MDNews - Long Island

Dr. Derasari consults with a patient. Rapid Rehabilitation TO IMPROVE CARE and recover y times for patients who need ar throplasty, specialists at NewYork-Presbyterian Queens prepare patients for rehabilitation long before they reach the operating room. "Patients are evaluated by a physical therapist before they come in for a surgical procedure," says Aditya M. Derasari, MD, or thopedic surgeon, Director of Total Joint Ar throplasty Ser vice at NYP Queens and Assistant Professor of Clinical Or thopaedic Surger y at Weill Cornell Medicine. "That way, both the patient and the therapist know what to expect before surger y takes place." A joint education class taught by a former surgeon also helps answer patients' questions before surger y. Typically, patients begin physical therapy on the same day as their surger y, which helps shor ten the length of their hospital stay and overall recover y time while bettering outcomes. "We're able to get patients home after just a few days and improve their joint function later on," says Robert Li, MD, attending orthopedic surgeon at NYP Queens and Assistant Professor of Clinical Orthopaedic Surgery at Weill Cornell Medicine. "We're able to get patients back into society and living their lives according to their normal routines in a quicker manner." NYP Queens also partners with an in-home therapy service, which allows patients to undergo physical therapy in their own home for the first two weeks after surgery. After that, patients return to the hospital multiple times a week to continue therapy and are often able to walk using only a cane — as opposed to using a walker or not walking at all — within a few weeks. "Much of the success we've seen in our arthroplasty program can be attributed to physical therapy and patient education," Dr. Derasari says. ex tra bone in ha lf-millimeter increments. The instrument glides into the proper plane at the correct angle, and we begin removing the appropriate amount of bone." Though ex tremely ra re, if a situation a rises where the 3-D model is drastica lly misa lig ned with the patient 's a natomy, surgeons ca n easily rever t to a ma nua l surger y. " The more robotic surgeries we perform, the more we've noticed t hat we were doing a g reat job using t he ma nua l surger y technique as well," Dr. Li says. PARTIAL KNEE REPL ACEMENTS Partia l knee replacements can offer many benef its to patients but provide less bone exposure for surgeons, ma king it more diff icult to avoid liga ments a nd hea lthy segments of the knee a nd complicating the placement of components. " The g reat thing about pa r tia l knee replacement is that patients ca n reta in a ll four of their liga ments in the knee, wh ich ke eps t hei r k ne e fe el i n g n at u r a l a f t er s u r ger y," Dr. Derasari says. "For tota l replacements, one or two of those liga ments a re t y pica lly cut a nd the results ca n feel a little less natura l for the patient." The robotic a rm a llows surgeons to use a sma ll round burr that precisely removes bone for the placement of components during pa r tia l knee replacement while providing surgeons with more information rega rding the ba la nce of the knee a nd its liga ments. " I wou ld say t hat pa r tia l k nee replacement is t he best application of the robot," Dr. Li says. "Historica lly, it 's ver y dif f icu lt to position a pa r tia l knee impla nt appropriately even if a surgeon is looking directly at it." PRECISION PL ACEMENT R at her t ha n inser ting instr uments into t he ca na l of t he femur, which may cause blood clots, surgeons ca n per form procedures without a ffecting the femur's ca na l or applying jigs. The robot a lso reduces the a mount of blood loss a nd a llows surgeons to place cups in more appropriate positions during hip replacements, which may lower the risk of disloca- tion for patients a f ter surger y. "The robot software also provides detailed information on how long a patient's leg will be after surgery," Dr. Derasari says. "This helps us avoid making a patient's leg too long, which can be a complication after hip replacement." 1 7 M D N E W S . C O M /// M D N E W S L O N G I S L A N D ■ 2 018

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