Five Questions With: Dr. Robert C. Marchand

South County Hospital surgeon talks about MAKOplasty, a surgery for partial knee replacement and total hip replacements. More

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Five Questions With: Dr. Robert C. Marchand

COURTESY SOUTH COUNTY HOSPITAL
"I THINK most people would expect a higher level from their surgeon," said Dr. Robert C. Marchand, a South County Hospital surgeon.
Posted 12/5/11

South County Hospital continues to invest in the use of MAKOplasty surgery for partial knee and total hip replacements, surgeries that have become more frequent as Baby Boomers age. The surgical technique makes use of a robotic arm and real-time 3D imaging.

In December 2010, Dr. Robert C. Marchand performed the first MAKOplasty surgery for partial knee replacement in Rhode Island at South County Hospital. Fittingly, the first patient to undergo the new surgical technique was a robotics professor at the University of Rhode Island, who videotaped the procedure to use as a teaching resource in his classes.

Providence Business News asked Marchand to share his insights about how the new technique is changing the future or orthopedic surgery.

PBN: The addition of the use of MAKOplasty for total hip replacements at South County puts the hospital in the forefront in orthopedic surgery in New England, following the use of MAKOplasty for partial knee replacements. How has this translated to increase in demand from patients?

MARCHAND: We had, [historically], done about 75-to-89 partial knee replacements over the course of a year. With the addition of the robotic arm technology, South County Hospital has done about 420 – and I have done [slightly more than] 300 – during this last year.

I think as people learn about the technology accuracy precision and reproducibility of the MAKOplasty hip procedure, I expect this will translate into similar results.

We are currently filling surgical schedules out though February now. We are also in negotiations to bring on another robotic arm to accommodate the growing demand. And, we are actively recruiting surgeons to the area.

PBN: The surgeon controlled robot arm with a “virtual GPS” for the body with real-time 3D images – is this the future of surgery?

MARCHAND: Good question. There is ongoing controversy concerning the use of robots and navigation. [There are] concerns are expense, and whether there is a need to shoot for precision, when maybe being good is OK.

I think most people don’t try to be just average or good enough; I think most people would expect a higher level from their surgeon. I do think the applications of robots and navigation as a tool to improve results is here [to stay], and the application of this to other fields exists, too.

PBN: There have been an increasing number of complaints regarding hip replacements, particularly partial hip replacements. How is the MAKOplasty surgery different?

MARCHAND: This question, I think, refers to the metal on metal problems reported in [a recent article] in The New York Times. This is a complex issue and has no bearing on the MAKOplasty procedure. The MAKOplasty procedure is a traditional uncemented stem and cup placed with the assistance of the robotic arm. The articulation is metal on cross-linked poly or ceramic on cross-linked poly cups.

PBN: How important is the development of orthopedic excellent at South County Hospital for the financial well being of the hospital?

MARCHAND: This is probable more accurately answered by [others at the hospital]. But we are increasing our inpatient bed capacity to 20, the operating rooms are filled though February with elective joint replacements, and we are contracting for a second robotic arm. My operating room time has gone from 2 full days to 3.5 full days, so I think it is huge for the hospital.

PBN: Is there great interest from other orthopedic surgeons in the region in being trained on MAKOplasty?

MARCHAND: Good question; I have no idea. I hear a few want on staff to utilize the robotic arm. I think the first hurdle is believing in the use of knee resurfacing for knee arthritis. Then you have to believe in navigation; then you have to believe in the use of robotic arm precision. I am not sure if these concepts are readily accepted by all orthopedic surgeons.

I do know our entire group has or is being trained on the hip application [using] the robotic arm.

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