Robot-assisted technology and 3D printing are among the tools being used at Tampa General Hospital and the USF Morsani College of Medicine to treat orthopedics patients with techniques that lead to improved outcomes, including quicker recoveries and less pain.
A National Leader in Orthopedic Care
Dr. Michael Miranda, an orthopedic surgeon at the Tampa General Hospital (TGH) Orthopedics Institute and Florida Orthopaedic Institute, has earned a sterling reputation for his use of robotic-assisted technologies to achieve greater surgical precision during knee and hip replacements. The all-fellowship trained surgeons of Florida Orthopaedic Institute, the largest orthopedic group in Florida, lead research and development of the latest surgical practices and technological advances to help keep TGH at the forefront of world-class care.
The MAKO RIO™ Robotic Arm Interactive Orthopedic System, one of the leading technologies at TGH, is used for hip replacements and total and partial knee replacements. TGH surgeons control the robotic arm using tactile, auditory, and visual feedback; the arm provides greater precision and consistency for bone preparation and customized implant positioning.
"It can cut to less than half a millimeter accuracy-that's pretty accurate," Miranda said.
Miranda's design team is currently developing pressure sensors that can help with the measurement and balancing of ligaments on both sides of the knee, "so the patient doesn't even feel like they have a knee replacement," he said. "Robotic technology is not just a cutting tool. It can give the surgeon a lot more information and feedback, such as component sizing and ligament balancing throughout the procedure."
Some of the newer, more advanced orthopedic procedures available at TGH include a direct anterior approach to hip replacement, performed through a small incision at the front of the hip rather than the more traditional posterior approach. Surgeons like TGH's Miranda are early pioneers of this anterior surgical approach, which is not universally practiced because of the technical demand. However, Miranda and his colleagues prefer the novel anterior approach because it avoids the need for a considerably larger incision. Furthermore, unlike most posterior techniques, the anterior approach reduces the need to cut -and later repair-muscles and tendons to reach the damaged joint.
"The results are proven," said Miranda. "Patients have less pain and get back to their normal activities more quickly."
Aside from using novel surgical technologies, the TGH Orthopedics Institute and USF Morsani College of Medicine's surgeons have leveraged 3D-printed models for preoperative planning, which has been critical in improving patient outcomes. These models, printed based on patient CT scans, allow surgeons to precisely size, rotate, and position implants customized to a patient's joint, consequently reducing surgical times and resulting in greater implant longevity and patient mobility and function.
"The thing I've been amazed about is the accuracy,'' Miranda said. "The preoperative plan and what you've executed match perfectly. Patients are up and moving and out of the hospital quickly and back to their activity level in four to six weeks. You can't argue with that kind of result."
Industry-wide studies show as many as 10 percent of orthopedic patients aren't satisfied with their care. However, Miranda believes that continued technological progress can improve outcomes for everyone. As such, the orthopedic team at the TGH Orthopedics Institute continues to refine surgical robotics and 3D modeling and develop the next generation of orthopedic technology, such as augmented reality (AR), for training and simulations.
