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Watching the iconic 1960s cartoon The Jetsons, many viewers thought that by now families would have their very own Rosie the Robot to do household chores and help make life easier. Although robotic maids are not yet real, robots are helping to make many activities safer and more predictable, including performing some orthopedic surgeries.

Orthopedics is the medical specialty that focuses on diagnosing and treating conditions and injuries to the musculoskeletal system, or our body’s bones, muscles and connective tissues. Welia Health recently became the first rural healthcare provider in Minnesota to add a Stryker Mako, a robotic-arm assisted machine used for total hip, total knee and partial knee replacement surgeries.

Mako does not perform the surgery; rather, it’s a device used by orthopedic surgeon Dr. Chad Holien to help him perform surgery. Dr. Holien, an orthopedic specialist with St. Cloud Orthopedics, has completed approximately 1,100 surgeries using Mako in St. Cloud, and has been providing specialty services for patients in the East Central region for the past 17 years. As part of the long-term partnership with St. Cloud Orthopedics, Welia Health welcomes Mako to its Mora campus.

How it works

Mako robotic arm used for knee and hip replacements at Welia Health
Mako, Robotic-Arm Assisted Surgery

Before surgery, a CT scan is performed, and the results are entered into Mako. A CT scan is a type of imaging using multiple X-ray measurements at different angles to produce cross-sectional (tomographic) images, described as virtual slices of a specific area.

Because each patient’s body measurements can differ, this allows Dr. Holien to correctly size the knee or hip implant and lets him know the precise angles he’ll be operating on before the surgery even begins.

Mako’s robotic arm has surgical tools attached but it’s not automated. Dr. Holien has full control of the robotic arm and manipulates the arms where they need to go. Once the system is loaded with the unique patient information, a surgery plan is made in the Mako system allowing Dr. Holien to know where everything is.

Once surgery begins, Dr. Holien places a tracker device on the patient, so it can map several points matching the CT scan measurements taken the day before. The precise system lets him know during surgery how any changes could affect the patient’s mobility by showing the patient’s virtual function of normal range of motion.

“Mako system allows my patient’s surgeries to become streamlined, predictable and more precise resulting in better patient outcomes. I cut where I need to because the system won’t let me deviate from the surgery plan.”

Dr. Chad Holien, orthopedic surgeon

Mako benefits

Mako helps in planning, especially when patients have had significant injuries, and lets the surgeon know, for example, if a rod that was previously inserted will be a problem. Unless Mako indicates it’s a problem, the surgeon just needs to follow the plan, and not worry about a rod or other hardware that might be present.

The system has a safety feature called AccuStop haptic control technology. It sets a range and guides the surgeon to cut what is precisely planned for each patient and will shut off cutting tools if the surgeon counteracts the set plan.

This technology prevents errors by recognizing soft tissue and healthy bone by not allowing the surgeon to cut outside the parameters of what was designated to be cut. It can also protect surrounding soft tissues by eliminating the need to introduce and remove instruments multiple different times during a surgery.

Innovative care

It is unusual for a hospital in a smaller community to invest in this type of device, but Welia Health is committed to providing excellent patient care. The goal in implementing the robot is to improve patient outcomes, increase operating room efficiency, and provide the best technology for our patients.

“I wasn’t thinking about robots helping me perform surgery when I was in medical school 20 years ago, but we’ve come a long way,” adds Dr. Holien. “Mako is a new, leading-edge tool that streamlines and reduces time in surgery because I know the precise size of the implant the patient needs and exactly where to begin.”

“Welia Health is proud to support our community with innovative care. We want our patients to live their lives to the fullest, and that means not having to travel to a bigger city to receive excellent care and rehabilitation following surgery.”

Randy Ulseth, Welia Health CEO

For questions or to learn more about Mako and how it can aid your surgery, contact Welia Health at 320.679.1313 to schedule an appointment with Dr. Holien.


Have you ever sat on an old couch and felt the metal springs through the cushion? It’s unpleasant and uncomfortable. Cushions are key.

Cartilage is the cushion for our joints. As we age, cartilage becomes brittle and wears away. When this happens, the end of the bones rub together, and it’s much more painful than springs on an old couch.

If your joint pain is unbearable, you could be a candidate for joint replacement. With the procedure, your surgeon replaces the damaged joint with an artificial one. While it might sound complicated, it’s a simple and safe procedure that improves the lives of those who struggle with painful joints.

Are you a candidate for joint replacement?

Joint replacement doesn’t make sense for all patients. Only your provider can determine whether joint replacement is a good treatment option. But here are some factors to consider on your own.

You have pain limiting daily functioning

If you’re having significant pain in joints such as your hip, shoulder or knee, and you’re experiencing a limited range of motion, you might have a damaged joint. Sometimes, simple rehabilitation exercises might help. However, in more severe situations, joint replacement might be best.

Non-invasive surgical treatments haven’t worked

There are a number of first-line, non-surgical treatments for joint pain that your doctor will recommend. They include physical therapy, injection therapy, bracing devices and nonsteroidal anti-inflammatory drugs (e.g. ibuprofen).

If those options haven’t worked, your joint damage may just be too severe, and joint replacement might be right for you.

You’re in overall good health

Joint replacement recovery requires diligent rehabilitation. The procedure itself also requires anesthesia. Your doctor will determine if you’re healthy enough for both the surgical procedure and the rehabilitation before scheduling. Joint replacement is considered major surgery and is typically a last resort to reduce pain and discomfort.

Your joint pain prevents a good night’s sleep

If your joint pain is severe enough that it prevents you from sleeping well and receiving restful sleep, you might be a good candidate for joint replacement.

If you answered “yes” to most of these factors, you might be a good candidate for joint replacement. First, schedule an appointment with your primary physician to discuss your overall health and initial candidacy for the procedure. Your physician will then refer you to orthopedics for a more detailed examination into whether you’re a good fit for joint replacement.

Welia Health provides orthopedic services including surgery. Dr. John Kampa has a special interest in hip and knee joint replacements and has performed hundreds of these procedures.


An Anterior Cruciate Ligament (ACL) tear is a dreaded season-ending injury. The recovery is long and challenging. Any athlete participating in high-intensity contact sports has the potential to sprain, tear or even rupture the ACL, a flexible band of tissue that runs diagonally in the middle of the knee and provides the knee the stability it needs to rotate.

Female athletes are between two and 10 times more likely than male athletes to tear their ACL. There isn’t one specific reason this is the case, and it has been a source of great debate. Orthopedic experts are starting to agree that differences in how a woman’s body is structured (anatomy) and how it moves (biomechanics) both contribute to women’s increased risk of ACL injury.

Anatomical Factors: There are anatomical differences between men and women that might cause women to have more ACL injuries for several reasons. They include:

  • Pelvis width
  • Q-angle or the angle at which the femur meets the tibia
  • Size of the ACL
  • Size of the intercondylar notch (where the ACL crosses the knee joint)

Women also have more elastic ligaments than men do, and this greater flexibility makes the ACL more prone to being stretched and twisted.

Technical or biomechanical factors: Some orthopedic researchers believe that the most conclusive evidence shows that ACL injury rates are most influenced by biomechanical differences between men and women. Some of these include:

  • Landing position: When landing from a jump, women tend to land with their knees straight, which transfers the force of impact to the knee joint. Because they tend to land with their knees bent, men tend to absorb more of the energy.
  • Flat-footed landings: When they jump, women also tend to land with the soles of their feet instead of on the balls of their feet. By landing flat-footed, the knee has to absorb most of the shock.
  • Quadricep vs. hamstring strength: Because women tend to have stronger quadriceps than hamstrings, female athletes tend to rely on their quads for movement. The knee compensates for this by putting added stress on the ACL.
  • Running upright: Women tend to run in a more upright position than men do, giving them less control over how the knee rotates.

Lowering the risk of ACL injuries

The Welia Health team can help female athletes lower their risk of ACL injuries. Preventing ACL injuries is most effective with a comprehensive approach. To lower a female’s risk of an ACL injury, it’s important to:

  • Increase leg muscle strength and core muscle strength
  • Improve or learn proper jumping and landing techniques
  • Improve balance and speed
  • Wear proper footwear specific to the sport

The most effective methods to reduce ACL injury risk is to strengthen the muscles that support the knee, including the quadriceps, hamstrings, hip adductors, and gluteus muscles and to do plyometric training. Plyometric training involves various jumping techniques, lateral bounding and lunges, sprinting and resistance training and helps to build strength, speed, agility and coordination.

Athletes will also want to consider an evidence-based, sport-specific training program. These programs will not only help athletes lower their risk of injury but will also improve their performance.

What to do when you experience an ACL injury

Even with proper prevention programs, injuries can occur. If you suspect an ACL injury, contact Welia Health’s orthopedics department. Early treatment is critical to reducing pain and swelling and to recovering quickly.


Medical disciplines have their own set of procedures designed to treat their specific area of the body. A prefix often identifies the part of the body involved. Cardiologists have angioplasty, orthopedics have arthroscopy.

Angioplasty is a procedure to remove something blocking an artery and is most common for cardiologists to perform. “Angio” denotes blood or lymph vessels. Meanwhile, “arthroscopy” is a procedure using special cameras and equipment to visualize, diagnose and treat problems inside a joint. “Arthro” means “joint.”

Another example in orthopedics is “osteotomy,” the correction of bone deformity by cutting and re-positioning the bone. “Osteo” means bone.

Arthroscopy and osteotomy are two common procedures in orthopedics that we perform here at Welia Health. Other common orthopedics procedures we perform include:

  • Fusion: A “welding” process by which bones are fused together with bone grafts and internal devices (such as metal rods) to heal into a single solid bone.
  • Internal Fixation: A method to hold the broken pieces of bone in proper position with metal plates, pins or screws while the bone is healing.
  • Joint Replacement: A procedure in which an arthritic or damaged joint is removed and replaced with an artificial joint called a prosthesis. Procedures include partial, total and revisions.
  • Soft Tissue Repair: The mending of soft tissue, such as torn tendons or ligaments.

If you have any questions about these or other orthopedic procedures, please contact us at 320-679-1313. As your partner in health, we are here for you.


American Academy of Orthopaedic Surgeons

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