Makoplasty is a robotic partial knee replacement method applied to suitable patients where only a specific part of the knee osteoarthritis is affected, preserving healthy bone and ligaments. With the support of the Mako robotic system, personalized planning is performed via 3D tomography, and the goal is to replace only the damaged joint area with a prosthesis.
What is Makoplast?
Makoplasty, commonly known as robotic partial knee replacement or robotic partial knee prosthesis, is a surgical procedure.
The knee joint is not made up of a single surface. It has different sections located on the inner, outer, and behind the kneecap. In some patients, osteoarthritis may affect only one of these sections without spreading to the entire knee.
In this case, replacing only the damaged section may be considered instead of a total knee replacement. In partial knee replacement, the remaining bone surfaces, ligaments, and healthy joint sections of the knee are preserved as much as possible.
The Mako Partial Knee system supports personalized planning based on the patient’s 3D tomography data and the placement of the prosthesis in the planned position.
What does partial knee replacement mean?
The word “partial” means a portion of the joint. In partial knee replacement, only the osteoarthritic part of the knee joint is replaced with a prosthesis, not the entire knee joint.
In total knee replacement, multiple sections of the knee joint are replaced, while in partial knee replacement, the goal is to preserve healthy areas.
This method may be considered particularly in suitable patients with localized osteoarthritis on only the inner, outer, or posterior side of the kneecap. The American Academy of Orthopaedic Surgeons also defines partial knee replacement as a method in which only the damaged portion of the knee is replaced with metal and plastic parts.
What is the difference between macoplasty and total knee replacement?
In both methods, the goal is to replace painful and worn joint surfaces with prostheses. However, the amount of joint replaced differs.
In Makoplasty
- Only the calcified section is replaced.
- Healthy bone tissue is preserved as much as possible.
- It may be possible to preserve the anterior and posterior cruciate ligaments.
- Healthy parts of the knee joint are not interfered with.
- A smaller prosthesis is used.
In Total Knee Replacement
- Multiple sections of the knee joint are replaced.
- Larger surfaces of the femur and tibia are prepared.
- Common osteoarthritis and advanced deformities in the knee are treatable.
- It may be preferred in patients where osteoarthritis affects almost the entire knee.
The appropriate method is determined not only by the patient’s preference but also by the examination and imaging results.
Who is a candidate for Makoplasty?
Robotic partial knee replacement is not suitable for every patient with osteoarthritis. One of the most important conditions is that the osteoarthritis is limited to a specific part of the knee.
Makoplasty may be considered especially in the following situations:
- The osteoarthritis is found only on the inner or outer part of the knee.
- Limited joint wear behind the kneecap.
- largely preserving the function of the knee ligaments.
- The knee movement has not been completely lost.
- The leg deformity is at a level that can be corrected.
- Failure to achieve sufficient benefit from medication, physical therapy, and injections.
- Knee pain significantly affects daily life.
Whether a patient is suitable for a partial prosthesis is evaluated through a detailed orthopedic examination, standing X-rays, and necessary imaging methods.
In which patients might it not be suitable?
If osteoarthritis has spread to multiple sections of the knee, a partial knee replacement may not be sufficient.
Moreover;
- Severe ligament damage,
- Significant and uncorrectable leg curvature,
- Widespread inflammatory rheumatic disease,
- Severe limitation in knee movement,
- Osteoarthritis affecting many parts of the knee joint.
Total knee replacement may be more suitable for patients with these conditions.
Before surgery, not only is the painful area examined. The entire knee is evaluated in detail.
How to Plan a Makoplasty (Makoplasty)?
Mako robotic partial knee replacement surgery begins with a patient-specific planning process.
Computed tomography (CT) scans of the patient’s knee and leg area are taken. These images are processed in the Mako system to create a three-dimensional digital model of the knee joint.
The surgeon is using this model;
- The boundaries of the calcareous zone,
- Bone structure,
- The size of the prosthesis to be used,
- The position of the prosthesis,
- The amount of bone to be removed,
- Joint space,
- Balance of the knee ligaments
They can evaluate it before the surgery.
Mako’s CT-based 3D planning helps position the prosthesis according to the patient’s unique anatomy.
Why is 3D CT Scanning Important?
Every patient’s knee structure is different. The size and angle of the bones, the location of the osteoarthritis, and the placement of the prosthesis can vary from person to person.
The 3D tomography model allows the surgeon to examine the patient’s actual bone structure from different angles before surgery.
The prosthesis can be virtually placed on this model. Whether the prosthesis protrudes beyond the bone, its conformity to the natural bone curvature, and its position within the joint can be evaluated before surgery.
In macular degeneration surgery, only a small section of the joint is replaced, so the size and placement of the prosthesis are particularly important.
How is Haptic Technology Used in Makoplast?
Mako robotic systems feature AccuStop haptic technology, which helps surgical instruments remain within a predetermined working range.
The surgeon plans the area of bone to be removed on a three-dimensional model. During the operation, the robotic arm is guided according to this plan.
When the surgical instrument approaches outside the designated area, the system restricts movement. This helps protect healthy bone and surrounding soft tissues.
According to Stryker’s official data, haptic boundaries help ensure that the preparation of the femur and tibia is done according to an individual 3D plan.
How are healthy tissues preserved in macoplasty?
The primary goal of partial knee replacement is to replace the diseased section while preserving the healthy parts of the knee.
Compared to total knee replacement, a more limited bone surface is prepared. Joint surfaces unaffected by osteoarthritis are not interfered with.
In suitable patients;
- Healthy bone tissue,
- Anterior cruciate ligament,
- Posterior cruciate ligament,
- Healthy cartilage surfaces,
- Unaffected sections of the index
It can be protected.
Protecting ligaments and healthy joint surfaces can help maintain the knee’s natural range of motion.
What is Dynamic Joint Balancing?
In knee replacement surgery, preparing the bone alone is not enough. The tension of the knee ligaments and the balance of the joint space must also be evaluated.
The Mako Partial Knee system helps the surgeon assess soft tissue tension and knee movement during surgery.
The surgeon can reassess the position of the prosthesis by checking different ranges of motion of the knee. Minor adjustments can be made to the plan if necessary.
The dynamic joint stabilization feature of the Mako Partial Knee system is used to support the creation of a balance that closely mimics natural knee movement.
What are the advantages of makoplasty?
The goal of robotic partial knee replacement is to preserve as much natural tissue as possible by replacing only the damaged joint area.
In suitable patients, the following advantages may be observed:
Preserving More Healthy Bone
Compared to total knee replacement, less bone preparation is required.
Preserving Healthy Joint Sections
Areas unaffected by calcification will not be intervened.
Protecting the Bonds
In suitable patients, the important ligaments of the knee can be preserved.
Personalized 3D Planning
The size and placement of the prosthesis are planned according to the patient’s CT scan images.
Controlled Enforcement with Haptic Limits
The robotic arm only assists in working within the bone area specified by the surgeon.
More Natural Knee Feeling
Preserving intact ligaments and joints can contribute to a more natural feel in the knee for some patients.
Increased chance of faster early recovery.
Partial knee replacement is a more limited surgical procedure compared to total knee replacement, so suitable patients may have a shorter hospital stay and faster recovery time. However, the recovery rate is not the same for every patient.
Is a robot performing macular degeneration surgery?
No. The Mako robotic system does not perform surgery on its own.
Surgeon;
- Examines the patient’s 3D model,
- It evaluates suitability for a partial prosthesis.
- Choose the prosthesis size.
- He prepares the surgical plan,
- It controls the robotic arm.
- It prepares the bone surfaces,
- He inserts the prosthesis,
- It controls joint balance.
The Mako system provides support for planning, measurement, and haptic restraint. The robotic arm does not move on its own without guidance from the surgeon.
Recovery Process After Makoplasty
The post-operative process varies depending on the patient’s age, weight, muscle strength, overall health, and pre-operative mobility.
Patients can be mobilized early under the supervision of the healthcare team. Walking and knee movement exercises are initiated according to the physical therapy program.
In the first period;
- Control of pain and swelling,
- Wound site monitoring,
- The use of blood-thinning medications,
- Proper use of walkers or crutches,
- Performing knee movement exercises,
- Monitoring for signs of infection.
It is important.
Although partial knee replacement is a more limited surgical procedure compared to total replacement, it is essential to follow the doctor’s and physiotherapist’s recommendations after the operation.
Are there any risks associated with makoplasty?
Like other surgical procedures, makoplasty carries some risks.
Potential risks include:
- Infection,
- Bleeding,
- Clot formation,
- Blood vessel or nerve injury,
- Restricted knee movement,
- Loosening around the prosthesis,
- Ongoing knee pain,
- The progression of osteoarthritis to other parts of the knee.
It may be included.
After a partial knee replacement, osteoarthritis may develop in other parts of the knee in the following years. In such a case, a switch to total knee replacement may be necessary.
How long does Makoplast last?
The lifespan of a partial knee replacement varies from patient to patient.
The lifespan of the prosthesis;
- Correct positioning of the prosthesis,
- The patient’s weight,
- Daily activity level,
- Bone quality,
- The condition of other parts of the knee,
- Regular orthopedic checkups
It can have an effect.
Robotic systems help in placing the prosthesis according to the individual’s personalized plan. However, no prosthesis can be guaranteed to last a lifetime.
Makoplasty and Robotic Partial Knee Replacement in Adana
In Adana, when evaluating patients for Makoplasty treatment, the first step is to determine which parts of the knee are affected by osteoarthritis.
At Adana Ortadoğu Private Hospital, 3D tomography-based robotic partial knee replacement planning can be performed on suitable patients using the Mako robotic surgical system.
In patients where osteoarthritis is limited to a specific area, personalized surgical options aimed at preserving healthy bone and ligaments may be considered.
Makoplasty Planning with Op. Dr. Muhsin Dursun
Op. Dr. Muhsin Dursun evaluates patients in the field of orthopedics and traumatology at Adana Ortadoğu Private Hospital.
In makoplasty planning, not only the patient’s knee pain but also the location of the osteoarthritis, the condition of the ligaments, leg alignment, and joint movements are considered together.
In patients deemed suitable for robotic partial knee replacement, a three-dimensional surgical plan can be prepared using the Mako system. The goal is not only to replace the painful area but also to preserve the healthy bones, ligaments, and natural structure of the knee as much as possible.
When should you have a check-up for makoplasty?
If knee pain is concentrated in a single area, worsens when climbing stairs or walking, and persists despite non-surgical treatments, an orthopedic examination should be performed.
Having an examination doesn’t automatically mean a decision will be made for surgery. First, the level of osteoarthritis and which joints it affects are determined.
If osteoarthritis is limited to one area and other conditions are suitable, Makoplast, or robotic partial knee replacement, may be considered instead of total knee replacement.
