Surgeons use robotic arm to assist in joint surgeries

Janie Wagner says if she had a third knee she would go under the knife again for a total joint replacement surgery without blinking, assuming the procedure was performed at North Valley Hospital and with the assistance from the hospital’s new Stryker Mako Robotic Arm technology.

The 73-year-old Flathead County resident has had the daunting surgery performed on both of her knees at two separate times by the same surgeon at North Valley.

Her left knee was replaced first by traditional methods and then in November 2019 her right knee was replaced, but this time with assistance of Mako, which guides doctors through their operations, helping them make more precise cuts and better-protect healthy bone.

And for Wagner, the difference in her procedures and recovery times between the traditional surgery and Mako-assisted surgery were striking.

“It was a night-and-day difference,” Wagner said. “It was simpler, easier and I recovered my movements in my knee faster. I barely had to use prescription painkillers even. The whole process felt less invasive.”

According to Dr. Timothy Joyce, the surgeon who performed both of Wagner’s surgeries, the robotic device allows him and the two other doctors at North Valley who use the machine to cut less, and “better personalize” the joint replacement surgeries. Joyce said this particular technology is the first of its kind in Northwest Montana.

The Mako — one of the hospital’s most recent capital investments — uses a CT-based planning software to capture 3D images of the patient’s joint so surgeons can have a clear understanding of the person’s individual anatomy prior to operating. Joyce said this is important because the size and wear and tear of joints vary from patient to patient.

“Before this we would be looking at 2D images instead, and going from that to 3D is like going from using a map to using GPS instead. We can read maps and get from point A to point B just fine, but now we can do even better,” Joyce said. “This type of accuracy is not usually found in traditional methods. We can make very, very fine-tuned adjustments.”

Joyce noted it is important to understand the Mako is not an autonomous robot, but a tool that assists him. Aside from capturing 3D images for study prior to operation, another way it assists is if for some reason a surgeon begins pushing a blade too far into a person’s bone, there is a safety feature that shuts the machine off.

This feature, which ultimately sets certain boundaries for a surgeon, was one that Joyce and others highlighted when asking North Valley leadership to consider the robotic arm as a capital investment. They also pointed to how the device is in its third generation — a sign the technology has advanced greatly since first being rolled out in the early 2000s. Finally, the fact that the Mako can assist surgeries other than a total knee replacement was a selling point.

“There was an opportunity to spend money on our orthopedic side to update software and we knew we wanted to pitch this,” Joyce said. “This is tech that we believe in.”

Since the Mako was purchased, Joyce and two other doctors have performed more than 80 joint-replacement surgeries. Although there is no set number of cases or when the technology may need replacing, hospital officials say the equipment the robotic arm replaced was at least 10 years old.

And Joyce said the hospital’s investment in Mako certainly won’t go to waste.

“There is a myriad of people that will need these types of joint-replacement surgeries,” Joyce said.

The procedures are becoming far more common, particularly among active individuals and older adults — two populations that are prevalent in the Flathead Valley. Not only is the area a prime location for outdoors enthusiasts leading active lifestyles, but Flathead County is one of the fastest-aging counties in the state as well.

According to a recent report from the Area IX Agency on Aging based in Kalispell, about 28% of Flathead County’s population is 60 years of age or older and officials only expect this number to increase in the coming years.

“The baby boomer age group that is starting to hit retirement age is large and many will be going into a phase soon where maybe they had some soreness in a joint, but now it’s likely becoming worse,” Joyce said. “So there is that, and then the average age for a knee replacement surgery is also getting younger, so have a large age range to cover.”

That average age these days is 65. And the average lifespan of a new knee is about 18 to 20 years, depending.

Joyce said it’s too early to tell whether the Mako will extend the lifespan of a new knee, but results from the technology’s first few generations are yielding promising results.

“The preliminary data is showing technology like this is the way to go and it’s clear that our industry is going down a path where robotics will become more common,” Joyce said. “For North Valley to be able use the same type of cutting-edge tech that you see being used in really big-name hospitals where patient outcomes and care are top priorities as well, is huge.”

Kianna Gardner can be reached at 758-4407 or kgardner@dailyinterlake.com