Questions and Answers About MAKOplasty Surgery

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What is osteoarthritis?

Osteoarthritis (OA), a form of arthritis, is a degenerative joint disease characterized by the breakdown and eventual loss of joint cartilage.  Cartilage is a protein substance that serves as a cushion between the bones of a joint.  With OA, the top layer of cartilage breaks down and wears away, allowing bones under the cartilage to rub together.

What causes OA of the knee?

Although the root cause of OA is unknown, the risk of developing symptomatic OA is influenced by multiple factors, such as age, gender, and inherited traits that can affect the shape and stability of the
joints.  Other factors can include the following:

• A previous knee injury;
• Repetitive strain on the knee;
• Improper joint alignment;
• Being overweight; and
• Exercise or sports-generated stress placed on the knee joints.

What are the symptoms of OA of the knee?

Symptoms of OA of the knee include the following:

• Pain while standing or walking short distances, climbing up or down stairs, or getting in and out of chairs;
• Knee pain with activity;
• Start-up pain or stiffness when activities are initiated from a sitting position;
• Stiffness in the knee joint after getting out of bed;
• Swelling in one or more areas of the knee; and
• A grating sensation or crunching feeling when using the knee.

How is OA of the knee diagnosed?

Your physician will begin by reviewing your medical history and discussing your symptoms with you. He or she will observe the natural movement of your knee, evaluate your knee and ankle joint alignment, and check your reflexes, muscle strength, range of motion, and ligament stability in the affected knee.  Your physician may order X-rays to determine how much joint or bone damage has been done, how much cartilage has been lost, and whether bone spurs are present.  Additional medical imaging tests, such as computed tomography or magnetic resonance imaging, may be ordered to determine the exact site and the extent of the damage.  Your physician may also order blood tests to rule out other causes of symptoms or may order a joint aspiration, which involves drawing fluid from the joint through a needle and examining the fluid under a microscope.

How is OA treated?

Whether your OA is mild or severe, your physician will likely recommend certain lifestyle changes to reduce stress on your knee joints.  Additional disease and pain-management strategies may include physical therapy, steroid injections, and over-the-counter pain medications, such as cetaminophen, nonsteroidal anti-inflammatory drugs, or topical pain relieving creams.

You should speak with your physician if your symptoms are not responding to non-surgical solutions or if your pain can no longer be controlled by medication.  You could be a candidate for surgery.

The most common surgical knee intervention performed for OA is a total knee replacement.  During this procedure, the natural joint is removed and replaced with an artificial implant.  This treatment option is usually offered to patients with advanced osteoarthritis of the knee.

Total knee replacement is not always optimal for patients with early- or mid-stage osteoarthritis in just one or two compartments of the knee.  For atients with partial OA of the knee, MAKOplasty® Partial Knee Resurfacing may be the more appropriate solution.

What is MAKOplasty®?

MAKOplasty® Partial Knee Resurfacing is an innovative treatment option for adults seeking relief from the pain of early- to mid-stage osteoarthritis (OA) in the medial (inner), patellofemoral (top), or lateral (outer) compartments of the knee. Powered by the RIO® Robotic Arm Interactive Orthopedic System, MAKOplasty® offers surgeons consistently reproducible precision in performing partial knee resurfacing. 

Saint Michael’s Medical Center in Newark is the only hospital in New Jersey offering this minimally invasive procedure.  MAKOplasty® enables the hospital’s orthopedic specialists — committed to serving the community’s largely underserved population — to address the needs of patients seeking effective treatment, reduced pain, rapid recovery, and a quick return to their active lives.

Unlike a total knee replacement, MAKOplasty® results in repair to only the diseased portion of the knee, sparing the patient’s healthy bone and surrounding tissue.  An implant is then secured in the joint to allow the knee to move smoothly again.

MAKOplasty® partial knee resurfacing offers a variety of benefits:

• It facilitates optimal implant positioning to result in a more natural feeling knee following surgery;
• It results in a more rapid recovery and shorter hospital stay as compared to recovery from traditional knee-replacement surgery;
• It can be performed on an outpatient basis;
• It promotes rapid relief from pain and a faster return to daily activities; and
• As a knee arthroplasty procedure, MAKOplasty® is typically covered by most Medicare-approved and private health insurers.

The MAKOplasty® Partial Knee Resurfacing procedure is designed to relieve the pain caused by joint degeneration and potentially offers the following benefits:

• Improved surgical outcomes;
• Less implant wear and loosening;
• Precise joint resurfacing;
• Less bone removal;
• Smaller incision;
• Less scarring;
• Reduced blood loss;
• Minimal hospitalization; and
• Rapid recovery.  *

How does MAKOplasty® work?

The RIO®  Robotic Arm Interactive Orthopedic System features three-dimensional pre-surgical planning.

During MAKOplasty®, the RIO®   system provides the surgeon with real-time visual, tactile, and auditory feedback to facilitate optimal joint resurfacing and implant positioning.  It is this precise placement that can result in more natural knee motion following surgery.

Who would be a good candidate for the MAKOplasty® procedure?

Typically, MAKOplasty® patients share certain key characteristics:

• Knee pain with activity, usually on the inner knee and/or under the knee cap, or the outer knee;
  
• Start-up knee pain or stiffness when activities are initiated from a sitting position; and
• Failure to respond to non-surgical treatments or nonsteroidal anti-inflammatory medication.

If I undergo MAKOplasty®, what can I expect?

MAKOplasty® can be performed either as an inpatient procedure or on an outpatient basis, depending on what your orthopedic surgeon determines is right for you.  Hospital stays average from one to three days; ambulatory patients return home the same day.

In many cases, patients are permitted to walk soon after surgery, drive a car within two weeks, and return to normal daily activities shortly thereafter.  *

What is the lifespan of a MAKOplasty® implant?

Implants have a life expectancy that depends on several factors, including the patient’s weight, activity level, quality of bone stock, and compliance with his or her physician’s orders.

Proper implant alignment and precise positioning during surgery are also very important factors that can improve the life expectancy of an implant.  Surgeons using RIO® can achieve optimal implant alignment and positioning to ensure the longest benefit.  RESTORIS® MCK implants enable the treatment of one or two compartments with OA disease.  With single compartment disease, a second compartment may be treated in the future if OA spreads.  In addition, because very little bone is actually removed during a MAKOplasty® procedure, the implants can be replaced with another procedure, such as a total knee replacement, if necessary.

* Individual results may vary.  There are risks associated with any surgical procedure, including MAKOplasty®.  Your doctor can explain these risks to you and help you determine whether MAKOplasty® is right for you.