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Finally, Off the Sidelines

A Customized Replacement for Painful Knees

Lynne Karp couldn't enjoy her favorite activities due to pain from osteoarthritis. She underwent arthroscopic surgery and injection therapy for her right knee in 2000, yet the problem progressed.

"After my last round of injections, I struggled to do Pilates, yoga, play tennis or anything that involved pivoting on my knee," said Ms. Karp, manager of operations in Northwell Health's cytogenics laboratory. "Even walking was painful."

Sometimes called "wear-and-tear arthritis," osteoarthritis causes cartilage break-down, according to the Arthritis Foundation. The knees are among the joints most commonly affected, states the National Institute of Arthritis and Musculoskeletal and Skin Diseases. Symptoms include stiffness, swelling and pain, which make everyday movement progressively harder and can even lead to disability.

Joint replacement can restore function, and robot-assisted surgery minimizes the significant soft tissue trauma ordinarily associated with traditional joint replacement. Like other minimally invasive procedures, robotic joint replacement reduces scarring, blood loss and recovery times compared to traditional surgery.

quotation mark Every week, I’m able to do more. I wish I had this operation sooner. Now, I feel very little pain in my knee. I recommend this solution to anyone looking for similar relief.
Lynne Karp

The robotic advantage

"With LIJ's [Long Island Jewish Medical Center] Navio robotic system, orthopedic surgeons can align and place implants with even greater precision. That makes operating in limited spaces, such as the knee, less invasive," said Vijay Rasquinha, MD, LIJ's chief of reconstructive surgery. "Operating less invasively gives patients faster recoveries with less pain. And greater precision provides them with better postoperative functionality."

When Ms. Karp discussed options with Dr. Rasquinha, she quickly saw the benefits of robotic surgery for her treatment goals. "I didn't want to be sedentary," she said. "I wanted to explore my candidacy for the procedure so I could do the things I love again."

"We focus on returning patients to high functional levels and helping them get back to work," Dr. Rasquinha noted. "Ms. Karp wanted to return to work in three weeks. She was a candidate for robotic surgery, so we started the process."

Proprietary software in the Navio robotic system uses a patient's knee X-ray to create a 3D map of the joint. Dr. Rasquinha and other LIJ orthopedic surgeons use this map to plot the surgery, align the implant and balance the knee to maximize mobility after surgery.

Ms. Karp underwent robot-assisted partial knee replacement surgery on June 21. She left the hospital the next day and returned to work a week later.

"Within a week of surgery, I walked with a cane," she said. "Before surgery, I couldn't even exercise on an elliptical machine because of the pain. Within two weeks of surgery, I rode a stationary bike. Before the end of the third week, I could drive again. I stick to my physical therapy regimen, and I feel great. I may have the same procedure on my left knee."

LIJ's Partial Joint Replacement Program, a preoperative learning session, prepared Ms. Karp for what to expect after surgery and stressed the importance of adhering to her physical therapy schedule.

"Surgery is only one part of the process, and I worked hard during therapy," she said. "Every week, I'm able to do more. I wish I had this operation sooner. Now, I feel very little pain in my knee. I recommend this solution to anyone looking for similar relief. It's not necessary to be in pain. You can feel better."

Harmonious healing

To ease your discomfort and reduce how long you must stay in the hospital after joint replacement, Dr. Rasquinha's team at LIJ uses an aggressive pain management protocol. They're also providing some unexpected avenues of relief.

After checking in for total joint replacement surgeries, patients receive an iPod Mini loaded with a variety of music to enjoy before and after their procedure. Hospital room TVs provide musical choices and meditation programming.

Incorporating music into postoperative pain management can reduce the need for pain medication and increase patient satisfaction, according to a growing body of medical research.

"We have examined methods to reduce the use of narcotic pain medications," said Dr. Rasquinha, who launched the music therapy program. "We studied the link between pain scores and medication use, and found music and other techniques are effective alternatives for reducing pain and anxiety."

LIJ’s hip and knee replacement services have earned the Joint Commission’s Gold Seal: