Novel Robotics Platforms for Orthopedic Care   

Hackensack University Medical Center Surgeons on Emerging Trends in Orthopedic Robotic Surgery

Orthopedic Surgeons Yair Kissin, M.D., and Gregg Klein, M.D., share perspective on technology and technique developments

Ortho Robotic

Orthopedic surgeons at Hackensack University Medical Center aren’t just performing the latest robotic surgery techniques; they’re helping engineers develop the next generation of surgical robots.

Yair Kissin, M.D., serves on the development team for the THINK Surgical TSolution One robot, while Gregg Klein, M.D., contributes expertise to the Zimmer Biomet ROSA Robotics global physician development team. Given their development roles, both surgeons hold a unique vantage point on the emerging future of orthopedic robotic surgery. 

Dr. Klein notes the international perspectives and diverse capabilities preferences led to engineers adding more adaptable settings to a single robot. The development team is currently informing design of the ROSA 1.5, giving input and feedback to engineers on what the ideal surgical experience will ideally entail. 

“We’re part of an exciting new frontier just in its infancy,” said Dr. Klein. “The future looks really great.”

Embraced for the accuracy it provides, Dr. Kissin said he expects robotic surgery of the future to include more partial knee and hip procedures. He also anticipates new applications, such as trauma and revision procedures and ligament placement in ACL repair. Dr. Kissin says bringing virtual reality (VR) and augmented reality into robotic surgery could help make these applications possible. 

He also credited VR and augmented reality applications in teaching, both in medical education and continuing education. VR-enhanced education can help continue the expansion of robotic surgery, training established orthopedic surgeons trained in traditional surgery to meet growing patient demand. 

Dr. Kissin also has observed recent discussion of AI, particularly in pre-surgical assessment to ensure patients are good candidates, including more complex cases, such as patients with diabetes. Assessment of patient fitness and risk is an important first in achieving a positive outcome. 

Another noted trend: migration toward open platform robots that can accommodate multiple manufacturers’ implants, rather than hospitals procuring multiple proprietary robots as is often the case today. Dr. Klein expects that future generation robots will become more autonomous in procedures over time, rather than primarily providing an assist. 

Another trend that may help transition more surgeons into robotic surgery is the emergence of handheld robots, which are less expensive, less cumbersome and user-friendly, more closely resembling the familiarity of the traditional approach, but availing the accuracy of robotic cuts.

Dr. Kissin credits a recent development Hackensack University Medical Center is incorporating with potential to impact robotic surgery moving forward: the Persona Smart Knee implant from ROSA. In the Smart Knee, a sensor incorporated in the implant feeds physicians gait analysis data and monitors recovery. This level of post-surgery performance data access opens a new level of analysis and opportunities for refinement of robotic surgical techniques and implant devices.

“It’s like a growth chart in a child. It shows if we need changes in PT; we catch issues early. We know how they’re really doing,” Dr. Kissin said, noting that implanted sensors could potentially show temperature changes indicative of infection.

Dr. Klein notes that smart wearable devices are also helping fuel this new surge of post-op implant performance data that will provide rich, evidence-based guidance to inform future robotic surgery techniques.

Learn more about innovative orthopedic care at Hackensack University Medical Center.

USNWR Orthopedics
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