OhioHealth Enhances Patient Care with Orthopedic Robotic-Assisted Surgery

OhioHealth is using orthopedic robotic-assisted surgery as a technology to enhance the ability to perform hip and knee replacements with improved accuracy, while also providing a less invasive technique. OhioHealth performed its first robotic-assisted partial knee replacement in 2010 using the MAKO® platform.  Since then, the organization has invested in software and platform enhancements to now offer robotic-assisted total knee replacement and hip replacement. 

James Miller, DO, Orthopedic Surgeon with OhioHealth Physician Group is a physician utilizing this technology. He is fellowship-trained in Adult Joint Reconstruction, and he specializes in hip and knee joint replacement.

“The robotic software allows for the surgery to be pre-operatively planned based on a 3D-CT scan of the patient’s (hip or knee) anatomy,” Dr. Miller said, “This scan provides us with significant detail for planning patient-specific sizing and positioning of the replacement implants. The robot also allows for us to get the leg lengths to within a millimeter or accuracy. This is a HUGE benefit of using robotics in hip replacement and important to emphasize.”

All planning is performed ahead of the surgery before the patient even enters the operating room. This level of planning allows for minimization of unexpected challenges in the operating room.

“Although the plan is made ahead of the surgery, there are still adjustments that can be made during the surgery prior to performing the final critical steps of the procedure,” Dr. Miller said, “Once the plan is confirmed intra-operatively, the robotic arm allows the surgeon to make bone cuts to within a single millimeter and/or degree of accuracy for preparation of the final implants.”

Not all patients recover the same, but typically after the surgery, patients who undergo joint replacement can expect close to full recovery within six to eight weeks.

“This less invasive technique preserves the surrounding soft tissue and can provide the patient with a quicker, easier recovery, significantly less pain and more rapid return to daily activities. Depending on the health of the patient, some of these surgeries can even be performed in a same-day, outpatient setting.” Dr. Miller said.

Q: Does the robot do the surgery by itself?

A:  The robot does not perform the surgery by itself, the surgeon controls the robotic arm when making the bone cuts during the surgery.  The robot is a platform, utilized by the surgeon, which contains an arm that uses haptic technology and live feedback to perform the preoperatively planned bone cuts to within a millimeter and degree of accuracy. This accuracy re-establishes the patient’s normal anatomy/alignment and allows the improvement of the longevity of a patient’s hip/knee replacement.

Q: Does insurance cover this procedure?

A: Almost all companies cover hip and knee replacement procedures. This is not affected by the “technique” utilized for performing the surgery itself. However, some insurance companies are starting to cover an extra fee that may be charged for using robotic technology to assist with hip and knee replacement.

Q: Why is this technique significant for OhioHealth and the surgeons who utilize it?

“The volume of joint replacements performed in our country has been rapidly increasing over the past decade and is expected to continue to increase by almost 600% by the year 2030. Further projections predict that over 3.5 million joint replacements will be performed annually in the United States in 2040. With these expected projections, there has been a significant precedence placed on safety, patient outcomes and the longevity of surgical implants for hip and knee replacement. Technology such as the robotic software utilized at OhioHealth provides our surgeons with an extra tool to ensure our ability to perform accurate joint replacement surgery to the highest standard.”

Kurtz et al. Projections of Primary and Revision Hip and Knee Arthroplasty in the United States from 2005 to 2030. JBJS 2007; 89: 780-785.

Singh et al. Rates of Total Joint Replacement in the United States: Future Projections to 2020-2040 Using the National Inpatient Sample. Journal of Rheum; 2019: 1134-1140.