Robodoc will see you now – for the perfect new knee

Robodoc will see you now: High-tech £800,000 surgeon set to transform knee replacements with perfect joint fitting for thousands of NHS patients

• A robot surgeon is set to transform knee replacements for thousands of patients
• £800,000 ‘robodoc’ is so exact it lets doctors make artificial joints fit perfectly 
• Surgeons hope it means implants will now last a lifetime – helping patients avoid more surgery and saving the NHS vital cash 

A high-tech robot surgeon is set to transform knee replacements for thousands of NHS patients.

The £800,000 ‘robodoc’ is so precise it allows doctors to make artificial joints fit perfectly, reducing the chances of them wearing out after ten or 15 years, as many do.

Surgeons hope it means implants will now last a lifetime – helping patients avoid more surgery and saving the NHS vital cash.

Called Mako and made by US tech firm Stryker Inc, the device has been used in the UK private healthcare sector for some years.

The £800,000 ‘robodoc’ is so precise it allows doctors to make artificial joints fit perfectly

But now a number of NHS trusts are adopting the technology to try to improve outcomes for patients.

The Queen Alexandra Hospital in Portsmouth is using the Mako machine for knee and hip replacements, while the Royal Orthopaedic Hospital in Birmingham says it has plans to make it available to NHS patients soon.

About 90,000 knee replacements are carried out each year in the UK to help people who have had crippling osteoarthritis, in which the smooth cartilage that lines the joints wears away, leading to pain while moving.

The procedure usually involves highly skilled surgeons cutting out bone and cartilage before fitting a new implant. But it can be extremely difficult to ensure man-made joints are a perfect fit for the patient’s anatomy. As a result, components rub against each other and, over time, wear away. The robodoc device reduces the risk of this happening because of its pinpoint accuracy, claim some experts.

First, medics take a CT scan of the patient’s joint, creating a virtual model of the knee. Using this computerised model, they can practise the surgery on a 3D image of the patient’s joint to ensure the new joint is a snug fit, reducing the dangers of wear and tear.

The data is then fed into the Mako machine, a mobile device about the size of a small fridge, with a robotic arm protruding from the top.

The device does not actually carry out the surgery – instead the robotic arm guides the surgeon as they hold a cutting instrument called a burr. This grinds away bone on the top of the tibia (the knee bone) and the bottom of the femur (the thigh bone) so the implant fits snugly. The robot’s role is to guide the surgeon’s hand so only the precise amount of bone is removed to make the new joint fit. If the surgeon goes as little as one-tenth of a millimetre too deep into the bone, the computer console beeps and flashes red as a warning. And if the surgeon strays fractionally off to one side, the robotic arm nudges their hand gently into the correct position.

All this ensures the position of the replacement knee matches the location of the original one as closely as possible.

Now a number of NHS trusts are adopting the technology to try to improve outcomes for patients (file image)

A study by a team from University College Hospital London analysed the impact of the Mako device on 40 patients undergoing knee replacement compared with conventional surgery. The results showed that it slashed post-operative pain and cut the time to hospital discharge from nearly five days to just three.

Jeremy Rushbrook, consultant orthopaedic surgeon at Portsmouth Hospitals NHS Trust, says: ‘The robot will not cut outside the area of unhealthy bone and therefore protects the surrounding areas from damage. The result is a significant reduction in pain.

‘Patients who have had previous knee replacements have said how much more comfortable they are after surgery with the robot.

‘It also provides significant cost savings for the trust as there is less analgesia requirement, less blood loss, and reduced discharge times.’

One of the first NHS patients to receive an implant with the Mako robot was Diane Proudlock, 72, from Waterlooville, Hampshire, who had severe pain in her right knee for almost a decade.

The retired secretary says: ‘I could hardly walk on it and couldn’t straighten my knee.

‘If I was going shopping I would have to hang on to my husband Ron or the supermarket trolley.’

Diane had the robotic procedure earlier this year at the Queen Alexandra. She says: ‘Within 24 hours I was walking about and able to bend my knee 90 degrees. I was in hospital for only two nights and discharged with crutches. After two weeks, the staples from my incision were removed at my GP surgery.’

Now she just needs an occasional painkiller and is fully mobile.

‘My new knee feels fantastic and I am enjoying my long walks with my dogs and Ron once more,’ she says.

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