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Hoag Orthopedic Institute adds 2nd joint replacement robot

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Irvine, Calif.-based Hoag Orthopedic Institute added a second robot to its technology lineup.

Hoag began using the Velys robot from Johnson & Johnson, according to a May 18 news release. So far more than 25 cases have been completed with it. Nader Nassif, MD, chief of joint replacement, was one of the first surgeons to use the robot.

“We realize through many studies that a percentage of knee replacement patients still have some pain, stiffness or are just not satisfied with their new knee, even though they would agree that they would have still undergone the procedure,” Dr. Nassif said in the release. “If the robot can help reduce that small percentage of unsatisfied patients even more, we have made progress.”

 

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Hoag Orthopedic Institute adds knee robots at 2 ASCs

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Irvine, Calif.-based Hoag Orthopedic Institute has added two total joint replacement robots at its ASCs, the hospital said Aug. 15.

Hoag Orthopedic’s surgery center in Mission Viejo, Calif., added the Rosa knee robot, and its ASC in Orange, Calif., added a Corin OMNIBiotics system, Hoag stated in a news release. The new additions bring Hoag’s total to four knee replacement robots at its facilities.

“Robots in general don’t make a surgeon better, but the next-generation robotic devices have the potential to augment a good surgeon’s skill,” Nader Nassif, MD, Hoag Orthopedic Institute’s division chief of joint replacement, said in the news release.

Another robot is slated to be included later this year at Hoag’s upcoming surgery center in Aliso Viejo, Calif.

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Originally Appeared Here

American Joint Replacement Registry Releases 2021 Annual Report, Showing Increase in Number of Hip and Knee Procedures Despite Pause Due to COVID-19

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ROSEMONT, Ill., Nov. 12, 2021 /PRNewswire/ –The American Joint Replacement Registry (AJRR), the cornerstone of the American Academy of Orthopaedic Surgeons (AAOS) Registry Program, released its 2021 Annual Report on hip and knee arthroplasty procedural trends, and patient outcomes today at the American Association of Hip and Knee Surgeons’ (AAHKS) 2021 Annual Meeting. Despite the disruption to the delivery of joint replacement care during the initial impact of the COVID-19 pandemic (March through May 2020), procedures rebounded to historic averages by June 2020. Even with the temporary decline in procedures, the report demonstrates an overall cumulative procedural volume growth of 18.3% compared to the previous year and includes findings from 2,244,587 hip and knee arthroplasty procedures performed between 2012 and 2020.

The American Joint Replacement Registry 2021 Annual Report shows an increase in the number of hip and knee procedures despite pause due to COVID-19 pandemic.

“The ability to return to normal procedural volume rates just a few months after the COVID-19 pandemic began is a testament to the commitment and resiliency of healthcare institutions, clinicians and patients,” said Bryan D. Springer, MD, FAAOS, chair of the AJRR Steering Committee. “While we are experiencing unprecedented times in healthcare and continue to navigate the challenges of the pandemic, the AJRR remains committed to the growth and expansion of the registry to paint a more complete picture of our patient population. Through increased participation and a successful integration of Medicare claims data, we are providing orthopaedic surgeons, hospitals and stakeholders with actionable data, insights and trends to improve the lives of millions of Americans who suffer from hip and knee arthritis.”

AJRR is the largest orthopaedic registry in the world based on annual procedures submitted, and the 2021 AJRR Annual Report marks the eighth annual report. With the collection and reporting of U.S. hip and knee arthroplasty data, the report aims to provide valuable information to orthopaedic surgeons, hospitals, ambulatory surgery centers, private practices, device manufacturers, payers, and most importantly patients. The 2021 report represents over 2.2 million hip and knee procedures from over 1,150 hospitals, ambulatory surgery centers (ASCs), and private practice groups submitting data from across all 50 states and the District of Columbia.

James A. Browne, MD, FAAOS, chair of the AJRR Publications Subcommittee and editor of AJRR Publications added: “This year’s AJRR Annual Report provides the most comprehensive picture to date of patterns of hip and knee arthroplasty practice and outcomes in the United States. For the first time this year, cumulative percent revision curves were produced with a diagnosis-specific endpoint examining revision due to infection for total knee arthroplasty (TKA) and revision due to periprosthetic fracture for total hip arthroplasty (THA) patients over 65 years of age. The registry continues to use more sophisticated and detailed survivorship curves, including device-specific cumulative revision stratified by bearing and fixation type, in addition to utilizing Centers for Medicare & Medicaid Services (CMS) data.”

Additional findings from the 2021 AJRR Annual Report include:

  • Device-specific revision analyses showed that all included hip device constructs had a cumulative percent revision of less than 2.8% at one year and less than 4.7% at final follow up for each respective device. All knee device constructs included in analysis had a cumulative percent revision of less than 2.5% at three years and less than 3.7% at final follow up for each respective device.  
  • The use of cement for femoral component fixation is slowly increasing for both elective primary THA as well as arthroplasty for femoral neck fracture, and cementless fixation shows a statistically significant reduction in early revision due to periprosthetic fracture, compared to cementless fixation in elective primary THA patients over 65 years of age.
  • While cemented fixation for TKA still predominates, the report shows that cementless fixation continues to increase and was associated with significantly less revision due to infection in elective primary TKA patients over 65 years of age.
  • For both TKA and THA procedures, postoperative length of stay continues to decrease.

Enhanced Registry capabilities offerings and include:

  • Additional opportunities for sites to track performance measurements and use Registry data in national quality improvement (QI) programs.  
  • A 39% increase in sites reporting patient-reported outcome measures (PROMs), compared to the previous year, through continued support of the RegistryInsights® PROM platform and partnerships with third-party vendors with the expanded Authorized Vendor Program.
  • Peer-reviewed publications and presentations based on AJRR Registry data.

To read and download the complete 2021 report, visit the AJRR website. Slides with figures and data tables as featured in the report are also available.

AAOS Registry Program 
The AAOS Registry Program’s mission is to improve orthopaedic care through the collection, analysis, and reporting of actionable data. The American Joint Replacement Registry (AJRR), the Academy’s hip and knee replacement registry, is the cornerstone of the AAOS’s Registry Program, and the world’s largest national registry of hip and knee joint replacement data by annual procedural count, with more than 2.4 million procedures contained within its database. Additional registries include the Fracture & Trauma Registry, the Musculoskeletal Tumor Registry (MsTR), the Shoulder & Elbow Registry (SER), and the American Spine Registry (ASR), a collaborative effort between the American Association of Neurological Surgeons (AANS) and the AAOS. 

About the AAOS
With more than 39,000 members, the American Academy of Orthopaedic Surgeons is the world’s largest medical association of musculoskeletal specialists. The AAOS is the trusted leader in advancing musculoskeletal health. It provides the highest quality, most comprehensive education to help orthopaedic surgeons and allied health professionals at every career level best treat patients in their daily practices. The AAOS is the source for information on bone and joint conditions, treatments, and related musculoskeletal health care issues, and it leads the health care discussion on advancing quality.

Follow the AAOS on Facebook, Twitter, LinkedIn, and Instagram.

SOURCE American Academy of Orthopaedic Surgeons

Related Links

www.aaos.org


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Kinematic Alignment Bi-unicompartmental Knee Arthroplasty With Oxford Partial Knees: A Technical Note

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Bi-unicompartmental knee arthroplasty (BiUKA) is an alternative to total knee arthroplasty for selected patients. Although it is thought to be technically demanding, the technique has not been previously described in detail. Kinematic alignment (KA) implantation and bone cuts parallel to the native joint line would be beneficial to ensure optimal mechanical loading. Here, we detail a technique for KA-BiUKA using the Oxford partial knees. The joint line is identified using the spoon of the microplasty instrumentation system with/without the accessory spoons. The tibia is cut parallel with the joint line using a side-slidable ankle yoke so that the inclination of the cutting block is parallel with the spoon surface. After defining the horizontal bone-cutting lines, the predominantly affected condyle is operated upon, followed by the lesser affected condyle. Although custom-made devices are required, the technique is useful and reproducible in the performance of KA-BiUKA with the Oxford partial knees.

Introduction

Unicompartmental knee arthroplasty (UKA) is an attractive surgery for unicompartmental knee osteoarthritis with functioning anterior cruciate ligament (ACL) [1,2]. It is characterized by quicker recovery, fewer systemic complications, lower postoperative mortality, and better range of motion than total knee arthroplasty (TKA) [3-5]. Another advantage of UKA is the retention of the ACL; once the ACL is sacrificed to facilitate a TKA, minor instability and alteration of kinematics are inevitable [6]. Unlike TKA, the original kinematics and joint stability can be retained in UKA, with improved patient satisfaction [7-9].

Despite these benefits, the usage of UKA depends on the integrity of the lateral compartment cartilage [10]. If the lateral compartment is damaged, conversion to TKA is unavoidable, even if the ACL is healthy. Bi-cruciate retaining (BCR) TKA is a possible alternative to conventional TKA, but it is a technically demanding procedure, and the results are not always consistent [6,11]. As described in the four-bar linkage theory, the ligament condition and morphology perfectly correspond to each other. If the morphology of the component matches the native morphology, the results can be excellent; otherwise, tightness and looseness inevitably emerge at certain angles. Complete replication of both medial and lateral components using existing TKA components is thus virtually impossible.

Bi-compartmental knee arthroplasty (BiUKA) is a potentially useful alternative to BCR because both compartments can be resurfaced individually [12-14]. Moreover, the kinematic alignment (KA) procedure is also possible if the components align with the original coronal joint line (CJL) obliquity. Performing KA-BiUKA with Oxford partial knees (OPKs) is also beneficial because the femoral components of OPK are partly spherical, meaning it can serve as a good imitation of the cylindrical axis. Moreover, bone cuts implemented along the CJL might be advantageous for the mechanical properties. Despite such benefits, however, there are no previous reports on BiUKA using OPKs (BiOUKA) except for its initial stage [15], where the surgical technique and instruments are immature and staged BiUKA for lateral compartment osteoarthritis after medial UKA [16]. We have modified the microplasty instruments to ensure tibial cuts parallel to the joint line. And there are no reports of KA-BiOUKA using additional components. This technical note describes KA-BiOUKA using custom-made instruments in detail.

Technical Report

Patient selection

The indication of KA-BiOUKA is functioning ACL and cartilage damage in both medial and lateral compartments. Full-thickness cartilage defects should be found in at least one compartment. In most cases, BiOUKA is a conversion from medial or lateral OPK owing to the intraoperative finding of cartilage damage on the opposite femoral condyle. BiOUKA is not applicable for severe patellofemoral joint diseases, such as bone defects and subluxation.

Preoperative radiographical planning

Preoperative anteroposterior radiography is used for planning. The medial and lateral joint lines are identified as the tangential line of the tibial articular surfaces. If both lines are straight and on the same level (leveled type; Figure 1, Panel a), the medial or lateral joint line is considered to be the CJL, and the single-spoon technique is used (described below). Otherwise, in the case of uneven type (Figure 1, Panel b), the double-spoon technique is performed with reference to the posterior condylar axis (PCA) intraoperatively. The predominantly affected condyle is determined, and this is operated first.

Figure
1:
Preoperative radiographic classification

(a) Leveled type: The medial and lateral tibial surfaces are aligned. In this type, the medial tibial surface represents the CJL obliquity. (b) Uneven type: The two tibial surfaces are not aligned. The posterior condylar axis is used to define the CJL obliquity.

CJL: Coronal joint line.

Joint opening

The medial parapatellar incision and medial parapatellar capsulotomy are performed for medial osteoarthritis (OA). Once the lateral cartilage lesion is found, the skin is peeled laterally so that the lateral border of the patella and patellar tendon is exposed. A lateral parapatellar capsulotomy is then added so that the lateral compartment can be manipulated (Figure 2). For the lateral OA, the lateral parapatellar approach is made and skin is peeled medially to expose the medial border of the patella and patella tendon, and this is followed by medial capsulotomy. Oxford mobile-bearing UKA is used for the medial side and fixed-lateral Oxford (FLO) is used for the lateral side. With the exception of the above-mentioned decision process regarding the tibial cutting plane, both procedures are implemented following the manufacturer-provided operation manuals [17].

Joint-opening

Figure
2:
Joint opening

For the medial OA, the medial parapatellar skin incision is used. The medial capsulotomy is implemented, and if lateral cartilage damage is found, the skin incision is extended proximally and slightly laterally. The skin flap is then peeled laterally to facilitate lateral capsulotomy.

OA: Osteoarthritis.

Deciding the tibial cutting plane

After joint opening and osteophyte removal, the tibial cutting plane is set parallel with the CJL. The single-spoon technique is used for leveled-type knees. The spoon gauge is inserted into the dominantly affected condyle, representing joint line inclination (Figure 3, Panel A). Our custom-made side-slidable ankle yoke is connected to the extramedullary (EM) rod instead of the original ankle yoke [18]. The sagittal inclination of the EM rod is adjusted so that it is parallel with the anterior cortex of the tibia. The cutting block is set just below the spoon. In most cases, the spoon is not parallel but rather varus to the cutting block (Figure 3, Panel B). The custom-made yoke is then slid laterally until the cutting block and the spoon are parallel (Figure 3, Panel C).

The-medial-spoon-technique-for-the-cutting-line-definition

Figure
3:
The medial spoon technique for the cutting line definition

(A) A spoon is inserted into the medial joint space. In straight-type knees, the inclination of the spoon represents the CJL inclination, the target of the cutting line. (B) The inclination of the tibial cutting block is different from that of the spoon. (C) The slide bar of the ankle yoke is adjusted so that the spoon and the cutting block are parallel.

CJL: Coronal joint line.

In non-straight-type knees, the double-spoon technique is performed with custom-made accessory spoons (Figure 4, Panel A). The accessory spoon is 0.5 mm thick and inserted into the opposite joint space, then incorporated with the conventional spoon. The spoons are thus set at the same level (Figure 4, Panel B). When both spoons are inserted into both compartments, it indicates the PCA (Figure 4, Panel C). The coronal alignment of the cutting block is adjusted as the single-spoon technique.

The-double-spoon-technique

Figure
4:
The double-spoon technique

(A) Accessory spoons. The accessory spoons are spoons of 0.5 mm thickness that can be joined with conventional spoons. (B) Once the accessory spoons are incorporated with the conventional spoon, both spoon levels are the same. (C) The inclination of the spoon indicates the posterior condylar axis when both spoons are inserted into the medial and lateral joint spaces.

The spoon and the cutting block are fixed using the G-clamp, and the cutting block is fixed using a headless pin (Figure 5, Panel A). After the bone cut and adjustment of the flexion-extension gap are completed on the predominantly affected condyle, the cutting block is removed from the headless pin and changed to that on the opposite side using the same pin along with the extramedullary guide (Figure 5, Panel B) and the ankle yoke with retained extension, side-slide length, and posterior slope to maintain the cutting level as well as sagittal and coronal inclinations. The lesser affected compartment procedure is then performed. When the horizontal cuts are made, insertion of a K-wire at the tip of the tibial spine is recommended to prevent a horizontal overcut (Figure 5, Panel C). After the implantation, the CJL and cutting lines are virtually parallel (Figure 5, Panel D).

Bone-cutting-procedure-for-a-medial-dominant-osteoarthritis

Figure
5:
Bone-cutting procedure for a medial dominant osteoarthritis

(A) After the inclination and level of the cutting block are decided, a headless pin (arrowhead) is inserted into the tibia through the most lateral pinhole of the cutting block. The medial procedure is then performed. (B) The medial cutting block is changed to the lateral cutting block using the same pin connected to the yoke, and the same extent, slide, and posterior slope are maintained. (C) When performing the horizontal cut, a 2 mm K-wire is inserted to prevent a horizontal overcut. (D) The lateral procedure is then performed to set the medial and lateral cutting lines to be parallel.

When the lateral tibial cuts are made, the shim is removed so that the cutting level is set to 2 mm lower than the medial cutting level. Both bearings are numbered, but the exact thicknesses of the bearings are 0.5 mm and 2.0 mm thicker than the labeled number. Complete leveling of both plateaus is therefore impossible when the level of the cutting block is constant (Figure 6). Eventually, the lateral CJL is inevitably 0.5 mm higher than the medial CJL, although this can be ignored.

Medial-and-lateral-tibial-cutting-level-in-the-kinematic-alignment-Oxford-unicompartmental-knee-arthroplasty

Figure
6:
Medial and lateral tibial cutting level in the kinematic alignment Oxford unicompartmental knee arthroplasty

The actual thicknesses are 0.5 mm and 2 mm thicker than the labeled number. Once the shim is removed, the lateral cutting level is 2.0 mm lower than that of the medial one. Eventually, the lateral bearing surface is 0.5 mm higher than the medial one when the same number bearing is used with the same cutting block level.

Postoperative radiographical evaluation

True anteroposterior radiography aligned to the tibial component surface is used for postoperative evaluation. Ideally, the postoperative CJL, which is the line tangential to both medial and lateral femoral components, is parallel with the medial and lateral cutting surface, and the medial cutting surface is 2 mm higher than the lateral cutting surface. In straight-type knees on the preoperative radiography, the CJL is expected to be parallel with the preoperative CJL (Figure 7).

Postoperative-radiography

Figure
7:
Postoperative radiography

The coronal joint line (CJL) is parallel to the cutting lines. Note that the lateral cutting line is lower than the medial cutting line.

Discussion

This is the first report to document KA-BiUKA by OPK in detail. Robotic-assisted BiUKA using a fixed-bearing component was recently reported, and constitutional whole leg alignment and joint line obliquity were shown to be restored [19]. Regarding OPK, it was used for BiUKA in the initial stage of the OPK [15]. Pandit et al. reported the staged BiUKA – adding a lateral UKA after medial UKA due to lateral compartmental osteoarthritis and showed satisfactory results [16]. More recently, a gait analysis showed that the subjects with BiUKA using OPK had similar gait characteristics to the normal subject compared to TKA subjects [20]. BiUKA has been reported to have mechanical advantages. A compression force on one component would cause a lift-off of the other component in the one-piece TKA component, but it never occurs in the two-piece tibial components in BiUKA [15,21]. The bone-cutting line was not shown in the previous studies; however, it is thought to play an important role in load transmission. A slight varus implantation of the tibial component was reported in previous biomechanical studies to reduce stress concentration in the medial tibial cortex, but a valgus placement increases it [22]. Although avoidance of valgus placement is important, the placement can be valgus against the proximal tibia in knees with tibia vara, which is especially prevalent in Asian patients [23,24]. Component placement parallel to the CJL might enable a proportioned load transmission across the joint.

In our technique, the dominantly affected compartment is operated upon prior to the lesser affected compartment. In this sequence, the operated condyle is always normal or nearly normal. By contrast, the procedure of the lesser affected condyle can be influenced by the disease of the opposite condyle, such as contracted or relaxed soft tissue and cartilage as well as bone loss. Our technique is a tibia-first sequence, in contrast with most KA-TKA techniques, in which the femur-first technique is used [25,26]. However, this is a standard technique in OPK and has been used for more than 40 years [27]. The tibia-first approach and incremental gap adjustment using the milling system can facilitate easy and precise adjustment of flexion and extension gaps. We believe the dominantly affected condyle-first and the tibial-first sequence might be ideal for facilitating the KA-BiOUKA.

There are some limitations in our report and technique. First, it was necessary to use custom-made devices (accessory spoons and side-slidable ankle yoke). Although a similar operation can be performed without the custom-made devices, where the cutting levels are decided individually using the standard spoon, the cutting plane is not parallel to the CJL. The CJL could be made parallel to the original CJL, but the kinematics and load distribution might be affected. Second, the lateral component is set in varus in the technique. This alignment is equivalent to a valgus placement of the medial UKA, which has reportedly increased the mechanical stress on the tibial cortex. Therefore, it can increase the risk of failure. Varus placement has not been reported to increase the risk of failure in lateral UKA. Third, there was no evaluation of clinical outcomes, in particular its superiority over TKA. A larger number of cases and long-term studies are needed to prove the benefits of the KA-BiUKA. Lastly, we used medial and lateral capsulotomy and disturbance of blood supply for the patella, followed by the avascular necrosis of the patella, and the anterior knee pain is a concern. The medial parapatellar approach for femoral and tibial bone cuts like TKA along with small lateral capsulotomy for lateral gap evaluation using the feeler gauge might be helpful. However, it might require additional instruments.

BiUKA is a great technically demanding operation; therefore, the establishment of the procedure is necessary for a fair evaluation of its effect. Our technique is considered to be easy and reproducible, so it can be implemented widely.

Conclusions

The details of an operative technique of BiUKA using OPK are presented as an alternative procedure for osteoarthritic knees with a functioning ACL and cartilage interaction on the lateral compartments. The technique can replicate the pre-arthritic joint line and maintain both cruciate ligaments, and a cylindrical axis is completely constructed. Moreover, the bone-cutting surface can be set in parallel to the joint line, which might be beneficial to load transmutation.


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Gut permeability may be associated with periprosthetic joint infection after total hip and knee arthroplasty

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    Originally Appeared Here

    Lose Weight, Slow Knee OA Progression? New Study Suggests Yes

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    Declines in body mass index (BMI) were linked with slower worsening of knee osteoarthritis (OA), according to data from three large longitudinal cohort studies.

    With more than 6,000 knees evaluated for OA progression and 4 to 5 years of follow-up, “each 1-unit decrease in BMI was associated with a 4.76% reduction … in the odds of the incidence and progression of the overall structural defects of knee osteoarthritis” as assessed under the Kellgren-Lawrence grading system, reported Zubeyir Salis, BEng, of the University of New South Wales in Kensington, Australia, and colleagues in Arthritis & Rheumatology.

    While such a relationship seems obvious, it has evaded firm proof, the researchers noted. Earlier studies had tied body weight to risk of OA development and the likelihood of progression and end-stage outcomes such as total joint replacement. But whether losing or gaining weight alters the trajectory over time is another matter.

    Salis and colleagues identified just one previous attempt to address the question directly: patients already showing joint degeneration who lost around 10 kg (22 lb) on average in a randomized diet-and-exercise trial showed no less progression than a control group with little weight loss, but follow-up only lasted 18 months. (A number of other studies had lumped patients without structural damage at baseline together with those with established degeneration, and they had mixed results.)

    For the current analyses, Salis and colleagues combined data from three independent cohort studies from the U.S. and the Netherlands: the Osteoarthritis Initiative (OAI), which was also the basis for some of the above-mentioned studies; the Multicenter Osteoarthritis Study (MOST); and the Cohort Hip and Cohort Knee (CHECK) study. These data covered 9,683 knees (5,774 individual patients) for assessing the incidence of structural knee degeneration (i.e., no evidence of joint damage at baseline) and 6,074 knees (3,988 individuals) for progression of established degeneration.

    Structural joint parameters were measured with x-rays at baseline and at follow-up, which was 4 years in the OAI and 5 years in the other two cohorts. Changes in these parameters (medial and lateral joint space narrowing and femoral and tibial surface osteophytes) were correlated against changes in BMI.

    For patients included in the evaluation of new-onset structural damage, mean age at baseline was 60; about 40% were men and 88% were white. BMI at baseline averaged 28.2, with 33% of participants classified as obese (BMI ≥30). A total of 1,101 participants in this analysis saw BMI declines of at least 1 unit during follow-up, whereas 1,611 had increases of 1 or more units.

    Patients’ baseline characteristics in the study of progression were similar. Baseline BMI was a bit higher on average (30.4), and 48% were obese. BMI declines of 1 or more units were seen in 798 participants, while 1,008 had increases.

    Salis and colleagues found a significant association between BMI changes and the risk of developing structural damage, with an odds ratio of 1.05 (95% CI 1.02-1.09) for each 1-unit increment in BMI. This value was nearly identical to that seen for risk of progression in patients with damage at baseline (OR 1.05, 95% CI 1.01-1.09). In both analyses, joint space narrowing in the medial area largely drove the overall findings, with odds ratios in both cases of 1.08 per 1-unit BMI increment.

    However, the results suggested that weight loss was far from the only factor at play in governing joint-damage incidence and progression. The researchers estimated population-attributable fractions of the total risk accounted for by weight loss at 13% for incidence and 10% for progression.

    In addition, the investigators stopped short of asserting that the findings prove that weight loss slows OA disease progression, saying they “showed evidence of association, not causality.” But the researchers did argue that “people with overweight or obesity — and potentially also those of normal weight — may benefit from a decrease in BMI to prevent, delay or slow the structural defects in knee osteoarthritis.”

    • John Gever was Managing Editor from 2014 to 2021; he is now a regular contributor.

    Disclosures

    This study was supported by the Australian government; the individual cohort studies each had their own funding sources, none of which were commercial entities.

    Salis and one co-author were co-owners of a company dedicated to education around weight management. Two co-authors also reported relationships with multiple pharmaceutical companies.

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    Originally Appeared Here

    4 orthopedic surgeons making headlines

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    Here are four stories involving orthopedic surgeons Becker’s has reported on since Aug. 4:

    1. Steven Shin, MD, performed wrist surgery on Alex Kirilloff of the Minnesota Twins at Kerlan-Jobe Surgery Center in Los Angeles.

    2. John Fernandez, MD, performed successful hand surgery on Chicago White Sox shortstop Tim Anderson at Midwest Orthopedics at Rush Oak Brook (Ill.).

    3. Eric Tannenbaum, MD, performed the region’s first outpatient robotic joint replacement surgery at Columbus (Ind.) Specialty Surgery Center.

    4. Matthew Dobzyniak, MD, performed Virginia’s first smart knee implant for total knee replacement at an ASC at Henrico-based St. Mary’s ASC.

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    Originally Appeared Here

    Parkview Health System unveils orthopedic hospital in Pueblo West

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    Originally Appeared Here

    Consultant offers reduced waiting times and better outcomes for hip and knee surgery

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    With NHS waiting times for hip and knee replacements in the North East and North Yorkshire currently up to two years, Mr Andrew Port, a highly experienced consultant orthopaedic surgeon, is offering the people of these regions quicker access for their joint replacement surgery.

    Mr Port offers his patients individualised care pathways for hip and knee replacements, including partial knee replacements, complex and revision (redo) hip and knee replacements, for which he is a regional specialist.

    As a pioneer for robotic joint replacement surgery in the UK, his patients are now able to take advantage of the quicker recovery times, reduced pain and improved function, following robotic joint replacement surgery.

     

     

    His current waiting time for a joint replacement privately is four weeks, and for and NHS patient is around six months.

    Mr Port has more than 30 years’ experience in orthopaedic surgery, during which time he has led and guided local, regional and national directives in improving the quality of orthopaedic surgery. He has been based at the BMI Woodlands hospital in Darlington for 22 years.

    The Northern Echo:

    He performs more than 500 hip and knee replacements a year, including 50 revision surgeries and 40 partial knee replacements. The “Getting It Right First Time” (GIRFT) Department of Health directive and the British Orthopaedic Association advocate that surgeons should perform a minimum of 15 of each of these procedures per year to maintain standards. Mr Port has one of the highest patient satisfaction outcomes and lowest complication rates nationally.

    The Northern Echo:

    Being one of the first surgeons in the UK to introduce robotic hip and knee replacement surgery, Mr Port has performed more than 300 robotic-assisted hip and knee replacements using the Stryker Mako Robotics system.

    From his experience he explains: “The technology combines 3D planning with accurate intra-operative reconstruction of the hip or knee replacement. Following robotic surgery, patients are reporting less pain, quicker recovery times and greater satisfaction rates”.

    The Northern Echo:

    The BMI Woodlands Hospital, in Darlington, is the only hospital in the northern region that offers access to augmented surgical assistance with the Stryker Mako Robotics system.

    Mr Port is currently chairman of the Surgical Collaborative at South Tees NHS Trust, incorporating The James Cook University Hospital and the Friarage Hospital. He leads on the strategy to standardise the delivery and quality of orthopaedic surgery over the Tees Valley and North Yorkshire.

    Further information can be found at: www.circlehealthgroup.co.uk/consultants/andrew-port or, to book an appointment, contact 01325 341784, or Mr Port’s practice manager on 07855 364475.

     

     

     

     


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    Originally Appeared Here

    Hoag’s joint replacement chief on the future of orthopedic robots

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    Irvine, Calif.-based Hoag Orthopedic Institute has grown its robotic arsenal in 2022, installing its fourth system in August.

    Nader Nassif, MD, HOI’s division chief of joint replacement, told Becker’s about his outlook for robots in orthopedics.

    Note: Responses were edited for clarity.

    Question: What considerations do you weigh when deciding to try new surgical technology?

    Dr. Nader Nassif: I think the biggest considerations when deciding on any new technology is value. We need to consider how this is going to make a real impact in the outcome of a patient’s procedure versus the cost, including capital purchase, additional operating room time, disposables. There are some really “cool” technologies out there right now that are just fancy gadgets and provide no improvement in patient care. Those technologies cost the healthcare system. 

    Q: What aspects of orthopedic robots need more development?

    NN: Robots continue to improve in the way they are being implemented both in the tools used as well as the software. Improved efficiency of the tools as well as improved robotic intelligence will be important in the next generation of robotically assisted tools. 

    Q: How do you think orthopedic robots will change in the next five years?

    NN: In the next five years, I believe that the data currently being gathered by robots will be able to be fed back into the systems for improved decision support to the surgeons.

    Q: What advice do you have for students and early-career surgeons who want to use robots without becoming over reliant on the tech?

    NN: Robots do not make surgeons better, but robots can help good surgeons execute plans they have otherwise been unable to do with traditional analogue instruments. For early-career surgeons it is paramount that they learn to operate without the assistance of technology first to hone their skill, perfect basic principles. In real life, surgeons may not necessarily have a robot for every case. What if the robot is not functioning? Surgeons cannot be entirely reliant on technology. 

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    Originally Appeared Here

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