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Far Too Young to be Feeling So Old

Robotic partial knee replacement surgery gets Glenside woman back in her hiking boots.

Eileen Mather and her dogs“Like many people, I was under the misconception that you had to wait until you were old and severely disabled by arthritis pain to have joint replacement surgery,” said Glenside resident Eileen Mather. “I was only in my early 50s and had grown tired of sitting on the beach like an old lady.”

Eileen’s reflection comes on the heels of the technologically advanced mini-partial knee replacement surgery she underwent at Abington – Jefferson Health’s Orthopaedic and Spine Institute (OSI) in March 2015. The second of two joint replacement procedures Eileen had experienced in two years, the mini-partial knee surgery was made possible by a sophisticated robotic arm system used under the skilled guidance of Andrew M. Star, MD, chief of Orthopaedic Surgery, Abington Hospital – Jefferson Health.

Robotic ArmThe procedure, known as MAKOplasty®, is among the newest options for mini-partial knee replacement surgery. Harnessing advances in robotic and computerized technology, surgeons at the OSI are able to replace – with greater precision than ever before – just the part of the knee damaged by osteoarthritis (rather than replacing the total joint). “Although we’ve been performing partial knee replacements for nearly 15 years, today we can use MAKOplasty to completely customize the procedure for each individual, sparing as much healthy bone and tissue as possible,” said Dr. Star, who also serves as medical director, OSI. “In most cases, we save two-thirds of the knee.”

“After the robotic mini-partial, I felt really well in just two weeks and had very little pain. These procedures transformed my lIfe.

Ideal candidates for MAKOplasty are those who, like Eileen, are in their 40s and 50s with osteoarthritis that affects one side of the joint. Like other minimally invasive procedures, the mini partial-knee surgery is performed through a relatively small incision using specialized tiny instruments. The advanced MAKOplasty, however, results in less bleeding, dramatically reduced recovery and rehabilitation time, and an implant that moves more naturally than a total joint replacement.

Eileen is not new to joint replacement surgery. In 2013, Dr. Star performed a mini-total knee replacement surgery on Eileen’s left knee. Although she also had osteoarthritis in her right knee, it did not require surgery when her left knee was replaced. The disease continued to progress in Eileen’s right knee, but still affected only part of the joint when Dr. Star presented her with the newly available option of a mini-partial knee replacement. Having been specialty trained in the procedure, he could perform the robotic arm surgery before arthritis damaged Eileen’s entire joint. Because she had been so pleased with the results of her first joint replacement surgery, Eileen was eager to pursue the new option with Dr. Star.

A Custom Fit for Each Patient

The complexity of knee replacement surgery requires surgeons to align the knee with as much precision as possible. “With MAKOplasty computer guidance, we meticulously plan the surgery in advance with CT scans prior to surgery,” explained Dr. Star. The pre-operative CT scans provide an extremely accurate 3-D evaluation of the knee’s anatomy and a model for the computer to design a perfect fit for each patient.

“During surgery, we put that plan into action,” said Dr. Star. “At that time, we are also able to test the tension in the ligaments and refine the fit as needed. Next, we cut the bone surfaces to place the artificial components of the knee.” The cut is perfect, thanks to computer guidance and the robotic arm’s exactness. In the past, computerguided surgery was not nearly as precise, sometimes requiring surgeons to remove additional bone for a better fit.

Having experienced both procedures, Eileen said she’s been very satisfied with the results of both. “Following the mini-total surgery, I felt great after 10 weeks, but still had some pain,” she recalled. “After the robotic mini-partial, I felt really well in just two weeks and had very little pain.” In retrospect, Eileen said she wished she had undergone surgery sooner. “These procedures transformed my life.”

The Climb Back to Better Health

Eileen understands that due to wear and tear, artificial joints do not last forever, and she’ll most likely have to undergo revision surgery in the future. “I’m okay with that,” she said. “There’s longevity in my family and I plan to be exploring and feeling good well into my 70s and beyond.”

Hiking BootsExploring comes naturally to Eileen, who has travelled annually to Spain with husband Joe to visit family. “A few years ago, I would wait in cafes in severe pain with swollen knees, while everyone else was off having adventures,” she said. That is no longer the case. Just two and a half months after her most recent surgery, Eileen put her refurbished knee to the test. She and Joe spent 18 pain-free days trekking through the terrain of Sweden, Denmark and Spain, including a hike up the Rock of Gibraltar.

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