Are you considering a joint implant to relieve your knee, hip or shoulder pain? For joint replacement surgery to be successful, surgeons have to make precise cuts in the damaged bone before implanting an artificial joint.
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Accuracy and proper alignment are two critical aspects of this process, says orthopedic surgeon Joseph George, MD. “Several things go into the planning of a well-done joint replacement, but it begins with balance and accuracy,” he says.
If you’re getting a knee replacement, for example, there’s a gap between your bones when your knee is straight and when it’s bent.
“The art of doing a knee replacement is making sure those gaps match,” Dr. George says. “If they don’t, you will have looseness in the range of motion at some point. This can lead to instability and pain.”
Improper alignment or rotation can also cause issues with your knee cap, he says. For these reasons, surgeons need to stay sharply focused on accuracy when cutting away damaged bone and aligning and positioning the new joint.
Tools for more accurate joint replacement
There are tools surgeons use to help ensure precision and accuracy. In the end, they help you recover faster so you can return to your day-to-day activities.
1. Digital templating helps surgeons plan
Through digital templating, your surgeon uses a computer program to create a pre-operative digital model of your shoulder, knee or hip. This helps determine how much bone or cartilage to remove and shows exactly where the cuts will go.
A clear plastic template over the X-ray gives the surgeon an idea of the size and shape of the implant the team will need.
“Before you show up to play a game, you need a plan,” he says. “Templating allows us to take a step back and verify everything is OK and we have the right size implant before performing surgery.”
2. Computer navigation offers precise mapping ability
Surgeons may use computer navigation to aid in mapping exactly where to remove the bone from the joint with better precision.
“It helps you plan your cuts by registering bony landmarks on the patient,” Dr. George says.
3. Custom-made guides match your anatomy
Custom-fit joint replacements also greatly improve accuracy in surgery. Customized implants match your exact anatomy, based on your CT or MRI scan.
If you need a knee replacement, for instance, your surgical team can generate a 3-D model of your knee after you undergo preoperative scans. This records the precise measurements of your knee, Dr. George says.
The team feeds the data into a computer. During surgery, the surgeon uses specialized tools or jigs customized for each patient. The jigs ensure that the bone incisions line up precisely with the geometry of the implant.
4. Robotic assistance: Another step toward precision
If your vision of robotic-assisted surgery is the scene where the blue robot fixes Luke Skywalker’s hand, don’t worry.
“The robot doesn’t do the surgery,” Dr. George says. “The surgeon is in control. The robot is just a mechanical arm that assists us in making the cuts where we have decided ahead of time to make them. It’s another tool we can use to make sure that we get a good, reproducible solid joint.”
With any robotic-assisted surgery, the process is the same as traditional surgery, he says.
The surgeon still has to make the same number of cuts or incisions. But the robot mimics the surgeon’s movements. The surgeon’s hands control the movement and placement of surgical instruments. This makes it easier to perform the surgery with greater precision.