Special to Iredell Free News

Iredell Memorial Hospital is the first hospital in Iredell County to offer Mako SmartRobotics, robotic-arm assisted technology that transforms how total knee, partial knee, and total hip replacements are performed by helping surgeons know more and cut less.

Mako SmartRobotics is used in hip and knee joint replacement to allow precise placement of implants for each patient. It also helps protect soft tissues and ligaments in the patient’s joint.

Total knee replacements in the United States are expected to increase by 189 percent by 2030, yet studies show that 20 percent of patients are dissatisfied after traditional surgery.

The Mako system enables surgeons to have a more predictable surgical experience with increased precision and accuracy. It also helps patients have an easier experience after surgery.

“We are proud to be the first hospital in Iredell County to offer this highly advanced technology in our area,” said John Green, president and CEO of Iredell Health System. “The addition of Mako SmartRobotics further demonstrates our commitment to provide the community with outstanding healthcare.”

Mako SmartRobotics allows the surgeon to create a personalized plan based on each patient’s unique anatomy before ever entering the operating room. After a Mako surgery, patients experience less pain in the days and weeks following surgery than non-robotic surgery patients.

Dr. Jeffrey Reeves
Dr. Brett Feldman

Dr. Brett Feldman and Dr. Jeffery Reeves, orthopedic surgeons with Piedmont Healthcare, are utilizing Iredell’s Mako system.

“It is an exciting technology as it allows dynamic positioning of joint implants in the exact position the surgeon wishes to place them. It gives the surgeon control over the surgery that did not previously exist,” said Reeves.

Studies show that Mako SmartRobotics offers multiple benefits for patients, including:
• Less bone and soft tissue damage;
• Less time to hospital discharge;
• Less need for in-patient physical therapy sessions;
• Less pain after surgery; and
• Less need for opioid pain medications following the surgery

“Patient outcomes have been terrific. Some of the more challenging issues related to achieving balance and stability in the more difficult cases have been greatly simplified,” said Feldman, who has performed 51 knee replacements and 14 hip replacements using Iredell’s Mako system.

According to Reeves, patients with osteoarthritis, rheumatoid arthritis, post-traumatic arthritis, avascular necrosis, osteonecrosis, or certain types of femoral neck fractures, among others, could be ideal candidates for a Mako surgery.

How does Mako SmartRobotics work?

Before surgery, each patient will receive a CT scan of the joint needing replacement. The CT scan combines a series of x-ray images taken at different angles to make a 3D model of the joint. This virtual 3D model is then loaded into the Mako system and used to make a patient-specific, preo-operative plan.

“Once uploaded into the Mako system, we can accurately predict what size implants will be needed for each joint replacement as well as be able to see how the implants match the specific patient’s anatomy,” said Reeves.

After the surgeon reviews and validates the pre-operative plan, the patient is ready for surgery.

During surgery, Mako SmartRobotics uses special sensors to help the machine know where it is in relation to the patient’s bone. The surgeon registers the patient’s anatomy to the CT scan loaded into the system, allowing Mako to “see” the edges of the bone, which then ensures controlled and precise cutting during the operation.

“By seeing exactly where the saw is cutting on the computer screen, I am able to make the cuts without removing as much surrounding tissue,” said Feldman.

Once the patient’s joint is registered to the Mako system, the surgeon is ready to operate. The surgeon guides Mako’s robotic arm to the diseased bone and cartilage.

Using the pre-operative plan, Mako SmartRobotics creates a virtual boundary, preventing the surgeon from removing any more bone than needed. The robotic arm will only cut places that were previously selected during the pre-operative plan and will not go out of that zone. This preserves more bone and creates a smaller cut.

It’s important to note that although Mako SmartRobotics is a cutting-edge tool, it still relies on the data the surgeon inputs into it, as well as the surgeon to correctly utilize the data it generates.

“Occasionally, patients will wonder, ‘who does the surgery, the robot or the surgeon?’” said Reeves. “The robot merely helps the surgeon execute the plan. The surgeon is in complete control within the boundaries set to make the cut.”

“While there is no substitute for the training and experience of the surgeon, the Mako robotic system reduces the time and effort required to ensure proper balance and alignment of the joint replacement, which is critical to the long-term success of the procedure,” added Feldman.


If you are considering joint replacement, you can visit patients.stryker.com for more information and video walkthroughs on Mako SmartRobotics.

If you would like to schedule a consultation with Dr. Jeffrey Reeves or Dr. Brett Feldman at Piedmont Bone & Joint, call 704-873-3250.

About Iredell Health System

Iredell Health System includes Iredell Memorial Hospital; Iredell Mooresville; Iredell Home Health; Iredell Wound Care & Hyperbaric Center; Community and Corporate Wellness; Occupational Medicine; the Iredell Physician Network and more. Iredell Memorial Hospital is the largest and only nonprofit hospital in Iredell County. The comprehensive healthcare facility has 247 beds; more than 1,700 employees; and has 260 physicians representing various specialties. Centers of excellence include Women’s and Children’s; Cardiovascular; Cancer; Surgical Services and Wellness & Prevention. The Health System’s newest campus, Iredell Mooresville, is home to the area’s only 24-hour urgent care facility, as well as an ambulatory surgery center, imaging center, rehabilitation services, and physician practices. The mission of Iredell Health System is to inspire wellbeing. For a comprehensive list of services and programs, visit www.iredellhealth.org.