and the surrounding soft tissue sheath is recorded. This finally allows a very precise analysis of the knee joint function. Further planning adjustments are made in order to achieve optimum implant alignment in relation to both the bone and the soft tissue tension.
Planning and dynamic checking of the ligament tension during the operation with the leg axis (Stryker)
Based on the previously prepared planning, the bone cuts are made using the MakoTM robotic arm. The robotic arm holds the instruments for preparing the bone in the correct position while the surgeon performs the bone cuts independently. As the robotic arm knows the exact boundaries of the bone, even in poorly visible areas of the knee joint, and thus automatically stops the saw, soft tissue damage is avoided.
The robot arm holds the saw in the exact planned position (green area) and is guided by the operator. (Stryker company)
Once the incisions have been made, a trial implantation of the prosthesis is carried out. This is followed by an analysis of the stability, mobility of the knee joint and the position of the implants. This is carried out by both the surgeon and the robot. The trial implants are only removed and the original implant fitted once an ideal result has been achieved.
As of 2022, the company has 16 years of experience in robotic arm-supported prosthesis implantation and has over 1,500 systems installed worldwide. Over 850,000 implantations have already been performed. There are now more than 300 reviewed studies and publications.
Specialist in orthopaedics and trauma surgery
ZB Sports medicine, chirotherapy
Specialist in orthopaedics and trauma surgery
Specialist in orthopaedic surgery
Do you have questions about Mako Smart Robotics in knee prosthetics? Our specialists will be happy to provide you with detailed information and advice in a personal consultation. Simply make an appointment. We look forward to hearing from you.
Sehr geehrte Besucher,
Sie verlassen nun den Internetauftritt der ECOM® – Praxis für Orthopädie, Sportmedizin und Unfallchirurgie Dr. Erich Rembeck, Dr. Alexander Rauch, Prof. Dr. Hans Gollwitzer, Prof. Dr. Patrick Weber – Ärztepartnerschaft aus München.
Sie werden weitergeleitet auf den Internetauftritt von ECOM – Zentrum für Regenerative Medizin und Stammzelltherapie Dr. Erich Rembeck, Dr. Alexander Rauch, Prof. Dr. Hans Gollwitzer, Prof. Dr. Patrick Weber in Thiersee, Österreich.
Die im folgenden beschriebenen Therapien finden ausschließlich in Österreich statt und sind von der Ärztekammer Tirol, sowie der Österreichische Agentur für Gesundheit und Ernährungssicherheit (AGES) genehmigt.
Bitte bestätigen Sie mit OK. Wir bedanken uns für Ihr Interesse!
