ROBOTIC KNEE SURGERY IS JUST ONE OF THE LATEST GROUNDBREAKING ADVANCES AT HACKENSACK MERIDIAN HEALTH

BY JESSICA JONES-GORMAN • PHOTOS BY AMESSE PHOTOGRAPHY

The day before Dr. Anthony Costa performs a complex knee replacement surgery, he performs the same procedure virtually. Reviewing a computed tomography (CT)-based 3-D rendering of a patient’s orthopedic anatomy, Dr. Costa, who serves as director of joint replacement surgery at Hackensack Meridian Riverview Medical Center in Red Bank, is able to personalize the surgical experience to specific anatomic details. The groundbreaking robotic arm system has been revolutionary for hundreds of patients who require partial or total knee arthroplasties. And it has created a range of opportunity for the doctors and staff at Hackensack Meridian Health who use it.

“This system allows us to execute a precise plan and rehearse the surgery before we perform the surgery,” Dr. Costa said, referring to the Mako Robotic System, which is used for full and partial robotic knee replacement surgery at the medical center, as well as robotic technologies used at other hospitals in the network. “We have a very precise plan, which of course can be adjusted in real time once the surgery is underway, but the accuracy of this robotic arm has shown to be extremely beneficial.”

Believed to decrease blood loss and soft tissue damage, improve patient recovery, and allow more mobility at a more rapid pace, robotic knee replacement is associated with high accuracy and reproducibility.

“The robotic arm gives us more preoperative measurements and allows us to put in these three compartments very closely, which improves the patient’s outcome. It allows for more accuracy when we’re putting in the partial or total knee replacements.”

Suitable for nearly all patients, both young and old, Dr. Costa notes that this form of surgery breeds function. The specialist says that because there is less manipulation of ligaments and other soft tissue, initial pain generally subsides in about three weeks.

“Patients are up and moving only hours after their surgery. Although they are not fully healed for one year, much of their function is back within a few months. There is less bleeding with this surgery as we no longer have to drill a hole into the femur, which alleviates a lot of pain and swelling.”

A byproduct of computer navigated knee surgery (which has been around for decades), robotic technologies have brought joint replacement to the next level.

“It narrows the gap between what the doctor deems a successful surgery and what the patients feels is a success,” Dr. Costa said. “In post-op, we put the x-rays up and say ‘good job’ if all of the components are where they should be. But if the patient still feels pain or discomfort, is the surgery truly a success? This technology helps us do a better job with the placement of the implant. We can actually dial in the last couple of degrees to get as close as we can to perfection.”

It’s just one of the innovative approaches currently used at the hospital to care for orthopedic patients throughout New Jersey.

The ROSA (Robotic Surgical Assistant), which uses X-rays rather than a CT-scan to create a 3-D model of the patient’s knee for a personalized implant, is used to perform total knee replacement surgery. Two physicians at Hackensack University Medical Center contributed to the design of this technology, which was officially released in 2019. The hospital is a center of excellence for training other surgeons in its use.

There’s also THINK Surgical Inc.’s TSolution One Surgical System used for the treatment of severe osteoarthritis and performing total knee replacements. A Hackensack Meridian physician was part of the development process and participated in the clinical trial that lead to FDA approval of the new technology, and following FDA approval in 2019, Hackensack was the first hospital in the U.S. to utilize this active robot technology.

“Our network has robust and diverse surgical robotics offerings, which clearly demonstrates our commitment to enhancing patient care with the most advanced treatments available,” said Dr. Michael Kelly, chair and medical director of orthopedics for Hackensack Meridian Health.
The hospital has resumed these procedures at the respective locations with enhanced COVID-19 safety measures and precautions.

“It’s important for our patients to know and recognize that there are a variety of measures in place to protect both them and our staff. It is safe to get care.”

Throughout Hackensack Meridian Health’s facilities, non COVID-19 individuals are the majority of patients returning for medical care. The network continues to take every precaution in the safety and care of their patients.

Temperatures of all patients, visitors, team members, and physicians who enter Hackensack Meridian facilities are monitored. Masks are required for everyone, and every patient is tested for the virus. Each Hackensack Meridian facility regularly undergoes rigorous cleaning and sanitizing, which includes using ultraviolet (UV) light and fogging techniques.

“We have engaged a nationally recognized third-party organization to oversee these significant efforts, including the testing of air, water, and surfaces to make sure they’re safe for our patients and team members,” the hospital noted.

And with all of those safety measures being utilized, Dr. Kelly emphasized the importance of timely orthopedic care.

“Many people put o treating issues with their painful arthritic joints or sports injuries due to the pandemic. It is vital that patients stay on top of their regimen and consult with a doctor for issues like chronic pain, loss of motion, or an injury that isn’t improving. People should schedule any procedures that they need.”

“Before we opened our facilities back up for elective surgeries, we focused on safety in a huge way across the entire network. Patient safety has always been our priority, and we are taking extreme measures to ensure that each and every person who walks into one of our facilities remains virus free. We want patients to know they should not put o care. Now is the time to keep getting better with pain-free movement and improved quality of life.”

Hackensack Meridian Health
30 Prospect Aveune, Hackensack / 1.844.464.9355 /
hackensackmeridianhealth.org/getorthocarenow