The Spine and Orthopedic Institute at St. Vincent Charity Medical Center prides itself on having a deep bench of entrepreneurial physicians who are constantly exploring ways to improve life for patients. Some of the newer advances are designed to provide patients with improved long-term results and fewer complications. Ultimately, the name of the game is better care, whether it’s surgical or non-surgical.
Dr. Bernard Stulberg (view profile, 440-248-1297) recently became the first orthopedic surgeon in the world to use the newly released TSolution One only active robotic system to perform a successful total hip replacement surgery. This technology enables a surgeon-controlled robot to cut the bone to precise shape and position and is expected to increase the accuracy of hip implant placement and improve long-term outcomes for patients.
“This is a game changer for orthopedic surgery,” Dr. Stulberg says. “Advancing and combining previous surgical technologies with improved imaging capability allows surgeons to develop a patient-specific and unique surgical plan prior to surgery. The plan is then executed with the level of precision that only robotics can offer. That means more accurate placement, less post-surgical pain and fewer problems, such as hip displacement, after surgery.”
While robotic technology has existed for some time to assist with orthopedic surgery, the TSolution is the only one in place in which the robot prepares the cavity for surgery. With it, Dr. Stulberg says, he is able to create a cavity the exact size, with symmetrical, smooth edges, to accommodate the implant. “This precise fit creates less opportunity for movement of the implant in the bone, assuring a more predictable attachment,” he says. “The positioning accuracy enhances the ultimate stability and loads on the implant to allow for increased longevity of the device.”
With repetitive dislocation of a hip implant as the leading cause for the need for hip revision surgery, this revolutionary technology is expected to reduce the chances for implant failure and reduce post-surgical pain. St. Vincent is the only hospital in the Midwest currently certified to use this modern system, and has recently been approved as a site for a clinical trial for use of the robot in total knee replacement.
In addition to Dr. Stulberg, Dr. Audley Mackel and Dr. Louis Keppler are also trained on the system. Those who suffer chronic back pain now have a non-invasive outpatient option known as COOLIEF Cooled Radiofrequency System. Recognizing that many patients, even though they may be in extreme, chronic back pain, often refuse surgery because of the risks and extended recovery periods, St. Vincent is employing this system to bring patients relief without the complications of major surgery. With just a small incision, physicians target and burn the nerves causing a patient’s neck and back pain. Studies have shown the treatment provides patients with up to 24 months of pain relief and improved physical function without the months of rehab, risk of infection and hospitalization associated with surgery.
In less than six months, St. Vincent Sports Medicine Specialist Dr. George Friedhoff has performed nearly 100 ablations after receiving specialized training on the equipment.
“We have had tremendous success with this technology. With surgery, there are three options— a patient can get better, not get any better, or, sometimes, a patient can get worse. But, you don’t know which of those outcomes you will have until after surgery. With the COOLIEF, I know right away if the patient will respond to the procedure without any of the adverse outcomes of surgery.”
Prior to surgery, Dr. Friedhoff said he is able to perform a dry, test run with Lidocaine. If the patient feels relief from that, then he knows he or she is a candidate for a successful COOLIEF ablation.
While traditional radiofrequency ablation has been used for some time to heat and destroy nervous tissue causing back pain, the advanced COOLIEF system provides greater and longer relief for patients. The new technique uses cooled water to slow the heating process, thereby allowing the heat to penetrate a larger area of the offending nerve. This allows St. Vincent surgeons to create a larger lesion at the pain site, leading to more effective and longer last results.
“The majority of patients are completely pain free as soon as they get up from the table. I had one patient who was actually able to chop a pile of wood shortly after his procedure —something he could have never done before,” Dr. Friedhoff said. “One of the most significant benefits of the COOLIEF is our patients’ ability to stop taking narcotic pain medicines. With the opioid epidemic we are facing in our community today, we, as caregivers, are searching for less-invasive treatments that don’t rely on medication.”