Mobility and the freedom it provides is what Dr. Marc Roux hopes he can give his patients through the latest surgical innovation.
New software released earlier this year will allow patients at Baylor Scott and White Medical Center — Waxahachie to have a total knee replacement done with a Surgery Assisted Robotic Arm or SARA for short.
Before this new software release, the hospital has been using SARA to do partial knee replacements and total hip replacements since Oct. 2016. The first complete knee replacements done in Waxahachie took place the second week of November. This latest innovation increases the patient’s quality of life.
“It increases the precision of the joint balancing because fundamentally a knee replacement is a joint balancing procedure. We are taking a crooked, bow-legged or knock-knee and make it straight again and we do that for all total knee replacement,” Roux said. “For a knee to operate and to move correctly and to be a functional high-performing joint for a person it has got to be balanced. It has got to be balanced from the moment of straitening to deep flections so you can get out of a low chair, do squats, twists and turns, and go up and down stairs with good stability.”
Roux explained that the use of the robot helps to increase precision in surgery, which in the long run translates into a higher performing knee replacement. Before any surgery, there is a lot of planning that takes place to ensure the best possible outcome for the patient.
“We do a planning and preoperative planning just like we do with the partials and the total hips. So what it does it allows us to virtual plan the total knee replacement from a sizing perspective and from a bone cut perspective and a balancing perspective. Then we do the CT scan,” Roux explained. “We match to the balancing in real time with measurements in real time in the operating room and lock in that cutting plan with the robot. Then use the robot as a tool that keeps that precision within a fraction of a millimeter of what the plan was. It allows us to do a precise balancing procedure for that total knee.”
During the surgery, the SARA software allows the surgeon to make adjustments as needed. The 3D model of the patient’s knee is displayed on a monitor next to the operating table. The area of bone that the doctor is reshaping appears green on the screen. The robot’s program sets up a virtual wall so that the doctor can’t cut bone that does not need to be cut. Sensors are placed on the body, telling the doctor where the implant needs to be to make a perfect fit.
During the operation, the doctor, surgical staff, and the robot’s technician work together to make sure that everything goes smoothly. If an issue arises with the robot, the technician can troubleshoot and resolve rather quickly.
Each surgery is estimated at one hour and 15 minutes. Through this system, Roux has been able to do 200-250 total joint replacements that include hips, knees, and shoulders each month.
“A full recovery for a total knee or a total hip replacement is about six months. That is six months after surgery and, hopefully, you will have all your stamina, all your abilities, and all your strength to get you back to a normal gate. Getting back to where you cannot feel any limits,” Roux noted. “Typically folks at about the three-month mark can do pretty much want they can do or want to do. They just don’t have the strength and stamina (yet) and will have to continue on that aspect of their post-op rehab.”
Roux added that a person working in a manual labor type job can go back to work within 10-12 weeks. A person who is working in an office for a total knee or total hip replacement can go back to work in about six weeks.
“We have had excellent results with it and really high patient satisfaction. It has just opened up a door to increase in the precision of the total joint procedures. Our objective is to return folks to very active and a very functional lifestyle,” Roux said. “With our population, some of our patients are becoming younger and younger. Those folks that are younger and get a joint replacement have a little bit more demand out of their new joints. This is giving us another tool to increase the precision to give us a highly functional joint.”
Roux added that having this tool here provides people with more personalized service without having to travel to other cities to meet their healthcare needs.