Orthopedics (sometimes written as Orthopaedics) is the branch of surgery focusing in treatment of the muskuloskeletal system. Orthopedic surgeons use both surgical and non-surgical procedures to treat muskuloskeletal trauma, spine diseases, sports injuries, degenerative diseases, injections, tumors, and congenital disorders. Some orthopedic surgeons specialize in the joints of the hands or ankles, while others specialize in treating the shoulders or joints of the hip and knees. Dr. Robert Ference specializes in minimally invasive treatment of hip, knee, shoulder, hands and back pain diagnoses. He uses images such as xrays, MRIs, and CT Scans as well as a thorough evaluation to diagnose and treat.

Not all orthopedic surgeons have the training to provide your surgery using robotic technology. Or, the hospitals or surgical centers at which they perform their surgeries may not have invested in advanced technologies. Dr. Ference was one of the early adopters of Mako robotic technology for partial knee replacements, total knee replacements, and total hip replacements. The Mako system has been shown to provide better alignment for knee replacements and often allows for less scarring and surgical time, especially for partial knee replacements.

The majority of people who have chronic knee pain that makes mobility difficult also have arthritis which is causing the cartilage cushion between your bones to wear away. Some people only have arthritis in one or two compartments of their knees and can benefit from a partial knee replacement, while others have cartilage damage to all three compartments of their knees which is often treated with a total knee replacement. Both knee replacements can now be done robotically, minimizing scarring, recovery time, and creating a longer lasting and more aligned leg.

Dr. Ference explains in this video what he looks for in your xrays to determine in you are a candidate for a partial knee replacement using Mako robotic technology. Your knee is a joint made up of three different compartments: the inside knee, the outside knee, and the front of the knee called the patella. Generally speaking, your knee pain is caused by the wearing-away of cartilage as a result of arthritis or an injury. Once the cartilage is damaged, there is no longer a cushion between the bones so your knee becomes painful and inflamed. If the cartilage is only wearing away in one part of your knee you will feel pain in only one of those three compartments. The best way for Dr. Ference to diagnose how much disease is in the knee joint is by an x-ray. If he sees that only one of your knee compartments is diseased, you may be a candidate for a partial knee replacement. If you have pain and more arthritic damage in two or three compartments of your knee, it is more likely you would benefit from a total knee replacement (also called a total knee arthroplasty). For a video-recorded interview I did with more details, click here. He also wrote a blog post you may read for more details by clicking here.

Dr. Ference may use robtoc technology to remove arthritic bone to make a more perfect fit and better alignment for your implant in the knee or hip, but the robot does not perform the surgery itself. In the operating room, Dr. Ference guides the Mako’s robotic arm to remove the arthritic bone and cartilage from the knee or hip. The robotic arm provides tactile resistance to help protect soft tissue and helps the surgeon stay within the boundaries defined by your surgical plan.

Dr. Ference explains the different between an anterior hip replacement vs. surgery done going in through the side or back of the hip in this video.

If you have scheduled surgery for a partial knee, total knee, or hip replacement, a well-established program for patients has been created to optimize your preparation and recovery. This very beneficial educational program will provide you and your support person the tools to be confident you are well-prepared with equipment, medications, and therapy.

The clinical nurse who teaches this 45-minute educational program will also assist you with getting you the right equipment ordered, schedule your physical therapy, and provide your support partner with helpful guidance that will make your surgery go smoother and with optimal results. The clinical nurse will schedule your joint educational class prior to surgery.

Mako is for people with:

• Severe knee pain or stiffness resulting from noninflammatory degenerative joint disease (including osteoarthritis, traumatic arthritis, or avascular necrosis), rheumatoid arthritis, or post-traumatic arthritis.

• People who have not experienced adequate relief with conservative treatment options, like bracing, medication or joint fluid supplements.

Most people who get a knee replacement surgery and who also participate in a physical therapy regiman prescribed by Dr. Ference will return to their day-to-day activities like driving in 4 to 6 weeks, but everyone is different. Depending on your lifestyle, Dr. Ference will help you with a recovery plan best suited for your goals and needs.

In a few weeks following your knee surgery, Dr. Ference may encourage you to start lower-impact activities like hiking, walking, cycling, and golfing.

The first Mako procedure was performed in 2006. Since that time, more thant 200,000 Mako total knee, partial knee, and total hip replacement procedures have been performed. Dr. Ference was one of the first in Michigan to begin performing robotic-arm assisted arthroplasties in 2010. He has peformed over 6000 surgeries.

Most inpatient surgeries are done at one of three locations: the Detroit Medical Center Sinai-Grace Hospital in northwest Detroit, The Straith Clinic in Southfield, or St. Mary’s Hospital in Livonia. Dr. Ference provides patients with a smooth and safe surgical process from beginning to end. The nursing unit you will be admitted to will be 2-West. Most patients having joint replacement surgery will be in the hospital for a total of 1-2 days.

All patients are different but partial knee replacement patients are going home the same day or the day after surgery as surgery, while total knee replacement patients generally stay 2-3 days in the hospital.

Possibly. Some patients may benefit from revision surgery. A thorough exam, xrays, and review of your past studies will help Dr. Ference determine if you could benefit from a revision surgery. Please call the office at 313-581-2121 to schedule a consultation.

How do I know if I’m a candidate for a partial knee replacement as opposed to a total knee replacement?

Dr. Ference explains in this video what he looks for in your xrays to determine in you are a candidate for a partial knee replacement using Mako robotic technology. Your knee is a joint made up of three different compartments: the inside knee, the outside knee, and the front of the knee called the patella. Generally speaking, your knee pain is caused by the wearing-away of cartilage as a result of arthritis or an injury. Once the cartilage is damaged, there is no longer a cushion between the bones so your knee becomes painful and inflamed. If the cartilage is only wearing away in one part of your knee you will feel pain in only one of those three compartments. The best way for Dr. Ference to diagnose how much disease is in the knee joint is by an x-ray. If he sees that only one of your knee compartments is diseased, you may be a candidate for a partial knee replacement. If you have pain and more arthritic damage in two or three compartments of your knee, it is more likely you would benefit from a total knee replacement (also called a total knee arthroplasty). For a video recorded interview I did with more details, click here.