Gwang-won Lee, Director of Gangbuk Himchan Hospital. IS photo
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Winter is a time when patients with broken knee joints receive a lot of treatment. In particular, patients with severe degenerative arthritis endure pain and undergo artificial joint surgery in December and January, when external activity decreases.
The truth and misunderstandings of robotic artificial joint surgery, the director of Kangbuk Himchan Hospital
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Artificial joint surgery has been performed for a long time, so the surgical method is standardized and the safety is high. However, there are still many cases of reluctance due to concerns about side effects such as’stretched legs’, where the knee is still not bent enough.
The specialist contends that these concerns should be avoided. Lee Gwang-won (53), director of Gangbuk Himchan Hospital, said, “There were side effects when surgery was performed in a small hospital with little experience in the past, but these days, the side effects are less than 1% because experienced specialists in university hospitals and specialized hospitals do it.”
Director Lee also said, “Materials such as artificial joints have been greatly improved compared to the past, so they can be used for a long time without side effects.” “Recently, robots are also used, so artificial joint surgery is performed more safely and precisely.”
Director Lee, a veteran enough to perform more than 5000 artificial joint surgeries over 15 years, recently introduced robotic artificial joint surgery to increase safety and precision.
“It is important to do the artificial joint surgery perfectly once. That way, we can use it for a long time without getting rid of it,” he said. “The robots that support artificial joint surgery in recent years are excellent in performance and serve as a great assistant for perfect surgery.”
Nevertheless, there are many things wrongly known about robotic artificial joint surgery, such as knowing that robots do all the surgery. On the 3rd, at Gangbuk Himchan Hospital in Dobong-gu, Seoul, I heard about robotic artificial joint surgery from Director Lee Kwang-won.
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Gwang-won Lee, director of Gangbuk Hemchan Hospital, explains by looking at an X-ray of an artificial joint. IS photo
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“Robot surgery can improve accuracy and success rate”
-The reason for introducing robotic artificial joint surgery?
“Existing artificial joint surgery also has a high success rate and high patient satisfaction, but we decided to use a robot to increase the accuracy by even 1%. Mako robotic surgery can further increase the accuracy and success rate of surgery by enabling prediction of the surgical outcome. In addition, Mako surgery has been proven to be effective and safe enough to carry out more than 350,000 surgeries around the world, and several advantages of robotic surgery are confirmed through various studies and papers.”
-The biggest advantage compared to general artificial joint surgery.
“It is precision. In the case of robotic surgery in other departments such as urology and obstetrics, the accessibility of surgery is improved by replacing a robot arm when a human hand cannot be reached, but robots in knee surgery are surgery with increased precision.
Robotic artificial joint surgery can accurately analyze the patient’s condition with 3D CT scans before surgery to establish a surgery plan in advance. Before surgery, it is possible to calculate the bone cutting range, the size of the artificial joint, and the angle and position of the insertion. In addition, the error range of surgery can be reduced, and unnecessary damage to normal soft tissue can be prevented, thereby improving the patient’s surgical prognosis.
As a result of comparing and analyzing groups of patients with robotic surgery and general surgery at the Joint Medicine Research Institute of Himchan Hospital, it was found that the range of motion of the joint and the angle of leg correction were improved, and the amount of bleeding discharged after surgery was reduced.”
-Is the robot doing all the surgery?
“Sometimes people misunderstand that robotic artificial joint surgery is entrusted to the robot. Robots present data as an aid to surgery. It serves as an assistant to the operating surgeon.
Using a computer program, the robot calculates the thickness and size of the artificial joint that fits the patient’s knee in advance, and shows the data on the surgery that best suits the patient.
The surgeon’s experience is added to this, and the operation is performed by reflecting various variables such as the degree of bending of the leg, the axis of the leg, and the balance of ligaments.
When cutting a bone, the doctor holds the robot arm and performs cutting. At this time, the robot sets the cutting range (haptic zone) in advance so that it does not deviate from this range, thereby preventing normal soft tissue from being injured. If the robot is out of the haptic zone, cutting is stopped, so the surgical error can be reduced to less than 0.5mm and precise surgery can be performed.”
“Even if it is a robot surgery, the skill level and experience success of the surgeon can be determined”
-The most important thing for a successful robotic surgery.
“The proficiency of the surgeon and various clinical experiences are paramount. Because individual patients have different characteristics, unexpected situations can occur during surgery. Even in the same terminal arthritis patient, the degree of damage is different, and there are a number of different cases, such as valgus and varus, as for leg deformation. In this case, in order to accurately determine and judge how to perform surgery, the proficiency and clinical experience of the operating surgeon must be supported.”
-Patients who want to recommend robot surgery.
“I would recommend it to all patients with terminal arthritis who need an artificial joint. I think it is more effective especially for patients with severe leg deformation. In the past, the deformed leg was visually corrected, but if you use a robot program, you can correct the angle and axis of the leg while looking at the numerical values calculated by the computer.
-What patients must know.
“You should not neglect rehabilitation after surgery. Rehabilitation exercise after surgery is an important exercise that reduces knee pain and strengthens the surrounding muscles to speed up recovery and return to daily life early.
Exercises to increase the range of motion so that the joints are not stiff and rehabilitation exercises should be conducted with concentration so as not to weaken the thigh muscles.
If rehabilitation exercise is neglected because of pain, the range of motion of the joint may decrease after knee surgery, and the patient may feel uncomfortable. Because muscle recovery is slow, there are cases where pain around the knee remains or it becomes difficult to walk.”
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Gwang-won Lee, director of Kangbuk Himchan Hospital, is performing robotic artificial joint surgery. IS photo
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“In case of knee pain, you need to treat it early so you can use it for a long time”
-Artificial joint surgery is said to be the last option. I was told that it was not unconditional.
“The treatment of knee degenerative arthritis is different depending on the stage of arthritis. In the beginning, conservative therapy such as drugs, injections, and physical therapy can reduce pain. In the mid-term afterwards, various treatments such as microperforation, cartilage regeneration, autologous cartilage graft, and corrective osteotomy can prevent arthritis from worsening.
However, if the cartilage is worn on X-rays and the bones collide with the bones, or the shape of the leg is severely deformed in O-shape or X-shape, it is uncomfortable enough to make it difficult to walk with severe pain, but there is no effect of other treatments such as medication, artificial joints You have to consider surgery.”
-How to keep your knee joint healthy for a long time to avoid artificial joint surgery.
“Reducing the burden on the knee joint is the most important. Maintain an appropriate weight, and improve lifestyle habits that put strain on the knees, such as sitting with legs or squatting. It is also good to strengthen the thigh muscles with an exercise that can strengthen the lower body strength without straining the knees, such as indoor cycling or swimming.
Above all, if you feel pain in the knee, it is better to get appropriate treatment early to slow the progression of arthritis.”
-The last thing I want to say.
“Artificial joints are known to be used for about 20 years if used well. In old age, the movement decreases a lot, so it can be used for life. If the artificial joint is operated accurately and precisely, it will last longer. It’s important to do it perfectly at once.”
Reporter Kwon Ohyong [email protected]
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