OrthoNeuro orthopedic surgeon Dr. Mark Gittins has performed the first robotics-assisted bi-cruciate retaining total knee replacement in Ohio. The surgery took place on November 28, 2017, at the New Albany Surgery Center in Columbus. It was also among the first procedures of its kind in the world. That is because it used the NAVIO Surgical System without a CT scan.
The NAVIO system helps the surgeon implant the JOURNEY II XR, a bi-cruciate retaining total knee system. It is one of the few total knee designs that let the patient keep the ACL. The design also aims to improve patient satisfaction.
Gittins had already used robotics-assisted technology for partial knee replacements. Because of that, he said, he could easily see the same benefits in total knee surgery. He added that he is excited about where the technology is heading and what it means for his patients.
How the implant and robot work
Most total knee implants remove both cruciate ligaments, the ACL and the PCL. By contrast, according to Gittins, the JOURNEY II XR uses a U-shaped tibial base plate. As a result, these ligaments stay in place after surgery. Its anatomic design also aims to recreate the shapes and forces of a natural knee. That holds as the joint moves through its full range of motion.
NAVIO is a handheld robotics platform. It helps surgeons with implant alignment, ligament balancing and bone preparation. All three can affect how long an implant lasts. The unit is small, which makes it easy to set up and move. It also needs no preoperative image such as a CT scan. As a result, patients get robotic assistance without the extra steps, cost and radiation of added imaging.
Not every patient is a candidate for the JOURNEY II XR implant or the NAVIO system. Results of joint replacement also vary. Implants are meant to relieve knee pain and improve function. Even so, they may not feel or work exactly like a natural knee. Risks such as loosening, wear and infection can lead to further surgery.
OrthoNeuro is a multidisciplinary center of board-certified physicians in orthopedic surgery, neurology, neurosurgery, and physical medicine and rehabilitation. It has offices in Westerville, New Albany, Grandview, Pickerington and Dublin, serving patients across Greater Central Ohio. The New Albany Surgery Center is a single-specialty outpatient center for orthopedic procedures and has been open for five years.
The implant and robot come from Smith & Nephew, a global medical technology company. It holds leading positions in orthopaedic reconstruction, advanced wound management, sports medicine, and trauma and extremities. The company has about 15,000 employees in more than 100 countries, while its 2016 sales came to almost $4.7 billion.