What is Partial Knee Resurfacing?
Partial knee resurfacing, commonly referred to as partial knee replacement, is an alternative to total knee replacement in patients with a degenerative joint disease on only one side or one compartment of the knee. Partial knee resurfacing is a surgical procedure that involves resurfacing and replacement of only the diseased surface of the knee joint instead of the entire joint.
The knee has three compartments, the medial (inside), the lateral (outside), and the patellofemoral (kneecap) compartment. Partial knee resurfacing may be an option depending on the affected surface. During the procedure, your surgeon removes only the damaged area of the bone in the affected knee and fits the implant to that bone.
What is MAKOplasty Partial Knee Resurfacing?
MAKOplasty partial knee resurfacing is a robotic arm-assisted partial knee resurfacing surgery designed to alleviate the pain caused by degenerative joint disease, such as osteoarthritis. By selectively targeting the segment of your knee damaged by osteoarthritis, your surgeon can resurface the knee while sparing the healthy ligaments and bone surrounding it.
During the surgery, MAKOplasty utilizes the RIO® Robotic Arm Interactive Orthopedic System to assist the surgeon in aligning and positioning implants more precisely. Accurate placement and alignment of the knee implant are crucial in partial knee resurfacing surgery. MAKOplasty’s RIO® Robotic Arm Interactive Orthopedic System has three-dimensional pre-surgical planning. The RIO® provides the surgeon with real-time visual, tactile and auditory feedback to facilitate optimal joint resurfacing and implant positioning. Such optimal placement can result in a more natural knee motion following surgery.
MAKOplasty Partial Knee Resurfacing Features:
- Accurately plans implant size, orientation, and alignment utilizing CT-derived 3-D modeling
- Enables the pre-resection capture of patient-specific kinematic tracking through full flexion and extension
- Offers real-time intra-operative adjustments for correct knee kinematics and soft-tissue balance
- Minimally invasive and bone sparing, with minimal tissue trauma for faster recovery.
Anatomy of the Knee
The knee is made up of the femur (thighbone), tibia (shinbone), and patella (kneecap). The lower end of the femur meets the upper end of the tibia at the knee joint. A small disc of bone called the patella rests on a groove on the front side of the femoral end. The fibula, another bone of the lower leg, forms a joint with the shinbone. The bones are held together by protective tissues, ligaments, tendons, and muscles. Synovial fluid within the joint aids in the smooth movement of the bones over one another. The meniscus, a soft crescent-shaped area of cartilage between the femur and tibia, serves as a cushion and helps absorb shock during motion.
Indications for MAKOplasty Partial Knee Resurfacing
MAKOplasty partial knee resurfacing is usually indicated as a treatment option for patients with early to mid-stage osteoarthritis in either the medial (inside), patellofemoral (top), or both compartments of the knee.
Osteoarthritis, also called degenerative joint disease, is the most common form of arthritis. It occurs most often in the elderly. This disease affects the cartilage at the ends of bones in a joint. In osteoarthritis, the cartilage becomes damaged and worn out, causing pain, swelling, stiffness, and restricted movement in the affected joint.
MAKOplasty partial knee resurfacing can be considered in patients with pain while bearing weight on the affected joint, pain or stiffness in the knee while walking or performing other activities, and also in patients not responding to a conservative line of management.
Preparation for MAKOplasty Partial Knee Resurfacing
Preparation for MAKOplasty partial knee resurfacing surgery may involve the following steps:
- A review of your medical history and a physical examination are performed by your doctor to check for any medical issues that need to be addressed prior to surgery.
- Depending on your medical history, social history, and age, you may need to undergo tests such as blood work and imaging to help detect any abnormalities that could compromise the safety of the procedure and obtain dental clearance.
- You will be asked if you have allergies to medications, anesthesia, or latex.
- You should inform your doctor of any medications, vitamins, or supplements you are taking or any conditions you have such as heart or lung disease.
- You may be asked to avoid medications such as blood thinners, aspirin, or anti-inflammatories for a specific period prior to surgery.
- You should refrain from alcohol or tobacco at least a few days prior to the surgery and several weeks after as it can hinder the healing process.
- You should not consume any solids or liquids at least 8 hours prior to surgery.
- You should arrange for someone to drive you home after surgery.
- A signed informed consent will be obtained from you after the pros and cons of the surgery have been explained.
Procedure for MAKOplasty Partial Knee Resurfacing
Prior to surgery, a CT (computed tomography) scan is obtained, which the MAKOplasty RIO system utilizes to make a virtual 3-D anatomical model of your knee. This model enables your surgeon to plan the alignment and placement of your knee implants before the surgery. Once the surgical plan is established, it is programmed into the RIO system, which generates a “safety zone” for bone removal. During the procedure, the surgeon controls the robotic arm and is aided by computer imaging that assists to ensure exact implant placement.
MAKOplasty partial knee surfacing surgery is usually done under general anesthesia with you appropriately placed on the operating table. A 2- to 3-inch incision is made over your knee as opposed to an 8-inch or larger incision required for traditional total knee replacement surgery. As MAKOplasty selectively targets only the segment of your knee damaged by osteoarthritis, it resurfaces your knee while sparing the healthy ligaments and bone surrounding it. A patient-specific implant is then secured over the prepared segment of your knee joint to allow it to move smoothly again. MAKOplasty partial knee resurfacing combines a 3-dimensional CT scan, computer navigation, and a surgeon-actuated robotic arm for improved surgical precision. In addition, the preservation of your own natural tissue and bone along with a more ideal customized implant positioning also results in a more natural feeling knee.
Postoperative Care and Recovery
In general, postoperative care and recovery after MAKOplasty partial knee resurfacing surgery involves the following:
- You will be transferred to the recovery room where your nurse will closely observe you for any allergic/anesthetic reactions and monitor your vital signs as you recover.
- As it is a minimally invasive procedure, you may need to stay in the hospital for a day or two before being discharged home.
- You may notice pain, swelling, and discomfort in the knee area. Pain and anti-inflammatory medications are provided as needed to address these.
- Antibiotics may also be prescribed to address the risk of surgery-related infection.
- You will be placed on assistive devices such as crutches with instructions on restricted weight-bearing for a specified period of time. You are encouraged to walk with assistance as frequently as possible to prevent blood clots.
- Instructions on surgical site care and bathing will be provided to keep the wound clean and dry.
- Refrain from strenuous activities for the first few months and lifting heavy weights for at least 6 months. A gradual increase in activities over a period of time is recommended.
- An individualized physical therapy protocol will be designed to help strengthen knee muscles and optimize knee function once you are off crutches.
- Most patients are able to walk soon after surgery, drive a car in the first few weeks, and return to normal daily activities in 3 to 4 weeks.
- A periodic follow-up appointment will be scheduled to monitor your progress.
Benefits of MAKOplasty Partial Knee Resurfacing
Being a minimally invasive procedure, MAKOplasty partial knee resurfacing offers the following benefits:
- Smaller incisions
- Shorter hospital stay
- Less postoperative pain
- Minimal scarring/muscle trauma
- Increased surgical precision and implant positioning
- Increased longevity of the implant
- Quicker return to normal activities
- Improved range of motion
Risks and Complications
MAKOplasty partial knee resurfacing is a relatively safe surgery; however, as with any surgery, there are risks and complications that can occur, such as:
- Knee stiffness/instability
- Blood clots or deep vein thrombosis (DVT)
- Allergic/anesthetic reactions
- Damage to adjacent soft-tissue structures
- Implant fracture/failure