An orthopaedic surgeon practising at the Netcare Blaauwberg Hospital, Dr Mark van der Kaag performed a procedure earlier this year on a patient named Melanie van Heerden, after becoming accredited to perform total and partial knee, as well as hip replacements using the Mako SmartRobotics surgical system.
According to Netcare, the system combines three key components – 3D CT scan based planning, AccuStop technology and insightful data analytics – into one platform. Fortunately, the Mako robotic-arm surgical system has already translated into well-described patient benefits.
“I dreaded going to the shops before I had my partial knee replacement. I was in constant pain and it was stealing from my quality of life. There were so many everyday activities that became virtually impossible for me,” recalls Van Heerden.
She was the first person to have Mako robotic-arm assisted surgery at Netcare Blaauwberg Hospital, which is also the only facility in the Western Cape offering this advanced precision technology option to patients.
“Essentially, this robotic surgical system provides additional safeguards to ensure the surgeon only works within the dimensions required for optimal precision. I am fully in control of this highly sophisticated tool at all times, as the robotic software and hardware elements only work as guided by the surgeon through the pre-defined three-dimensional surgical plan”, says Dr Van der Kaag.
One of the advantages of this surgery is that the soft tissue and bone are preserved. Dr Van der Kaag said: “The system restricts cuts only to the specific dimensions required to achieve the placement and alignment of the prosthetic joint implants to match the patient’s individual anatomy.”
“There are three components to the knee joint, and in Melanie’s case, it was not necessary to replace the entire knee joint, and a partial knee replacement was all that was needed. Based on the detailed data of her CT scan we were able to map the surgery in advance with the planning software,” he adds.
“I was excited when Dr Van der Kaag said that the robotic-arm assisted surgery was an option for me because I believe in using up-to-date technology. It is reassuring to have this option when you go for an operation like this”, Melanie says.
In the operating room, Dr van der Kaag aligns the virtual 3D knee and surgical plan to the patient’s actual knee, which automatically sets the boundary in which the surgery will work. Once he validates the surgical plan and makes all the necessary adjustments, the robotic arm system provides detailed visual, auditory and tactile feedback to assist the surgeon in removing the damaged section of bone, and accurately positions and aligns the implanted prosthetic component.
“The more precise the fit of the implanted joint, the more comfortable and stable the knee is likely to be. Other potential benefits associated with this advanced surgical option include reduced post-operative pain and shorter recovery times, so it is an ideal option for people who wish to resume their daily lives as soon as possible”, Dr van der Kaag says.
“The ability to position the prosthetic knee more precisely often achieves a more natural feel to the knee, and allows patients to return to most of the activities they previously enjoyed,” concludes Dr van der Kaag.
“Before my knee problems, I was an avid runner and I competed in the Two Oceans and various half-marathons. Now seven months after my partial knee replacement, I am cycling at the gym and I am building up by walking longer distances,” Van Heerden adds.
Melanie says she was able to get up the very next day after her surgery, assisted by a physiotherapist, and started climbing stairs on the third day after the operation.
“My recovery has been amazing, and I only used crutches for the first two weeks after the surgery on my right knee. Next year I will have a procedure on my left knee – which used to be my ‘good’ knee but it’s now my ‘bad’ knee – and then I should be able to get back to normal activities,” she says.
Netcare introduced this advanced option for patients requiring knee replacements recently in the Western Cape after seeing what a great success the Mako robotic arm has been since used in 2019 at the Gauteng Netcare Linksfield Hospital.
Jacques Du Plessis, managing director of Netcare’s hospital division, commended Dr Van der Kaag and his team on their role in keeping the province in the loop with this new technology for patients in need of knee and hip replacement procedures. Who knows what other new technology could play a great role in our province?
“Developments in robotic assisted surgery are ushering in a new paradigm in applying world-class technology to surgery, providing greater choice in terms of the options available for patients. As the only hospital in the Western Cape to offer Mako SmartRobotics™ procedures, we look forward to seeing mobility restored for many more people so that they can enjoy an improved quality of life after hip and knee replacements,” Du Plessis concludes.