Hackensack University Medical Center Orthopedic Surgeon-Inventors Develop and Advance Techniques Used Around Globe, Publish the Go-to Textbook on Knee Surgery

Innovations Include ROSA Robotic Surgery, the THINK System for Total Knee Arthroplasty and Zimmer Persona Total Knee Arthroplasty

Already considered for decades to be one of the most successful surgical procedures in medicine, total knee replacement took another couple leaps forward recently with the introduction of ROSA robotic surgery and the THINK Surgical Inc. TSolution One System.

Hackensack Meridian Health Hackensack University Medical Center was first in the Northeastern US to use Zimmer Biomet’s Robotic Surgical Assistant (ROSA) for more precise, customized knee replacement. ROSA uses a 3D model system to facilitate customization of the surgical process and to better-fit knee implants, corresponding to the anatomy of the patient.

“Knee replacement had been done essentially the same way for 20 years – and with impressive results,” according to Gregg Klein, M.D., who together with Harlan Levine, M.D., developed the ROSA knee technology. “But technology has given us the ability to improve upon the conventional method,” he says.

The process begins with standard 2D X-rays, which are widely available and pose less of a radiation risk than CT scans. The ROSA software then turns the X-rays into a 3D model of the knee, which the surgeon uses to formulate a plan customized to the patient’s unique anatomy.

During surgery, the ROSA system provides real-time data to help the surgeon further assess the bones and soft tissues of the knee, as well as how the knee moves. This data also allows the surgeon to determine the optimal size and placement of the implants.

“By having the imaging technology coordinated with the computer and the robot, we can put the knee replacement components in very precise positions—down to a half millimeter, which is something that traditional technology hasn’t been able to allow us to do,” Dr. Klein says.

“We expect the ROSA to revolutionize the treatment of patients suffering from degenerative knee diseases such as osteoarthritis,” says Michael A. Kelly, M.D., chair of the Department of Orthopedic Surgery at Hackensack University Medical Center.

Also, a Hackensack team led by Yair D. Kissin, M.D., FAAOS, completed New Jersey’s first robotic-assisted total knee replacement using THINK Surgical Inc.’s TSolution One System in November 2017. It is the only available active robot which uses CT based 3D pre-surgical planning software to allow surgeons to virtually design and prepare a knee replacement plan that is unique to each patient.

Hackensack University Medical Center was one of five centers in the country to participate in an Institutional Review Board (IRB) and Food and Drug Administration (FDA) approved clinical trial to demonstrate that the TSolution One System is a safe and effective surgical alternative to traditional knee replacement using manual instrumentation. This new and innovative multicenter clinical trial is helping to develop the latest technology to further advance orthopedic care. The system was FDA-approved in October 2019 for use in total knee arthroplasty in the United States.

Also of note, Hackensack University Medical Center orthopedic surgeon Michael Kelly, M.D., is a recognized leader in joint replacement, having been involved with designing five knee implants. He was a member of the design team for the Zimmer Persona Total Knee Arthroplasty system. The Persona knee implant has been used by orthopedic surgeons around the world, with over 1 million implants used over the past 20 years.