In his office at the Heart of Texas Orthopedics in Brownwood, Dr. John Masterson noted the advances of technology in medicine.
Masterson, an orthopedic surgeon who is a 25-year veteran of orthopedics, was recruited to Brownwood four months ago from his practice in Jackson, Tennessee.
“Even in the time I’ve been in medicine, it’s been amazing to me to to see some of the things that have happened, that I wouldn’t have even thought, to be available to us now,” Masterson said. “It’s just exciting to see what’s going to come down the road. ”
Masterson made the statement while discussing a technology that’s not new to medicine, but is new to Brownwood. Available for use in hip and knee replacement, it’s called robotic-arm assisted surgery. Masterson made it clear that it’s still the surgeon doing the surgery, but the robotic arm is a tool that provides advantages including increased accuracy in alignment and positioning in joint replacement.
The equipment arrived at Brownwood Regional Medical Center in late October, and while it has not yet been used on a patient in BRMC, there are patients scheduled for surgery with the robotic-arm assist technology.
“It’s for total hips, total knees and also we do partial knee replacements,” Masterson said. “A t this point that’s what the technology’s limited to. It may be expanded in the future. That’s what we use it for now.”
BRMC issued a press release earlier stating the robotic-arm assist procedure allows surgeons to “create a 3D plan and perform joint replacement surgery using a surgeon controlled robotic arm.” The arm helps the surgeon execute the procedure with a high degree of accuracy, the press release states.
Masterson said the technology has existed since 2006. “It started with partial knee replacements and in 2015 it was expanded to do hip replacements,” Masterson said. Beginning in 2017, “we can do total knee replacements with it,” he said.
Masterson explained more about the procedure, saying the first step is a CT scan of the area that will be operated on.
“And then that CT scan is used to input data points into the robot, into the computer,” Masterson said. “Then in the operating room, we are able to get data points from the patient. Those points are used to give us a 3D image of the actual patient that we can use to get the right size of the implant, and also use to pre-position the implant where we want it to be.
“Once that’s done, the robotic arm is then used and we guide the robotic arm to make either the cuts, or if it’s the hip replacement, it’s a reaming step that we do to put the cup into the hip. And it helps us do it very very precisely and reproducibly.”
Masterson said there are four orthopedic surgeons including himself operating out of BRMC and the robot-arm assist is available to all of them if they wish to use it.
While the surgery can be done successfully without the use of the robot-arm assist, using the robot “will allow us to do things reproducibly, put the components in very accurately, which we believe, long term, is going to going to potentially affect the longevity of the components, decrease risk of failures and give the patient some more normal feel,” Masterson said.
He said the “more normal feel” is because “the soft tissues are better balanced because we have this technology to let us do things more precisely.”
In other areas where the robot-arm assist has been used, patients have benefitted from decreased pain and improved recovery in the early post-operation period, Masterson said.
“There is some controversy about using it because there is some increased cost in using it,” Masterson said. “But there are also studies that suggest that the cost is going to be offset by the fact there are going to be fewer revisions and issues, because you’re using the robot and you have such precision.
“When you do revisions, it’s big dollars and it’s certainly a big chunk of time out of somebody’s life to have to go back to the operating room. If you can minimize those situations it’s definitely worth its weight.”
If a patient is offered the robot-arm assist, “I would say go for it,” Masterson said. “If I were to have my joint replaced, knowing what I know and using this technology, I would definitely choose to have this technology used on myself.
“The robot’s been used in production and manufacturing for years and it’s just now becoming available to the medical field, so I think it’s a wonderful new technology that’s available to us now.
“It’s wonderful, it’s fascinating and it’s again a tool. It doesn’t do the surgery. The surgeon still does the surgery but it’s a tool that lets us do things very precisely.”
Masterson said he went to medical school at UT Southwestern and has family in San Antonio, Granbury and Sherman.
“So it’s good to come home,” Masterson said of returning to Texas. “Very much enjoying (Brownwood). Nice community.”