Surgery Center at Pelham in Greer, S.C., has made history as the first ASC in the world to perform total knee arthroplasty using Stryker’s Mako robotic power system. The milestone was years in the making and one that the performing surgeon played a unique hand in bringing to life.
Frank Armocida, MD, the orthopedic surgeon who performed the first procedure, and Bill Hazen, the center’s director, joined Becker’s to discuss the ASC’s journey to the achievement.
Dr. Armocida, who has spent years exclusively performing technology-assisted knee replacements, was directly involved in the research and design of the Mako RPS technology through a partnership with Stryker.
Through the ASC’s relationship with its Stryker representative, Dr. Armocida was connected with the company’s research team and eventually pulled in to participate in initial prototype testing on cadavers to assess the tolerances, accuracy and precision of the saw.
“When Stryker released their robot, I was curious: Why hadn’t they done more with their navigation system, which has been out for almost 30 years?” he said. “Because of my experience doing exclusively navigated procedures, I was able to provide useful feedback.”
For Mr. Hazen, the accomplishment comes down to a deliberate, relationship-driven strategy.
“Our entire philosophy is built on relationships,” he said. “By building that relationship with Stryker, we were able to get the equipment up here and collaborate hand in hand with them on how to make it work in an ASC setting, how to make it cost-effective and how to get a return on investment.”
Stryker announced the limited market release of the Mako RPS in February. The handheld robotic system is designed specifically for ASCs, delivering image-free intraoperative planning and robotic guidance without the use of cutting blocks. Compared to traditional robotic systems, it has a significantly smaller footprint, which is a key advantage in outpatient settings.
“It’s not a departure from what I’m used to in the sense that you’re still holding a saw,” Dr. Armocida said. “But you’re able to make a surgical plan for where you want to place the components and then make your cuts without using any cutting guide. The saw controls itself. As long as you’re within a centimeter above or below the plane of resection, it will make fine adjustments — around 100 per second. It’s a truly incredible piece of equipment.”
The system’s quick room-to-room portability is another operational advantage, Mr. Hazen noted, which is well-suited for a facility where patients are in and out within four hours.
For Dr. Armocida, the experience has also been personally meaningful.
“My undergraduate background is in engineering, so to sit there and have conversations with research and design engineers about what I think is genuinely groundbreaking technology has been remarkable,” he said. “This delivers an unprecedented level of accuracy and precision.”
Looking ahead, Surgery Center at Pelham is working with Stryker to become a demo site, where physicians and centers from across the country will visit to learn from Dr. Armocida firsthand.
“We’ve done something similar in the past with other technologies, and the staff actually loves it — there’s real pride in being the place others come to learn,” he said. “But what excites me most is that this is going to attract more surgeons and more patients. Patients are going to seek this out because of the accuracy.”
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