The Long Island resident says sports are a vital part of his life. He has an activity for every season and most days of the week. Sailing, sculling, tennis, bicycling, snow skiing and open-water swimming keep him busy year-round.

So, when he developed arthritis, he wasn’t about to let that stop him. “In my late 30s I felt the first twinge of pain in my right hip. Within a couple of years, it had worsened to the point that I needed care. I was told that I had arthritis likely from one of two serious falls as a young man,” he explained. “Because I was still young and active, I held off surgery until I hit 50, by which time I was using a cane.” He had his first hip replacement at HSS more than 20 years ago, and it’s still holding up.  

Years later, at age 66, he felt the same pain in his other hip, and he had a second hip replacement at HSS. This time, with advances in surgical technique and technology, the former attorney says, “I was up and about the following day, and in six weeks I had forgotten all about it.”

“More aging meant more arthritis,” he explained, and in 2024 he had both knees replaced in two separate surgeries by Fred D. Cushner, MD, a knee and hip surgeon at HSS. Four months after his second knee replacement, he went skiing in Vermont. "I am now back to all my activities, and best of all, just being able to walk around town without pain,” added Mr. Hanlon.

Read the full article at newswise.com. 

“Data points generate these recovery curves. Now I can actually see how people are doing compared to everyone else early on. The best thing I learned is how to best use the data. Log on, look for the outliers, then call to see how they are doing,” explained Dr. Cushner. 

Listen to the podcast at theshelbournekneecenterpodcast.podbean.com.

In the field of medicine, technological advances lead to new and better treatments, more personalized care, increased efficiency and improvements in safety. Such innovations have been a boon to orthopedic surgery, as engineers, scientists and inventors design systems to improve accuracy and safety in the operating room. As technologies evolve and studies demonstrate the benefits, increasing numbers of orthopedic surgeons are using robotics, computer navigation, augmented reality and smart sensors to improve patient care.

According to Dr. Dowdell, in spine surgery, surgical robots, advanced imaging technology and computer-assisted navigation provide enhanced precision, accuracy and predictability. “The system enables the surgeon to make very small incisions that preserve muscles and other structures surrounding the spine, so patients generally experience less pain after surgery, a shorter hospital stay and a quicker return to activities compared to traditional open surgery.” 

The technologies are especially useful for more challenging cases—patients whose anatomy differs from the norm— according to Dr. Sokunbi. He advised anyone considering spine surgery to carefully check the physician’s credentials and choose a hospital in which a high number of spine surgeries are performed. He noted that a good rapport with the treating physician, good communication and trust are also essential.

Dr. Vigdorchik performed the first knee replacement using augmented reality (AR) in the US in 2020, stating “It’s like a car that has the speedometer projected on the windshield, so you don’t have to look down when you’re driving.” Taking the car analogy one step further, he compared the AR knee replacement platform to GPS. “Everyone knows how to drive home, but you use GPS technology to find the best and most efficient route to take. Dr. Vigdorchik added that the augmented reality platform allows for an ultraprecise surgery.

HSS spine surgeons have also begun to use augmented reality technology. The spine system consists of a headset and the elements of a traditional computer navigation system. During surgery, it accurately determines the position of surgical instruments in real time and superimposes them on the patient’s CT scan. “The technology allows us to visualize the patient’s 3D spinal anatomy during surgery to accurately guide instruments and place surgical implants, such as pedicle screws, while looking directly at the patient rather than at a separate computer screen,” explained Dr. Cammisa “Improved control and visualization of the patient’s anatomy and critical structures can lead to a more precise, efficient surgery and can enhance safety.”

An innovation in the growing field of remote patient monitoring, it was the first implantable device approved to collect data on an individual’s progress after a knee replacement. Although the technology does not preclude office visits altogether, it enables the doctor to actively monitor a patient’s recovery with real-world, objective data to supplement his or her care. and recovery. Remote monitoring can be especially useful during the early post-operative period, said Dr. Sculco, who performed the first procedure at HSS. “In the first several weeks following knee replacement, hard work is required from the patient. The earlier you identify a patient who may not be progressing as well as you would like, the sooner you can intervene,” he explained.

Read the full article at autumnyearsmag.com.

Smart implants can provide continuous postoperative data and allow surgeons to take better care of their patients, according to Dr. Cushner.

“We have preoperative data with questionnaires and patient-reported knee scores. Intraoperatively, we have robotic data, how we put the knee in, and now we are collecting better postoperative data,” he said. “We will be able to correlate it all to see what is the best way [to treat patients] and even see if, perhaps, there is no one ‘sweet spot’ for everybody.”

Read the full article at https://www.healio.com/. 

Dr. Cushner explained, “What we found was that, compared to wearables, this [sensor-enabled tibial stem] is a highly reliable collection device. The data is not only collected, but it is also transmitted with over 99% success, and we concluded that we can monitor patients’ walking speed, cadence and other gait parameters reliably when this device is placed.”

Dr. Cushner continued, “We are focusing, right now, on recovery, but once these are [implanted] for 1 year, 2 years, 5 years, 10 years – our battery lasts 20 years – we may be able to look at gait patterns for happy patients vs. not happy patients. Who knows, we may see a certain pattern predictive of infection,”

He added, “These are all speculative, but we all know that with big data and [artificial intelligence] AI, we find out a lot of things the more patients that have this done.”

Read the full article at Healio.com.

It also may be able to teach physicians how to reduce pain after a replacement and how best to position the replacement joint, Dr. Cushner added, who helped develop the sensors.

Dr. Cushner explained that once surgeons begin implanting smart knees and the data starts coming in, “You have to do studies, but everybody is inclined to believe that we’ll be able to answer some of those unknown questions.”

According to Dr. Sculco, data coming from inside the patient’s body also may help scientists design better knees. He added, “That is an incredible treasure trove of research.”

Read the full article at Medtechdive.com.

The “smart” knee implant features an embedded sensor that counts the steps a patient takes, their walking speed and range of motion, so that the surgeon can monitor their progress from afar.

According to Dr. Sculco, “Data is key. Now we have the ability to analyze big data in a much more rapid fashion.”

He continued, “It’s very hard to get granular data.” And noted a smart knee can help with that by collecting daily data between a patient’s follow-up visits after the surgery.

Drs. Sculco and Cushner are investigating what type of patient is the best fit to benefit from the smart implant through multiple research studies.

“This is uncharted territory. We’re going to learn from the data that we collect, and that’s going to guide us,” Dr. Cushner said.

Read the full article at Modernhealthcare.com. A subscription is required to access. This article also appeared in print on December 6, 2021.

Dr. Cushner said, “The next game changer for orthopedics is going to be smart implants that are sensor-enabled and provide info and data. The first smart knee was implanted last week, and in time there will be smart hips, smart spine instruments, etc. Big data and AI [artificial intelligence] is going to change orthopedics!”

This coverage originally appeared in Becker's Spine Review. The original article is no longer available online.

Dr. Cushner said, “The smart knee uses the same material and technology found in implanted cardiac devices such as pacemakers. It collects data every day during the first year following surgery, providing objective, accurate information on how the knee is functioning. Patient monitoring can continue for much longer, though, as the battery that powers the device was made to last at least 10 years.”

Read the full article at Beckerspine.com. Additional coverage: Beckerspine.com.