Robot helps make joint replacements more precise

MANSFIELD - Patients who have either their knee or hip replaced at the OhioHealth Mansfield Hospital will notice an extra helper on the medical staff: a robot named Mako.

The robot has helped with more than 700 procedures since it joined the team in January 2018, according to Dr. Matthew Bernhard, an orthopedic surgeon who has been replacing joints since 1995.

"I hope it doesn’t put me out of work," Bernhard joked, although he knew that would never happen. "It needs me to operate it. It actually adds safety, because it doesn't let the human physician cut where it's not supposed to."

The hospital purchased two Mako robots in the summer of 2017 for about $1 million each. Bernhard said it took six months for them to be calibrated.

The robot by itself is worthless until the hospital staff uploads the proper software for whatever type of surgeries they need help performing.

"It's an application, like on your phone," Bernhard said. "Each application costs about a quarter of a million to on-board it to the robot."

The only two applications the hospital has used so far are those for knees and hips.

"We try to do every single total joint that comes into the hospital with a robot," Bernhard said.

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Knee and hip replacements became a reality in the 1960s, and Bernhard said no real upgrades to the instruments have been made since the early 1990s. The advent of Mako is making the procedures more accurate and safe.

"You can make adjustments right as you go," Bernhard said. "The precision level is just phenomenal."

Most joint replacements over the last 50 years have been reliant upon the experience level of the doctor performing the procedures. Bernhard said a young doctor might know all of the technical information required to complete the surgery, but wouldn't be enough of a veteran to recognize slight peculiarities in the joint that might require special treatment.

"It really comes down to how long has the surgeon been doing it and how many replacements has he done," Bernhard said.

He said it's similar to a young pilot landing an airplane on an aircraft carrier in the dark for the first time. The robot provides night vision and guidance systems.

"The robot takes the guesswork out of what we're doing," Bernhard said. "It gives us precise alignment."

The procedures take about 10 minutes longer with the robot's help, but that's because it's helping doctors ensure the joints are lined up perfectly so that the patients don't have any issues walking in the future.

"You're collecting data points and you're analyzing information," Bernhard said.

Although patients are still required to complete physical therapy after the surgeries, Bernhard has noticed their recovery time has been reduced, and they are less stiff.

"I'm finding with my patients that they are getting extension and flexion must faster," Bernhard said. "I'm a believer that when the knee is put in perfect alignment, it will last longer. That's the goal."

ztuggle@gannett.com

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