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Radical Robots

People & Places

Written by Lauren Hunsberger

Photography by Taryn Emerick

Local orthopedic surgeon Dr. Christopher Boone uses the most cutting-edge technology to perfect joint replacement surgeries.

There was exactly one instance in which orthopedic surgeon Dr. Christopher Boone disagreed with the information he received from the robotic arm-assisted technology he uses to perform knee and hip replacements. He immediately pulled the plug on the robot, grabbed the X-ray and finished without it.

“But the robot was right,” he says. Coming to the same conclusion cost him minutes while the patient was on the table with an open wound.

In the end, the operation was as successful as the hundreds of others he performed before he had the technology. But the experience made a strong impact on Boone, who has a background as a trauma surgeon and greatly values efficiency.

“The robot has never been wrong, not once. If it gives you numbers, and you think you know better, you are wrong. It’s that simple,” he says.

Boone currently practices with Proliance Bellevue, and he says the robots can see things even the best surgeons in the world can’t and therefore they can be much more precise.

“Everyone’s knee is different. Some people have knock knees; some have a more saddle shape. If you’re using the standard protocol, you pretty much put in all knees the same way,” Boone says. The robots he has been using for the past four years turn that process on its head, predicting the optimal fit down to a single degree.

“No human eye can do that,” he says.

As a result of his experience, both with and without robotic assistance, Boone explicitly trusts the technology. The use of it has helped him shave off up to 30 minutes on a single procedure. This reduces the risk of infection for the patient and allows him to help more people in a day. However, for many orthopedic surgeons, this is a difficult concept to accept.

“It’s hard for a surgeon who was trained to not be wrong and be very sure of themselves to make that switch and have the trust. It’s a fundamentally different idea from the one we’re trained with,” he says.

Boone was a very early adopter of robotics and believes it can significantly advance a field facing a major challenge. Right now, he says there is a specific subset of patients who struggle with knee replacement surgeries.

“One in five knees [post-surgery] are not happy. They just don’t do well, and we as a profession don’t know why. You can look at the X-ray, and it can be a perfect-looking knee, a great-looking knee, but the patient still says it is stiff and not comfortable.”

Boone says this phenomenon is currently the most pressing topic among orthopedic surgeons and cause for much debate at conferences and gatherings.

“We’re all chasing that 20 percent,” Boone says. “Because one in five—that’s a high number. And I think robotics gets at the problem.”

The robotic assisted technology Boone uses for knee replacements is called the NAVIO, created by Smith & Nephew, and it uses “direct anatomic mapping” to achieve a higher level of accuracy than ever before. It allows him to perform total replacements, ACL-sparing knee surgeries (on candidates with the right indications), and other complicated procedures. He uses similar robots for hip replacement and resurfacing surgeries as well.

Boone is excited about the possibilities in the future for incorporating more robotic-based technology into orthopedic surgery and says the industry is just now hitting the tipping point.

“We’ve only touched the surface. Robotics are just starting to take off and all the metrics are showing signs of enhanced outcomes,” he says.

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