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TRMC enters a new frontier

Troy Regional Medical Center has recently purchased Stryker Mako SmartRobotics, an advanced device that will assist in joint replacement surgery. This innovative technology offers a new approach to total and partial knee replacements and transforms the way total knee replacements are performed by Dr. Robert Liljeberg, Board Certified Orthopedic Surgeon.

Mako SmartRobotics consists of three unique components – 3D CT-based planning, AccuStop haptic technology and insightful data analytics. In clinical studies, Mako Total Knee demonstrated great results in pain management, reduction of hospital stay, improved knee flexion and soft tissue protection in comparison to manual techniques.

“Mako’s 3D CT allows me to create a personalized plan based on each patient’s unique anatomy all before entering the operating room,” said Liljeberg. “During surgery, I can validate that plan and make any necessary adjustments while guiding the robotic arm to execute that plan.”

Liljeberg described this device to be about the size of a washing machine. It has an arm with a saw attached to it and a leaver for the surgeon to press that turns the saw on. As it is brought close to the bone that needs to be cut, it will cut on the previous parameters that have been set.

“It’s all based off of the CT scan that will be done prior to the surgery. That’s where the precision part comes in. The image of the joint and the information is loaded into the robot so it will know the exact alignment of the bones,” said Rick Smith, Troy Regional Chief Executive Officer.

This device will also stop automatically if the saw comes close to any neurovascular structure or any ligaments that need to be preserved. Even if forced, it will not continue to make any cuts.

Liljeberg explained that this technology has been around for about 5 to 10 years already, but the first implementation for it was strictly for partial knee replacement. Because of the success, companies continued to develop the machine, and it is now eligible for total knee replacement as well as hip replacement.

“There are quite a few companies that make implants for joint replacement surgery and they last consistently for about 25 to 30 years. They are all so good, they’ve reached the point where they can hardly make it any better,” Lilgeberg said. “The new frontier now is the robot, and companies are racing to make the best one.”

The two companies Stryker and Mako merged together to create the Stryker Mako SmartRobotics, which is far ahead of the other companies in the race. Smith described it to be like the Cadillac, while the other companies are lagging behind.

“We’re grateful to be able to put together a deal to obtain this device,” said Liljeberg. “We want the best for our patients, we want them to receive state-of-the-art surgery, and we want them to receive the same or better care as anywhere else in the country.”

Using the Mako SmartRobotics will become standard care for every patient Dr. Liljeberg operates on, and he will start using this machine next week. Liljeberg has gone to multiple meetings to learn about and practice with this machine. After practicing on cadavers, Liljeberg is ready to take the next step.

“Right now it is state-of-the-art technology, but I predict it will become standard care in about a decade,” he said.

Liljeberg performs about 70 to 80 joint replacement surgeries a year. By 2030, total knee replacements in the United States are expected to increase 189%. Between 2015 and 2035, the over-65 population is projected to increase by 62%, driving demand for total joint replacement.

Smith believes there were many people who left the area for care because Troy didn’t have the robotics assistance technology. Now, local patients can stay close to home for their health care needs and patients from other areas may be drawn here for state-of-the-art care.

“We’ve had outstanding results even before this robotic technology,” Smith said. “Dr. Liljeberg has thousands of surgery’s well-documented. Our quality scores are excellent, our length of stay is excellent, and the recovery is excellent, so we didn’t have any problems with quality. This technology will simply improve precision. We have great results right not, but this will make them even better.”

Liljeberg enjoys changing the lives of his patients through joint replacement surgery. “We basically give the patients their life back when we give them their mobility back,” he said.

The Mako SmartRobotics will also result in faster rehab for patients. “I talked to a colleague of mine who said this technology allows him to perform less traumatic surgery to the soft tissue around the bone which results in faster and better rehab,” he said.

Dr. Lilgeberg explained he is excited to be able to offer this transformative technology across the joint replacement service line to perform total knee and partial knee replacements.

“With the Mako Total Knee Replacement, I know more about my patients than ever before and I’m able to cut less. For some patients, this can mean less soft tissue damage; for others, greater bone preservation,” Liljeberg said.

“We are proud to offer this highly advanced robotic technology in our service area,” Smith said. “This addition to our orthopedic service line further demonstrates our commitment to provide the community with remarkable healthcare.”