Pretoria hospital first in Tshwane to use robotics to help with knee and hip replacements

A Pretoria hospital has become the first in the region to use a state-of-the-art robotic surgical system to perform hip and knee replacements for patients from northern Gauteng and surrounding provinces.

The Netcare Pretoria East hospital is the first hospital in the province to use the so-called Mako robotic system.

There are only a handful of these advanced systems in the country.

The first assisted hip surgeries were performed last year November by Dr Wian van der Merwe.

According to the hospital, many more patients have since chosen to have this option for their surgery and 12 such surgeries have since been performed at the hospital.

Van der Merwe explained that the system was designed to further improve surgical precision.

“The technology assists the surgeon in planning the procedure, and provides additional checks in real-time at each stage during the operation,” he said.

“Based on a CT scan of the patient’s knee, the system’s sophisticated software develops a three-dimensional digital map of the knee. It calculates the optimal implant size, placement and alignment of the prosthetic knee joint to fit the patient’s specific anatomy. This data is then translated into a preoperative surgical plan.”

The system combines three key components – 3D CT scan-based planning, AccuStop technology and insightful data analytics – into one platform for more predictable and personalised orthopaedic procedures.

The orthopaedic surgeon said the technology offered an extra level of precision, adding to the surgeon’s technique and experience.

“On the day of the procedure, the digital 3D map of the knee is carefully aligned to the patient’s actual knee in theatre, and the surgical plan is validated,” Van der Merwe explained.

“The dimensions needed for the procedure are set. At these boundaries cutting automatically stops, serving as an additional safeguard to preserve the surrounding soft tissues and healthy bone. The resections achieved are extremely accurate to the surgical plan, being within a fraction of a millimetre.”

As the surgeon guides the robotic arm system, it provides detailed visual, auditory and tactile feedback.

While some may worry about machines replacing human beings in the workplace, this was not the case. The robotic system cannot do anything without the surgeon.

“Rather, it helps keep the surgeon within the optimal dimensions to match the patient’s anatomy through the defined surgical plan.”

Van der Merwe explained why accuracy was important.

“The stability of the knee joint, as well as the range of motion and comfort a person enjoys after a knee or hip replacement, can be greatly influenced by the accuracy of the fit of the prosthetic joint for the specific patient,” he said.

“In addition, where there is minimal interference with the surrounding soft tissues, the post-operative recovery can often be quicker. This technological advance is a further tool we can use to help deliver advantages such as these for our patients.”

The hospital’s general manager Pieter Louw congratulated Van der Merwe and his colleague Dr Tiaan Stoffberg for achieving full accreditation to use the advanced technology.

To achieve accreditation, the specialists completed comprehensive training in Istanbul, Turkey, with the new SmartRobotics surgical system.

“By the end of June, a further two orthopaedic surgeons practising at our hospital will complete the final leg of their accreditation in the use of the robotic-assisted system,” Louw said.

“This will result in a total of four experienced orthopaedic surgeons offering this option to people requiring knee and hip replacements at our facility.

“We are pleased that the introduction of this Mako robotic system now offers this world-class option to more patients in need of knee or hip replacement surgery.”

The hospital was only the fourth facility within the Netcare group where robotic-assisted knee and hip replacement surgery is available.

The others are the Netcare Linksfield, Pinehaven and Blaauwberg hospitals.

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