Surgeon touts high-tech Mako system for knee replacements – 32963 Features, Health


Osteoarthritis can make daily activities like getting up from a chair or climbing stairs difficult to perform without knee pain and stiffness. The need for knee replacements in the United States is increasing with over 600,000 knee replacements performed each year.

Fortunately, innovations in medical technology allow surgeons to perform more accurate and precise procedures using robot-assisted systems like Stryker’s Mako system.

Dr. Alfredo Arrojas, orthopedic surgeon certified by Vero Orthopedics, specializes in total joint reconstruction. He is Mako certified to perform total and partial knee replacements (and total hip replacements).

“One hundred percent of my knee replacement surgeries are done robotically,” Dr. Arrojas said. “The Mako System offers unparalleled surgical precision, allowing precise placement of implants while leaving surrounding tissue intact.

“Traditional knee surgery is done with metal cutting blocks that have to be pinned in place and you have to stretch the soft tissue and skin in order to get it into place properly.

With a robotic arm, I can make a cut without a metal guide, which reduces stress on the skin and tissues. We are able to do surgery without traumatizing the surrounding tissues and this leads to faster recovery.

So how does it work?

Well, first a scan of your knee is taken. Highly advanced software reads the scan and creates a 3D model of your exact knee, helping the surgeon formulate a personalized preoperative plan.

This 3D model is uploaded into the Mako so the surgeon can see the pre-surgical plan overlaid on the surgery in real time to use as a guide.

Mako’s robotic arm holds the surgical instrument, but the instruments are under the surgeon’s control the whole time. Your surgeon prepares the bone within visual boundaries that protect the knee structure and removes only the part that was affected. The implant is placed and the joint correctly balanced. Your surgeon can make adjustments if necessary.

“During the operation, we make an incision in the front of the knee that allows us to enter the knee with arthritis,” explained Dr. Arrojas. “The ends of the thigh and tibia bones that are worn away are shaved off just enough to insert the device. The implant is made of metal and plastic, with the metal parts replacing the damaged femur and tibia and the plastic replacing the cartilage on the tibia and patella We replace all surfaces that rub together.

“Patients walk with a walker just hours after surgery. If my patient has a good social organization at home, I can send him home the same day. If there is no home support or the patient has other medical issues, we will keep them longer but no longer than 23 hours, so it is still considered an outpatient procedure by the standards of insurance. Most patients will return to their daily activities in one to four weeks.

Knee replacements should last 15 to 20 years, depending on your activity level and health condition. It’s important to keep your weight low because every pound you gain feels like 4 pounds on your knee and hip joints. Low-impact sports like swimming, walking, cycling, and golf are safe ways to keep the knee moving.

Dr. Arrojas was drawn to the field of orthopedics because it blended his mechanical abilities with his surgical mind.

“One of the first procedures I saw in medical school was orthopedic surgery and it made sense. I was always mechanically oriented and loved taking things apart and putting things back together when I was a kid, and I quickly learned that joint replacement is one of the few specialties where you can change someone’s life so quickly.

“We can take a patient almost in a wheelchair and make them normal again. Giving them back their mobility and relieving their pain changes everything. It is very rewarding.

Dr. Arrojas was born and raised in Miami, the son of Cuban immigrants, and is fluent in Spanish. After graduating from Florida International University in Miami, he received his medical degree from Drexel University College of Medicine in Philadelphia and completed an orthopedic surgery residency at Palmetto Health/University of South Carolina in Columbia.

Devoting an additional year to specialty training, Dr. Arrojas earned a total joint reconstruction fellowship from the CORE Institute in Phoenix. He is now accepting new patients at Vero Orthopedics, 3955 Indian River Blvd., Vero Beach. Call 772-569-2330 or visit for an appointment.

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