Dr. Muhsin Dursun explains that in Mako robotic surgery, 3D tomography is used to create a three-dimensional model of the patient’s knee or hip joint. This model allows for detailed planning of the bone structure, joint angles, prosthesis size, and placement area before the surgery.
What is 3D CT Scanning?
3D tomography is the process of converting images obtained from computed tomography (CT) scans into three-dimensional images using specialized software.
While normal X-ray images evaluate bones in two dimensions, 3D tomography allows the joint structure to be examined from different angles. This enables the surgeon to see the patient’s knee or hip anatomy in more detail before surgery.
The three-dimensional model used in Mako robotic surgery is not a standard bone image. It is prepared for each patient from their own CT scan images.
How does the Mako System use 3D tomography data?
After the tomography scan, the resulting images are transferred to the Mako system’s planning software. The system then uses these images to create a three-dimensional model of the patient’s joint structure.
The surgeon uses this digital model;
- Bone structure,
- Wear and tear on joint surfaces,
- Leg alignment,
- Bone angles,
- The appropriate size of the prosthesis,
- Prosthesis placement position
They can evaluate it before the surgery.
This stage allows for personalized surgery planning.
Every patient’s joint structure is different.
Although knee and hip joints may look similar from the outside, each patient’s bone structure is different.
Bone size, leg angle, amount of wear and tear on the joint, and the location of osteoarthritis can vary from person to person. Therefore, applying the same plan to every patient in prosthetic surgery is not appropriate.
3D tomography allows the surgeon to see the patient’s actual anatomy. This allows prosthesis planning to be based not on general measurements, but on the individual’s own bone structure.
Prosthesis size can be determined before surgery.
Choosing the correct prosthesis size is crucial in knee or hip replacement surgery. A prosthesis that is too large or too small can affect joint stability and prosthesis placement.
Different prosthesis sizes can be virtually tested on the three-dimensional model within the Mako system. The surgeon can evaluate the most suitable prosthesis size for the patient’s bone structure before the operation.
If necessary during surgery, this plan can be reviewed and adjusted according to the patient’s actual joint structure.
Bone cuts are planned using a 3D model.
In prosthetic surgeries, incisions are made in specific areas of the bone to prepare damaged joint surfaces. The number, level, and angle of these incisions are important for the placement of the prosthesis.
Thanks to the 3D tomography model, the surgeon;
Determines the area where the incision will be made.
The specific portion of bone to be removed can be planned before the surgery.
Calculates the angle of intersection.
The angle of the bone cuts is evaluated to ensure the prosthetic components can be placed in the correct position.
Plans the amount of bone to be removed.
The goal is simply to prepare the bone area necessary for the prosthesis to be placed.
This plan is then implemented with the support of Mako robotic arm and haptic technology.
The Connection Between 3D Tomography and Millimeter-Precision Planning
The precise calculations performed by the Mako robotic system are based on a three-dimensional tomography model.
The surgeon can slightly alter the position of the prosthesis, the level of bone cuts, and the joint space. The digital model shows how these changes will affect the overall balance of the knee or hip.
Therefore, 3D tomography is not only used for imaging purposes. It is also one of the fundamental steps that enables surgical planning using numerical data.
How does 3D CT scan affect prosthesis placement?
Placing the prosthetic components at the correct angle to the bone is important for joint movement and stability.
The prosthesis on the three-dimensional model;
- Forward or backward position,
- Inward or outward angle,
- Direction of return,
- Its level on the bone,
- Effect on joint space
It can be examined before surgery.
Using these measurements, the surgeon creates a prosthesis placement plan that is suitable for the patient’s bone structure.
Can a robot plan a surgery using 3D CT scan on its own?
No. The Mako system processes images, provides measurements, and creates a three-dimensional model. However, the orthopedic surgeon is the one who evaluates, modifies, and approves the surgical plan.
Surgeon;
- He examines the tomography model,
- Choose the prosthesis size.
- It identifies bone cuts.
- It plans the position of the prosthesis,
- He controls the robotic arm during the surgery.
The Mako system helps the surgeon to execute the plan in a more controlled manner.
Is 3D CT Scanning Necessary for Every Patient?
In patients scheduled for Mako robotic prosthetic surgery, computed tomography is used to enable the system to create a patient-specific three-dimensional model.
However, not every patient experiencing knee or hip pain needs a CT scan. First, an orthopedic examination is performed to assess whether the patient is a suitable candidate for replacement surgery.
The decision to order a CT scan is made by evaluating the patient’s complaints, physical examination findings, and X-ray results together.
Mako Robotic Prosthesis Planning with 3D Tomography in Adana
In Adana, for patients scheduled for Mako robotic knee or hip replacement surgery, the process begins with a detailed orthopedic examination.
For patients deemed suitable for prosthetic surgery, a personalized three-dimensional joint model can be created using computed tomography (CT) scans. Using this model, the surgeon can evaluate the size of the prosthesis, the bone cuts, and the placement angle before the operation.
This approach helps to plan the surgery according to the patient’s own bone structure, rather than according to standard measurements.
