Robotic knee replacement surgery gets patient back on her feet

Nearly 30 years ago, Robin Ward was a passenger on the back of a motorcycle traveling near Bryce Canyon, Utah, when she was involved in an accident.

“We hit a deer at about 60 miles per hour and it’s amazing that we even survived,” she said. “My right knee hurt and was swollen but since X-rays showed nothing broken, that was that. But over time as I was running and doing lots of other things, my knee began to hurt more and more.”

Ward tried cortisone shots in her knee for several years to alleviate the pain but gradually they became less effective. An MRI showed that it was time to take a different approach, as her gait began to change and the left knee began to take the brunt.

A little help from friends

Robin shared her gratitude for the help that she and Scooter received from friends during her recovery. Pictured from left to right: Susan Henderson, Linda Morningstar, Robin Ward, Gail Vick and Julie Dunlap. Photo credit: Jeff Burkhead

She wondered if robotic surgery was an option. Ward knew about the MAKO robotic technology available at OrthoKansas.

“That’s what prompted me to make the call. I had been at Sports Pavilion Lawrence walking laps with my friend, Julie Dunlap. We were walking at a brisk pace and my knee gave out,” she said. “Julie told me to sit down and take a breath. While I was sitting there, I pulled my phone out and made the appointment. I was hoping that I was a candidate for robotic surgery and luckily, I was.”

Ward made an appointment with OrthoKansas and met with orthopedic surgeon Dr. Adam Goodyear. She shared that her biggest symptoms were pain and instability in her right knee, which were causing problems with the activities she enjoyed.

“Robin said that pain was limiting what she could do in her yoga practice. When we took images, they showed she had bone-on-bone arthritic changes in her right knee, bone spurs and pseudo subluxation. This means that the femur shifts a little on the tibia due to a lack of cartilage and that can give a feeling of instability,” Dr. Goodyear explained.

He wasn’t able to definitively link Ward’s symptoms to her previous injury, but Dr. Goodyear concluded that she needed surgery to replace the knee. He also made it clear that not everyone who comes in with arthritic changes needs a joint replacement.

“If we determine surgery isn’t the best option for you, we have an outstanding team of sports medicine physicians and therapists,” Dr. Goodyear said. “It’s our goal to make sure that you get care that’s not only exceptional for a community hospital – it’s among the best anywhere.”

He told Ward that since she was active, functionally able to tolerate surgery and didn’t have medical issues that would preclude it, she was a candidate for knee replacement using the MAKO robotic arm. This technology helps surgeons to customize the knee replacement for each patient, as there are subtle changes in anatomy from person to person.

But how does MAKO work? Dr. Goodyear explained that patients begin by undergoing primary X-rays in the clinic. If the surgeon decides that joint replacement is the answer, more scans are ordered.

“The patient gets a pre-operative CT scan and we use those images to create a 3D software model the surgeon uses prior to, and during, surgery,” he said. “This allows the surgeon to match the patient’s anatomy to the model and software helps run the robot during surgery, ensuring the joint is precise to the patient’s anatomy.”

LMH Health has two MAKO robots to serve patients – one at the Main Campus and another at the West Campus, allowing for outpatient joint replacement surgery at the Lawrence Surgery Center. Funded in part by donor support through the LMH Health Foundation, the MAKO robots have been proven to facilitate a shorter hospital stay, typically less pain and a quicker return to function.

Ward checked into the Main Campus for an inpatient knee replacement surgery in May and was able to have a spinal block to manage her pain. Ward joked that since she was immobile from the hips down afterward, it was probably a good idea for her to spend the night in the hospital.

“I didn’t feel any pain after surgery and still felt really good the next morning. I did physical therapy with the inpatient therapist, did a little occupational therapy and had breakfast. As Nate (Kasting), Dr. Goodyear’s physician assistant, was discharging me, I told him that I was expecting to be in a lot of pain but I wasn’t,” she said.

As the nerve block began to wear off, Ward started experiencing post-operative pain. She said the first night and several days were hard, but by day eight, the pain was very manageable. Robin was even walking without the use of a walker.

“I’m a rule follower almost to a fault, so I was really good about doing both my pre- and post-op exercises. I started physical therapy the day after I came home and was committed to doing it,” she said. “I knew it would hurt and be hard but if I didn’t push through it, I would hurt a lot longer. By the third week, I felt very good, and even better each week after.”

Ward also knows that she wouldn’t have been successful without help from family and friends.

“We had such good people looking after me and Scooter [Ward’s husband] and helping us through the whole situation. I’m so thankful that when I was feeling a little helpless and not knowing how to make it all work, our friends and family were right there to provide their support,” she said.

Dr. Goodyear is pleased with Ward’s progress.

“She’ll be able to get back to everything that her knee was limiting her from doing. Robin is going to have a fantastic recovery,” he said.

Ward is hopeful that she won’t need her other knee replaced anytime soon. If she does, she will turn to OrthoKansas. From calling for the first appointment to scheduling surgery, Ward said the process was smooth from start to finish.

“If I had a question about how I was feeling or if I needed to make a change to my pain management, the team was quick to answer and walk me through it,” she said. “I really appreciated that they were so responsive.

“If you’re a patient who lives anywhere near Lawrence, go to OrthoKansas. Dr. Goodyear is amazing. Not only is he very smart and skilled, he’s a great person. It was easy to get to know him and I always felt like he was taking a personal interest in me and my care.”