The Mako Knee Replacement: What Do You Need to Know?

by Kevin Sumida, M.D.

The Mako Knee Replacement: What Do You Need to Know?

No matter what surgery you may need, there can be feelings of uneasiness due to the unknown. A total or partial knee replacement procedure is no exception. These feelings are completely normal and valid for you as a patient to have.

And the need for knee replacement surgeries in the United States is on the rise with more than 600,000 knee replacements being performed each year.

Thankfully, innovations in medical technologies are allowing us surgeons to perform more accurate and precise procedures. Here at OrthoVirginia, we are the first outpatient operatory in Virginia to offer robotic-arm-assisted knee replacement surgeries using Stryker’s Mako System.

To help alleviate some of your worries, I want to inform you of the statistics and facts regarding knee replacements, answer questions patients frequently ask, and explain how a knee replacement using Stryker’s Mako System may be the best option for you.

Quick stats and facts about knee replacements

  • The first knee replacement was performed in 1968.
  • It’s estimated that by the year 2040, more than 78 million U.S. adults will be diagnosed with arthritis of the knee. That’s over a quarter of the U.S. adult population.
  • Around 15% of all patients suffering from knee arthritis can be treated with a partial knee replacement.
  • Maintaining a healthy lifestyle (exercising, quitting smoking, managing weight) can significantly help in relieving joint pain.
  • By losing 1 pound of weight, you take the equivalent of 4 pounds of pressure off your knees.

Frequently asked questions

What will surgery day look like?

What to expect on the day of surgery:

No two operatories are exactly the same, and each has their own set of procedures. However, generally speaking, you may expect the following with some degree of variation.

  • Upon arrival, you will complete the registration and admission process. Please leave all jewelry and valuables at home. Do bring a photo ID and your insurance card if you have one. Also, please note, for your safety, you must have someone that can drive you home after surgery and be with you for 24 hours or until the effects of anesthesia have abated. However, due to COVID-19 concerns, this person will not be allowed to be with you during the surgical process. They will, however, be notified throughout the phases of your care and will be called to come into the center when you are ready to be discharged. 
  • Once checked in, you will be taken to the preoperative area. Your care team will get you ready for surgery, which will include changing into a hospital gown and starting an IV that administers fluids and medications. You will have an opportunity to meet our anesthesiologist and ask questions. 
  • Your provider will see you prior to surgery to discuss your procedure and answer any questions you may have. You will give your consent in writing for the procedure, and for safety, your surgical site will be marked and verified by several different members of our care team. When the surgical team is ready, you will be taken to the operating room, and your procedure will take place.   
  • After surgery, you’ll be taken to a recovery room where you will have one to one care with a registered nurse who will monitor your vital signs and make sure you are comfortable. If ordered by your provider, you may have a physical therapist visit at the bedside who will work with you and provide teaching with regard to your movement.   
  • Once you meet our protocols for safe discharge, you and your caregiver will receive instructions, and you will be discharged to go home. We will provide you with a telephone number to call in the event of questions once you leave our facility, and you will be called the next day by our operatory staff to make sure you are doing well.   

What tests will be performed before surgery?

To ensure that your body is healthy and ready for surgery, your physician will perform a physical checkup and order routine blood work and urine tests. An EKG and chest X-ray may be necessary if you are over 50 or have a history of heart or respiratory issues.

Other tests may be conducted depending on your specific medical conditions.

Are there major risks of knee replacement surgery?

With any surgery, there are serious risks involved. Fortunately, severe complications occur in less than 2% of all knee replacement procedures.

Risks related to knee replacement surgery include dislocation, wearing down of the implant, the immune system rejecting the implant, soft tissue imbalance (ligaments of the knee carrying a heavier burden than normal), and more. If any of these complications develop after your procedure, a revision surgery may be necessary to correct them.

However, delaying your knee replacement out of fear of the complications can result in your knee function progressively decreasing. Exercising and daily activities may become more difficult, leading to other health issues such as depression.

When will I get to go home from the hospital?

Some patients go home the same day as the knee replacement. Others may spend 1 to 4 days in the hospital depending upon the specific surgery that patient received. If your procedure is completed at the Herndon Operatory, you will be discharged that day to recuperate at your home.

When can I start performing daily activities?

If you are committed to your rehabilitation program prescribed by your physician, many patients return to daily activities such as driving in 4 to 6 weeks after their surgery. However, every patient is different and may require differing recovery times.

Am I going to need a walker or crutches?

Most likely, yes, you will use a walker or crutches for 6 weeks following your knee replacement. Patients then usually graduate to using a cane for 6 weeks. Twelve weeks out from surgery, most patients are walking well without the assistance of a walker, crutches, or cane.

How long will my knee implant last?

Knee replacements do not last forever, but with normal amounts of wear and tear, most last for many, many years. The current literature shows us that at 16 years post-surgery, only 8% of knee replacements need to undergo revision. During revision, your physician will remove and replace any parts of the implant that are not functioning properly. Implant loosening is often the main reason for revision.

The lifetime of a knee replacement varies depending upon each patient’s weight and activity levels. Ask your physician for guidance on how to prolong the life of your implant based upon your medical conditions and lifestyle.

Why should I consider a robotic-arm-assisted knee replacement using Stryker’s Mako System?

After digesting the above facts and answers to frequently asked questions, you may now be wondering, “What is the right knee replacement procedure for me?”

If you’re looking for the most up-to-date, least invasive procedure, then it’s a knee replacement using Stryker’s Mako System.

Stryker’s Mako System has transformed our approach to joint replacement surgeries. It allows us as surgeons to be incredibly accurate when performing knee replacements. So, how does it work?

First, a CT scan of your knee is conducted. Highly advanced software takes your CT scan and creates a 3D model of your exact knee, helping surgeons formulate an even more personalized preoperative plan. That 3D model is then uploaded into the Mako, and the surgeon guides the robotic arm during surgery. No decisions are made by the robotic arm itself. The surgeon is in complete control and can make any adjustments during the surgery as necessary.

All patients in need of a partial or total knee replacement are candidates for a Mako robotic-arm-assisted procedure. The only requirement is that your physician must be properly trained and comfortable with using the Mako.

And last, but not least, what about the effects on recovery time? Due to the procedure being less invasive, patients may return home the same day as the procedure.

To make an appointment with me or any of our other physicians highly trained in Stryker’s Mako System, visit orthovirginia.com/appointments.