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Thu Dec 08 20:09:05 SAST 2016

Robotic arm used to perform Africa’s first hip and knee replacements

Roxanne Henderson | 2016-11-18 19:29:00.0

Image by: YouTube

Doctors have performed Africa's first orthopaedic surgery using a robotic arm.

On Thursday Dr Ebrahim Hoosen and Dr Lipalo Mokete‚ using the transformative technology‚ saw two hip replacements and one partial knee replacement go off without a hitch.

After being operated on by the robotic arm‚ their three patients are recovering in a hospital in Modderfontein‚ Johannesburg‚ without any complications.

“They had a very good night's sleep last night and thoroughly enjoyed their breakfast‚” hospital group Busamed's chief operating officer Barbara Moore said on Friday.

Over the past eight years the Mako Robotic-Arm has performed more than 70 000 surgeries in 19 countries. Now South Africans can get in on the action.

The robotic arm cannot do operations on its own‚ but it is a tool used to achieve more accurate results.

Surgeons do skin incisions and expose the joints to be operated on‚ and the robotic arm does the work of cutting bone and placing implants.

United States Professor of orthopaedic surgery Dr Richard Illgen‚ who trained at Harvard University with the doctor who had performed the first hip replacement in the United States in the 1960s‚ says the technology has been transformative in his practice.

“What I realised in the first decade of my career is you hit a certain point where you can't get any better with your manual techniques. You've done a thousand hip replacements and there are still limitations‚ there are still dislocations‚ there are still inaccuracies that happen.

“No matter how good you are‚ no matter how hard you work‚ no matter how hard you strive to be the best that you can be‚ there is human error that comes into play. What this technology essentially does is eliminate human error. It allows you to be accurate every time.”

With increased accuracy patients enjoy better results.

According to Illgen‚ who was involved with the robotic arm's development‚ one in five patients are dissatisfied or very dissatisfied with the results of their manual total knee replacement surgeries.

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Over the years he has seen the robotic arm provide patients with greater satisfaction‚ less pain and longer-lasting implants with fewer dislocations.

“It was very satisfying to see that what we were doing in terms of accuracy and reliability in the operation translated into better patient outcomes.”

The technology enables surgeons to create a patient-specific pre-operative plan for each procedure‚ before the patient goes under the scalpel.

The robotic arm‚ physically controlled by the surgeon‚ then cuts away at bone and places implants according to the specifications.

The arm physically stops the surgeon from removing bone that was not intended to be cut out. Once it has registered where the patient is in space‚ it will not cut outside the planned area.

Cameras allow doctors to see the procedure they are performing in greater detail than they would be able to see with the naked eye.

Mokete and Hoosen‚ the first local orthopaedic surgeons to perform the robotic surgery‚ spent one week in the US learning how to use the technology.

Mokete said that once medication‚ weight-loss and other conservative treatment have failed to reduce an arthritis sufferer's pain‚ surgery may be an option.

If a patient has arthritis in one component of their knee‚ they are probably good candidates for partial knee replacement surgery.

People who may benefit from robotic hip replacement surgery are people who have been in accidents and those who suffer from arthritis and osteonecrosis.

Osteonecrosis is a condition where bone dies because of poor blood flow. This condition is associated with HIV‚ alcohol abuse and steroid use.

Contrary to the traditional belief that joint replacement procedures are for the elderly‚ Mokete says he operates on many young people.

With the potential risks linked to manual surgery he would previously have asked younger patients to wait until they are older for surgery. Younger patients are also likely to require replacements again later in their lives.

The new technology and the demands of patients are now changing this.

“Joint replacements are quality of life operations. You need a job now‚ you to be active now‚ you need a better quality of life now‚” Mokete said.

Busamed has brought the robotic arm into South Africa through a three-year deal with orthopaedic device company Stryker.

The group plans to have three robotic arms‚ one in each of the main cities - Johannesburg‚ Cape Town and Port Elizabeth - by the end of this period.

The technology for total robotic knee replacement surgery will soon hit the US market.

- TMGDigitial

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