For 30 years, Janice Niederhofer proudly and enthusiastically served the community, first as a law enforcement officer in two police departments and later with the U.S. Drug Enforcement Administration. During her 21 years as one of the DEA’s most respected female special agents, she traveled the world interrogating international narcotics traffickers and training SWAT teams to make arrests. But then in 2008, from carrying out her DEA duties, a mysterious and crippling disease forced the Novato resident into early retirement.

Dr. Mayle has given me a big part of my life back.

“It was traumatic for me to retire,” Janice recalls. “I was used to being extremely fit, and suddenly my body was betraying me. I was wracked with pain. After extensive research, I finally found a specialist on the East Coast who correctly diagnosed me with chronic persistent bartonella.”

Triggered by pathogenic Bartonella bacteria, bartonella disease can produce a broad range of severe symptoms, making it somewhat difficult to pinpoint. It can also lead to long-term health consequences, and in Janice’s case, chronic persistent bartonella caused osteoarthritis in her knees and neck. Despite the intense pain, Janice was determined to keep moving. She saw several surgeons through the years for consultation on her knees.

“Since 2015, all were eager to perform surgery—except for one: Dr. Robert Mayle,” Janice recalls, referring to the board-certified orthopedic surgeon who performs knee and hip surgeries at Novato Community Hospital. “I was in his office for cortisone shots in my knees, and he discouraged me from having surgery until it was necessary. He said that 15% to 20% of patients still experience difficulties afterwards.”

Desperate for Relief

Initially, Janice took Dr. Mayle’s advice and decided against surgery. But by 2021, the arthritis was impacting her balance and mobility so dramatically that she started seriously considering a knee replacement. Janice applied her research skills to find the best specialist out there. She selected an in-demand surgeon in San Francisco and waited months to get on the schedule. But then serendipity led her back to Dr. Mayle. A friend sent her a newspaper article about the VELYS Robotic-Assisted Solution, a new knee replacement robot NCH had acquired thanks to generous community donors. The story also spotlighted the hospital’s lead orthopedic surgeon, Dr. Mayle. Remembering the impression he had made on her during her prior visits, Janice trusted her intuition and changed course.

“Dr. Mayle’s personality and confidence made it a no-brainer for me,” she says. “I was lucky he had a cancellation in his schedule and could see me right away.”

After undergoing successful surgery in March, Janice is thrilled with her decision to go with Dr. Mayle. “He was excited about the new robot, and he has given me a big part of my life back,” she says. “I can’t thank him or the donors enough for making my journey possible.”

Surgeon-Robot Partnership

With the acquisition of the VELYS system, NCH joins several other Sutter hospitals in employing this robotic surgery technology, including California Pacific Medical Center, Alta Bates Summit Medical Center and Sutter Roseville Medical Center.

During surgery, VELYS provides a multidimensional view of the patient’s knee, allowing surgeons to make cuts and place implants with incredible precision. The system also includes a special camera and optical tracking that provides real-time, exact information to ensure the joint’s proper fit and balance.

According to Dr. Mayle, an experienced orthopedic surgeon doesn’t necessarily need VELYS or any other robot to perform surgery successfully. “But having it brings benefits to patients postop,” he says. “These include the potential for less pain and faster recovery than traditional joint replacement because we can improve accuracy within millimeters and small degrees. We can now also serve the 15% to 20% of patients nationally who might otherwise continue to have pain after replacement.”

Without question, breakthroughs in surgical techniques, better instrumentation and more durable implant materials are making minimally invasive orthopedic surgeries highly successful today, while advances in robotics are redefining what’s possible for patients’ postoperation. Yet Dr. Mayle insists that surgeons are still in the driver’s seat.

“People assume that we hook this thing up and it does the knee replacement entirely— but that’s not true,” Dr. Mayle says. “As surgeons, we still have complete control over case planning and the actual surgery. It’s a partnership.”

More Joint Replacements, More Success Stories

Given the nation’s aging population and people’s desire to remain active into older age, total joint replacement is becoming increasingly common. Already, more than 1 million of theseprocedures are performed in the U.S. each year, and by 2030, this number is expected to approach 4 million.