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Meet Mako.

The new tool for joint replacement.

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Mako Robotic-Arm, Assisted Technology

Total knee/total hip replacement is a surgical procedure where a diseased or damaged joint is replaced with an artificial joint called an implant. Made of metal alloys and high-grade plastics, the implant is designed to mimic a normal, healthy knee or hip.

Mako Technology transforms how total and partial knee/hip replacement procedures are done by integrating 3D virtual modeling and robotic-arm precision into the process. It’s an innovative solution that has been helping knee/hip pain sufferers for more than a decade.

Mako_Total_Knee_

Contact Information

Care New England Department of Orthopedic Surgery and Sports Medicine
100 Butler Drive
Providence, RI 02906
P: (401) 681-2724

Surgeries performed at:
Kent Hospital
455 Toll Gate Road
Warwick, RI 02886

Assisting in total knee, & total hip surgery.

 

 

Total Knee

1. Personalized surgical plan

The first step is patient-specific surgical planning. Before surgery, a CT scan of your knee is taken to develop a 3D virtual model of your unique joint. Your doctor uses this model to evaluate your bone structure, disease severity, joint alignment, and even the surrounding bone and tissue, so they can determine the optimal size, placement, and alignment of your implant.

2. Range-of-motion assessment

Throughout your procedure, Mako provides real-time data to your surgeon. This allows them to continuously assess the movement and tension of your new joint, and adjust your surgical plan if desired.

3. Arthritic bone removal

In the operating room, your surgeon guides Mako’s robotic arm to remove the arthritic bone and cartilage from the knee. A virtual boundary provides tactile resistance to help the surgeon stay within the boundaries defined in your surgical plan.

4. Implant Placement

With the diseased bone gone, your implant is placed into the knee joint. Then it’s off to the recovery room to begin your journey to strengthen your new joint.

https://patients.stryker.com/knee-replacement/options/mako-robotic-arm-assisted-total-knee


 

 

Total Hip

1. Personalized surgical plan

Prior to surgery, a CT scan of your hip joint is taken in order to generate a 3D virtual model of your unique anatomy. The 3D model helps your doctor see things he or she can’t typically see with an x-ray alone. This additional information helps your doctor determine the optimal size, placement and positioning of your implant.

2. Range-of-motion assessment

Throughout your procedure, Mako provides real-time data to your surgeon. This allows them to continuously assess the movement and tension of your new joint, and adjust your surgical plan if desired.

3. Arthritic bone removal

In the operating room, your surgeon guides Mako’s robotic arm to remove the arthritic bone and cartilage from the hip. A virtual boundary provides tactile resistance to help the surgeon stay within the boundaries defined in your surgical plan.

4. Implant placement

As the surgeon prepares to place the implant into its final position, the robotic-arm guides the implant at the desired angle defined in the surgical plan. This helps ensure the placement and alignment of the implant are performed according to plan.

https://patients.stryker.com/hip-replacement/options/mako-robotic-arm-assisted

 

 

Recovery From Surgery

Although the recovery process varies for each patient, here’s what you might expect in the days following surgery.

1. Your orthopedic surgeon, nurses and physical therapist will closely monitor your condition and progress.

2. When you are medically stable, the physical therapist will recommend certain exercises for the affected joint.

3. To ease the discomfort the activity will initially cause, pain medication may be recommended by your doctor prior to therapy. If prescribed by your doctor, your pain medication will gradually be reduced, the IV will be removed, your diet will progress to solids and you will become increasingly mobile. 


4. The physical therapist will discuss plans for rehabilitation following hospital discharge. Your physical therapist will also go over exercises to help improve your mobility.
 
5. Depending on your limitations, an occupational therapist may provide instruction on how to use certain devices that assist in performing daily activities, such as putting on socks, reaching for household items, and bathing.
 
6. A case manager will discuss plans for your return home and will ensure that you have all the necessary help to support a successful recovery. 

Advantages of the technology.

  • May include greater component accuracy and precision
  • Soft tissue protection
  • Less drainage
  • Increase patient satisfaction
  • Less surgeon and surgical team fatigue
  • Reduced recovery time

Frequently Asked Questions

Am I too old for a joint replacement?

While age is an important factor in your health, age alone isn’t usually a reason not to have joint replacement surgery. Your doctor will be more interested in your overall health and will consider a variety of things, such as blood test results, physical strength, bone density, and diet and lifestyle, to determine whether joint replacement is right for you.

When will I be discharged from the hospital?

It depends on you, your recovery process, and your doctor’s recommendation. Most people go home within one to four days after surgery.

What kinds of tests will I need before surgery?

Your doctor will likely request a physical checkup, routine blood work, and a urine test. If you’re over 50 or have a heart or respiratory issue, you may also need an EKG and a chest X-ray. Your doctor will recommend tests based on your specific diagnosis and medical condition.

After surgery, will the doctor talk to my family about how my surgery went?

Typically, your doctor or one of the assisting surgeons will come out to the waiting area to talk with your family as soon as you’ve been taken into the recovery room. If your family misses seeing the surgeon, they should contact the surgeon’s office. Your doctor’s office will arrange a time for your surgeon to discuss your surgery with your family.

Meet the Team

Dr. Robert Shalvoy

Dr. Shalvoy is a board-certified orthopedic surgeon and sports medicine specialist and serves as executive chief of orthopedics and sports medicine for Care New England. He specializes in computer-navigated ACL reconstruction, knee replacement, rotator cuff surgery, and throwing injuries. Dr. Shalvoy earned a bachelor of science degree in biology summa cum laude from Boston College, and a medical degree from New Jersey Medical School, where he earned several scholarships and was a member of the Alpha Omega Alpha honor society. He completed a residency in orthopedic surgery at Boston University Medical Center, where he was chief resident in his last year. He also completed a fellowship in sports medicine at the Hughston Orthopedic Clinic in Georgia.

Dr. Shalvoy received Alpert Medical School’s Leonard Tow Humanism in Medicine Award in 2006. He is past president of The Hughston Society, serves on the American Orthopedic Society for Sports Medicine’s Team Physician Committee, and its Council of Delegates, is a principal reviewer for the American Journal of Sports Medicine, and serves on the Sports Medicine Advisory Committee for the Rhode Island Interscholastic League. He is a member of the American Academy of Orthopedic Surgeons, the American Orthopedic Society for Sports Medicine, the Arthroscopy Association of North America, and the Rhode Island Orthopedic Society.

Dr. Jonathan Gastel

Board certified in orthopedics and subspecialty certified in sports medicine by the American Board of Orthopedic Surgeons, Dr. Jonathan Gastel has been practicing in Rhode Island since 1999. As a specialist in sports medicine, he has served as the orthopedic sports medicine team physician for Division I Bryant University since 2001, and previously as the Rhode Island College team physician.

Dr. Gastel’s sports medicine and orthopedic trauma training includes orthopedic residency training at Brown University, sports medicine fellowship training at The Cleveland Clinic, and orthopedic trauma fellowship at Brown University/Rhode Island Hospital. He received his medical school education at the University of Rochester where he was honored by admission to the Alpha-Omega-Alpha Honor Society and graduated magna cum laude from Yale University.

Dr. Gastel treats a variety of conditions that are both sports and non-sports-related involving the upper and lower extremities. A majority of these problems involve the knee and shoulder (e.g. ACL reconstruction, meniscus repair, knee replacement, rotator cuff repair, shoulder replacement, shoulder instability, etc). Dr. Gastel also treats a variety of injuries/conditions including the elbow, hip, and foot including tennis elbow, tendinitis, ankle sprains, and fractures.

Dr. Gastel is an avid outdoorsman and sports enthusiast. His active and sports-filled lifestyle provides him with a unique and intimate perspective on the non-surgical, surgical, and rehabilitation treatments of a wide variety of bone and joint injuries.