Dr. Mayman is one of the nation’s leading experts in robotic-assisted and computer-navigated hip and knee replacement surgery. Widely recognized for advancing precision joint replacement, his work focuses on integrating robotics, computer-assisted technologies and personalized surgical planning to improve outcomes for patients undergoing hip and knee arthroplasty.

A member of the prestigious Hip Society and Knee Society, Dr. Mayman is also known for his translational research efforts that bring emerging technologies from the laboratory into clinical practice. He specializes in primary and revision joint replacement, minimally invasive hip and knee surgery, partial knee replacement and the treatment of arthritis in younger, active patients, helping shape the future of technology-driven joint reconstruction.

Read the full article at beckersasc.com. 

Matthew S. Austin, MD, hip and knee replacement surgeon at HSS, told Healio about results presented at the American Academy of Orthopaedic Surgeons Annual Meeting. “This study sheds light on the fact that if someone says they have an allergy to an iodine-related product one should not automatically avoid its use,” he said. Dr. Austin and colleagues retrospectively reviewed data from 3,696 patients who reported an allergy to iodine, iodine-containing products or shellfish who either did (n = 1,378) or did not (n = 2,318) receive an iodine-based product during primary TJA. 

“Instead of a blanket policy of if a patient says they have an allergy to an iodine-based product, they cannot receive any iodine-based product, institutions can have a protocol in place where you look at the patient’s history,” Dr. Austin continued. “What is the patient saying the reaction was? How severe was the reaction? How far in the past? Have they safely received an iodine-related product in the interim since they discovered they had this allergy? Putting appropriate pathways and protocols in place will allow many patients to receive an iodine-based product, which may reduce their risk for having an infection from the procedure.”

Read the full article at healio.com.

These forward-looking leaders help their organizations stay ahead in an evolving care landscape by championing inventive, strategic and future-focused solutions. From introducing transformative technologies and refining patient care approaches to cultivating impactful collaborations, chief innovation officers are accelerating meaningful progress throughout healthcare.

At HSS, Dr. Ast advances technology-enabled orthopedic care and scalable surgical pathways. He has spearheaded initiatives integrating robotics, data-driven decision-making and patient-specific solutions to improve outcomes and accelerate recovery in joint replacement. He pioneered joint replacement pathways implemented across more than 200 ambulatory surgery centers, expanding access while setting standards for safety, efficiency and recovery. A major focus of his work has been opioid-sparing pain management, with initiatives that significantly reduced opioid use in joint replacement patients while maintaining excellent outcomes. Dr. Ast collaborates with medical technology companies to design implants and tools now used globally, and serves as an educator for surgeons through trainings, webinars and international operating room observerships. 

Read the full article at beckershospitalreview.com.

One of the most integral parts of joint preservation is the preservation and restoration of cartilage, according to Ernest L. Sink, MD, chief of the Hip Preservation Service at HSS. 

“Maintaining cartilage is a main reason we are doing these procedures,” Dr. Sink said. “We are trying to conservatively prevent cartilage-advanced degeneration by diagnosing these deformities when they lead to hip pain, hopefully before you get to the cartilage changes. Because once you get cartilage changes and more advanced degeneration, you cannot preserve the cartilage with surgery.”

Read the full article at healio.com. 

The Joint Replacement Excellence Award recognizes hospitals with superior clinical outcomes in knee and hip replacement. HSS has been named among the list of recipients. 

Read the full article at beckersspine.com. 

Patients and doctors need to make decisions together for the best results. That’s especially true for people who have a history of mistrust in the health care system, as many Black Americans do, said Dr. Parks.

His and others’ research has found that African Americans — especially those from poor communities or who have less education are more likely to have poor outcomes from surgery and to require additional surgery resulting from complications. Research also has found that Black Americans are less likely to receive knee or hip replacement surgery and less likely to receive pain management than white patients.

That’s partly due to providers’ inherent biases, poor communication and because people in these communities are less likely to seek treatment, said Dr. Parks. 

“We've done studies where we looked at patients and how their perception of their interaction with the physician was, and many particularly African American patients who are women felt that their complaints were dismissed. So we have to think about that. What are our implicit biases or explicit biases when we're dealing with patients, and hopefully check those at the door and meet the patients where they are so that we can again treat them equitably,” he continued.

“The whole concept of shared decision-making is where you give a patient an array of options,” explained Dr. Parks. “I try to open a dialogue and make the patient feel comfortable with their questions. My role is to educate them, to tell them where I think they are, to give them my recommendations. And then I always tell them, "It's between you and that painful joint. It will often make you do something. I can’t make you do anything, but I think that’s going to lead you forward."

Read the full article at arthritis.org.
 

Read the full article: https://www.beckersspine.com/. 

Dr. Kahlenberg noted, “The components we use in joint replacement surgery are now better than past materials. We use highly cross-linked polyethylene providing greater durability and less wear. These new materials help hip replacement patients recover faster, be active and gain greater longevity from their new hip. For many, joint replacement surgery lasts a lifetime.”

She continued, “We’re involved with many cutting-edge studies to improve patient outcomes. I am working with a team of HSS hip and knee surgeons and our biomechanics department to run computer simulations of hip and knee replacement. These models help us determine individualized patient targets for ligament tensioning and balancing precisely for knee replacement. Our robotic and computer navigation technologies allow us to execute surgical plans and target specific alignment and balance of the knee with great precision."

Dr. Kahlenberg added, We’ve made great strides in speeding up patient recovery from joint replacement surgery. Also, new surgical techniques and the use of regional anesthesia instead of general anesthesia lowers the risk of complications and side effects. We like to get patients up and moving right after surgery; most can go home the same day or after a one-night stay. Within six weeks, many patients can return to low-impact activities, then higher-impact pursuits soon after that." 

Read the full article at greenwichsentinel.com/.

He explained, “Cell-free DNA is the genetic material that’s floating around in your bloodstream. It will give you a signal that an organism has been in blood and that there is an infection taking place. I started looking at cell-free DNA in pregnancy to look for abnormalities. But this is now applied to infections.”

Dr. Bostrom and colleagues worked with the medical technology firm Karius to discover that the method could detect infections in joint replacement patients via a simple blood test rather than pulling fluid out of knees, hips and shoulders. According to Dr. Bostrom, this method of infection detection allows experts to recognize specific sensitivities related to bacteria and identify multiple organisms, an asset not available through conventional methods.

He added, “Treating the infection means usually taking everything out, cleaning it out, applying an IV and antibiotics, and then finally time to put a new knee or hip in the patient. We never really know when it is the right time to take these steps. But this technology could be very useful in that setting. If the cell-free DNA is negative, it’s probably a good time to replant it. On the other hand, if the cell-free DNA sample is still positive for an infection, we gotta be aggressive and do something different, not put a brand new hip or knee in there.”

Read the full article at Bonezonepub.com.

Dr. Vigdorchik underscored the value of AR. “You could make an argument to use it on everything, because any time you are adding information, you are adding value to the surgeon,” he noted.

He continued that AR is the “next step toward a small profile, easy to use, efficient, low-cost computer-aided technology.”

Dr. Vigdorchik explained, “[Augmented reality needs to be] more readily adoptable so that the surgeon doing two or three [total joint replacements] a month can easily use it. If there is a learning curve and the learning curve is 10 cases, doing two or three a month, it is going to take you 6 months to learn how to do it efficiently and you may not be willing to invest in that learning curve.”

Read the full article at Healio.com/news/orthopedics.

Dr. Westrich noted that as hospitals seek to remain competitive with the latest technology, the needs, goals and values of patients must always play a key role in health care decisions.

He underscored the importance of patient-centered care, in which the latest and greatest tech advances go hand-in-hand with respectful and compassionate care.

Read the full article at Healthcarebusinessreview.com.

HSS researchers focused on preoperative IgG antibody test results in 5,354 patients who were operated on between May 2020 to January 2021.

Dr. Miller explained, “While there were no differences with respect to age, sex or comorbidity indices, COVID-19 history patients were more likely to be Black, more likely to be Hispanic, to be obese and be anemic, and somewhat less likely to have a history of rheumatoid arthritis.”

He added, “Overall in-hospital complication rate was 0.4% with no significant difference between groups and zero complications in our COVID-19 history cohort.”

Read the full article at Healio.com/news/orthopedics.

HSS anesthesiologist and principal investigator, Stavros G. Memtsoudis, MD, PhD, MBA, and colleagues including researcher Julia F. Reichel, compared the efficacy of a single preoperative oral dose of TXA to a single preoperative IV dose of TXA in patients undergoing total joint replacements.

Read the full article at Healthday.com.

Additional coverage: Physiciansweekly.com.

Dr. Roche explained the advancement of robotic applications, including the innovation of a partial knee replacement developed at HSS Florida, which fixes just the worn-out part of the knee and allows people to get their range of motion and function back in a matter of weeks, which is a tremendous improvement in the treatment of arthritis.

Dr. Roche said, “I always want to tell the patient that - knee arthroplasty, even though a complex surgery, it has a successful up-to-20-year lifecycle, so it enables you to restore your function – you can hike, swim, cycle, tennis, golf and restore your active lifestyle.”

The segment aired on May 20, 2021.

HSS believes the best orthopedic care begins with the proper diagnosis and a comprehensive treatment plan delivered by top medical talent every step of the way. The goal is to continue to provide unmatched, personalized care to improve mobility and restore quality of life for its patients. 

Read the full article at Questmag.com. This article also appeared in the February 2021 print issue.

Additional coverage: Beckersspine.com.

Dr. Ast underscored the importance of developing and implementing strong, structured protocols (focused on patient selection, pain management and blood and fluid management) which are evidenced-based for successful outpatient joint replacement; aligning with the correct site of service for their patients and their practice; and collecting and understanding of data with respect to patient outcomes.

Read the full article at Beckersasc.com.

As patient selection is a top consideration for the success of outpatient total joint replacement, Dr. Haas explained he is a big proponent of putting patients on comprehensive prehab programs and optimizing their pre-op nutritional status. This prepares the body for the trauma of major surgery and improves the ability to recover quickly. “Prehab is important because the better condition patients are in heading into surgery, the better condition they’ll be coming out,” he said.

Is it important for surgeons to understand and commit to an approach that prepares patients for same-day discharge. Dr. Haas has developed a surgical technique that involves operating through small incisions and eliminates the need to cut the quadriceps tendon, factors that limit post-op pain and help to prepare patients for same-day discharge.

The quality of care that patients receive in the weeks and months after surgery and the amount of work they put into their rehab regimens are essential to ensuring they achieve the outcomes they expect. Digital platforms now allow patients to follow prescribed physical therapy programs at their convenience and from the comfort of their homes. HSS launched a telehealth physical therapy program prior to the COVID-19 pandemic for select patients, but has since expanded its use. Patients go home, get online and work with a physical therapist remotely. HSS plans to expand the remote rehab program over the coming year and study its impact on post-op results.

Read the full article at Outpatientsurgery.net.

"The pandemic will potentially accelerate the pace of technology adoption in joint arthroplasty because there will be a focus on efficiency and supply chain, and enabling technology has the potential to benefit both areas," said Dr. Ast. "ASCs don’t typically have the capacity to deal with nine trays and complicated room turnover. They benefit from technology that integrates easily and will be able to adopt to their individual center’s capacity," he added. 

HSS has spent the past five years adopting the protocol and patient selection policies for joint replacement in the outpatient setting and are now prepared to take on additional patients during the pandemic. "We are prepared for the sudden onset of more joint replacements in the outpatient setting from a capacity and safety standpoint," noted Dr. Ast. "That’s why the ramp up will be so dramatic. CMS [Centers for Medicare & Medicaid Services] and private payers have been predicting the shift of outpatient total joints and I think there will be a big opportunity in the next five years for that trend to accelerate."

Read the full article at Beckersasc.com.

“It’s a very difficult decision to decide to get hip or knee replacements,” says Mathias P. Bostrom, MD, chief of the adult reconstruction and joint replacement service at HSS, who recognizes that a postponement may feel like a setback since the patients are now ready to move forward. “And now [with social distancing], throw in that you’re isolated, and it is very frustrating.”

Dr. Bostrom advises to be patient and to try to manage the pain as much as possible. “Trying to maintain some exercise is so critically important,” he adds.

Dr. Bostrom says that the good news is that any unexpected delay will not result in long-term damage. “It’s unlikely that you are going to make [your arthritis] worse by waiting one, two or even three months; your pain will be worse, but not the outcome of the operation,” he explains.

Read the full article at Arthritis.org.

Reuters Health spoke to Michael M. Alexiades, MD, hip and knee surgeon at HSS, who wasn’t involved in the study to comment on the findings. “Most surgeons do not stick to the recommendation of waiting six weeks, and instead provide a general guideline, letting patients decide when to get back on the road,” noted Dr. Alexiades. “A lot of surgeons hesitate to give patients a definitive time to return to driving,” explained Dr. Alexiades.

Dr. Alexiades concluded, “The reality of the situation is they’re driving earlier today than what is recommended, but the question as to whether they are truly ready to return to driving in that time period still has to be answered.”

Read the full article at Reuters.com.