Knee surgery goes robotic at Swedish/Issaquah
March 20, 2012
By David Hayes
Jeff Pochop said he plans to be physically active until he’s at least 100 years old. Now 69, the former athlete stays fit biking and hiking so he can attend his annual fishing and hunting trips with his buddies.
Unfortunately, an old football injury had been slowing him down lately — he partially tore an interior ligament in his left knee while playing football for the Harvard Crimson back in the 1960s.
Temporary fixes were no longer working — he’d had an orthoscopic procedure to clean it up about 20 years ago and a series of rooster comb injections about six months ago. It was starting to affect his tennis game and his outings hunting chucker and pheasant.
“Even my hunting buddies had noticed I’d developed a limp,” the Bellevue resident said.
So he went back to the well one more time. His doctor, orthopedic surgeon Gregory Komenda, had also operated on injuries to Pochop’s shoulder and elbow. And the timing couldn’t have been better to try something new — robotics.
Pochop became one of Swedish/Issaquah’s first patients to be operated on using MAKOplasty. It’s a new partial resurfacing procedure developed to treat early- to mid-stage osteoarthritis, a viable alternative to total knee replacement or traditional manual partial knee resurfacing, Komenda said.
A surgeon with Proliance Orthopedic & Sports Medicine for the past 15 years, Komenda has been performing MAKOplasty at Swedish’s Seattle location for a little over a year.
MAKOplasty uses the RIO Robotic Arm Interactive Orthopedic System. Rather than the old days of flaying open a patient’s knee to gain access to the entire site, a 3-D picture is scanned to help the surgeon identify only the arthritic portion of the knee that needs treatment. Now, the procedure can be done through a three- to four-inch incision, preserving much more of the natural bone and tissue.
“I like the confidence it gives me to provide consistent and precise results,” Komenda said. “I know during the post operation check up, the X-ray will look perfect every time.”
The system develops a pre-surgical plan that outlines a specific technique for bone preparation and customized implant positioning based on a CT scan of the patient’s knee. During the procedure, the system creates a live, 3-D virtual view of the bone surface and correlates it to the pre-programmed surgical plan.
“The robotic arm provides real-time tactile, auditory and visual feedback, Komenda said. “This helps surgeons accurately balance the knee and correctly position the implants.”
However, as advanced as the new system is, MAKOplasty isn’t for everyone. Good candidates for the surgery must have three typical common traits:
- Knee pain with activity on the inner knee, under the kneecap or the outer knee,
- Pain or stiffness when starting from a sitting position,
- And failure to respond to nonsurgical treatments or nonsteroidal anti-inflammatory medication.
As a match for the system’s requirements, Pochop was excited to try something new.
“I was delighted to learn this thing was up there,” he said.
But due to logistics and an untimely assertion of Mother Nature, his Jan. 20 surgery almost wasn’t.
“That was the week of the snowstorm, so Swedish didn’t have the extra power for elective surgeries,” Pochop said. “And my part was stuck, somewhere out there in the nether world in transit.”
What to know
Free educational seminars about the MAKOplasty, a new robotic-assisted, partial-knee replacement (resurfacing) procedure, are from 6-8 p.m. April 4 at Swedish/Issaquah (Conference Center, Level 2), 751 N.E. Blakely Drive. Register at www.swedish.org/classes. Select ‘Health and Wellness,’ choose ‘Eastside,’ and scroll down to select ‘Joint Replacement: The Right Choice for You?’
Once the logistics were worked out, Komenda performed the MAKOplasty without a hitch and Pochop went home the next day.
Komenda said the new procedure isn’t necessarily faster than the old method, what with all the calibrations under the 3-D imaging necessary.
“What it does do is make the surgery more consistent,” he added. “And post op, a partial replacement has much quicker recovery than a full knee.”
Three weeks later, Pochop was back hiking and biking on flat surfaces. Then five and a half weeks later, he was given the green light to return to his favorite activities of biking local cross-country trails.
With his new partial implant in place, Pochop, a father of four and grandfather of seven, is almost done with his post-op physical therapy and anticipating returning to playing tennis twice a week.
“I’m told patients are getting up to 20 years of service out of these implants,” Pochop said. “That should almost get me to 100 before they’ll have to take another look at my knee.”
David Hayes: firstname.lastname@example.org or 392-6434, ext. 237. Comment at www.issaquahpress.com.