tomized for each patient. We even have computer navigation that
serves as a sort of mini-GPS in the OR, giving surgeons a firm under-
standing of the terrain of the knee even before we get inside. A lot of
surgeons — myself included — go into the operation with a backup
plan to do a total knee replacement in the event that the pattern of
arthritis or the state of the knee cartilage and ligaments differs signifi-
cantly from what the pre-operative imaging tests indicated. Pre-opera-
tively counseling patients about this contingency and getting their per-
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learning curve is pretty quick — maybe a dozen cases. But even if
it does take longer, the benefit you gain from the precision and
accuracy is worth an extra 20 or 30 minutes of my time for the life
of the patient."
Tom Antkowiak, MD, MS, an orthopedic surgeon with the
Midwest Institute for Robotic Surgery at Silver Cross Hospital in
New Lenox, Ill., still does total knee replacements without robotic
assistance. Unis are a different story; he performs almost all of
his unis robotically.
"Robot-assisted partial knee replacements may be a good
segue for surgeons who are interested in learning the outpatient
side of arthroplasty," says Dr. Antkowiak. "It has certainly made
me more comfortable doing these as outpatient procedures."
At the moment, cost is the biggest roadblock to broader adop-
tion. Of the orthopedic robotic surgical arms currently on the
market, prices range anywhere from a few hundred thousand
dollars to more than $1 million. But Dr. McWhorter believes
health systems will see a comparatively quick return on the
investment.
"People want the latest and greatest technology, so it draws
people to a health system," he says. "As a patient, you may not
even qualify for the procedure, but it still might draw you in for
other services, so it's a marketing tool in and of itself."
— Bill Donahue
