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Innovative Clinical Trial Underway Which Studies New Technology

and Technique to Improve Total Knee Replacement Results

As the principal investigator overseeing a clinical trial if the integration of intraoperative sensing data had the potential to decrease the
studying a new technology and technique for Total Knee need for all component revision. In this review, approximately 88 percent of
Replacement (TKR) surgery, I am delighted to share details on intended total component revisions were changed to partial revisions based on
ground-breaking advancements which may potentially help the surgeons’ interpretation of the sensor feedback. This sparing of components
an even greater number of patients who are not satisfied with saved an estimated $4,990 in healthcare provider implant costs, per case.
the results from an earlier knee replacement. Because only one component was changed and not two, patients benefited by
Total Knee Replacement has been a well-established and requiring less operative dissection, less bone loss, less operative time and often
successful procedure for over 50 years and has helped mil- a faster and easier recovery.
lions of people worldwide. More than 750,000 TKRs are per- As the surgeon takes the knee through a range of motion (ROM), dynamic
formed each year in the United States and recent studies indi- load measurements are generated for the lateral and medial tibial compart-
cate that number is expected to increase more than 650 per- ments. A reference location of the load in each compartment throughout the
cent from 2005 through 2025. ROM can also be used to evaluate knee kinematics. Armed with this data, Dr.
While the vast majority of patients are very pleased with BY WILLIAM A. LEONE, Leone will be able to determine if compartmental loading and knee kinematics
their outcome, multiple studies have revealed that 20-30 per- M.D., F .A.C.S. are desirable or if further resection or soft-tissue releases are indicated.
cent of individuals are not satisfied following TKR, when The most consistent and best results after TKR are in those patients whose
measured with validated patient reported outcome measures knee movement after TKR most closely matches their natural knee movement
(PROM). Component malposition, malrotation, and soft tissue imbalance can result before TKR and when soft tissue loads medially and laterally are nearly equal and
in pain, stiffness and instability and are common reasons for dissatisfaction after physiologic. These patients are also most likely to report that their TKR feels natural
TKR. These conditions are often difficult to recognize at the time of surgery and dif- and comfortable.
ficult to correct until now. The data from the sensors may enable the surgeon to address such soft-tissue
For the last several years, I have been utilizing a new FDA approved technology, abnormalities that may otherwise be unknown during traditional total knee revision
VERASENSETM by OrthoSensor Inc., which incorporates microelectronics and sen- procedures. Furthermore, the economic implications from converting a total revision
sors to measure real-time kinetics and intercompartmental loading during total knee to a partial revision could have a profound effect on the patient and healthcare
arthroplasty (TKA). A computer microchip and load sensors are incorporated into provider, such as decreased rehabilitation regimes and opportunity for cost savings.
trial tray inserts whose geometries match exactly the geometry of the final plastic Eligible revision patients who agree to participate will be followed for a period of 12
insert provided by the manufacturer. These sensor trials are placed in the tibial tray months after the revision procedure. I have outlined the patient eligibility criteria
both during the “trialing phase” and after the final components are implanted for below.
“final trialing.”
Holy Cross Hospital is currently heading up a multicenter study using For more information, a list of the study eligibility criteria, or to schedule an evaluation,
VERASENSE to evaluate Revision TKR. This study attempts to draw relationships contact The Leone Center for Orthopedic Care at Holy Cross Hospital at (954) 489-4575
between the soft-tissue related complications contributing to early TKA revision and or LeoneCenter@holy-cross.com or visit holycrossleonecenter.com.
the loading and positional patterns observed using intraoperative tibial trial sensors.
Over the last several years I have been using VERASENSE during revision TKR. A Dr. William Leone is head of The Leone Center for Orthopedic Care.
few colleagues and I looked at a series of revision cases retrospectively to determine

MAKINGROUNDS…MAKINGROUNDS…MAKINGROUNDS…

Interventional Cardiologist Joins Ronald Young, II, M.D.,
Tenet Florida Physician Services in Distinguished Neurosurgeon,
Fort Lauderdale Joins Brain and Spine Center
South Florida
Tenet Florida Physician Services (TFPS) is pleased to
announce Ricardo Vicuna, M.D., FACC, FASE, a board-cer-
tified interventional cardiologist, has joined the TFPS mul- Ronald L. Young, II, M.D., recently joined the Brain and
tispecialty physician group with an office located in Fort Spine Center South Florida team of board-certified neuro-
Lauderdale. Dr. Ricardo Vicuna surgery specialists. He brings more than 20 years of expe- Dr. Ronald L. Young, II
Prior to joining TFPS, Dr. Vicuna worked in a Miami- rience in treating brain tumors, hydrocephalus, traumatic
based private cardiology practice with colleague, Dr. David Perloff, a general and brain injuries, cervical spine problems, spinal cord tumors, and other brain, neck
invasive cardiologist. Dr. Vicuna is also clinical assistant professor in the Department and spine conditions.
of Internal Medicine, Division of Cardiology at Nova Southeastern University’s Dr. Young was affiliated with Terre Haute Regional Hospital in Indiana before mov-
College of Osteopathic Medicine. ing to Palm Beach County. He was listed as one of the top neurosurgeons in the
Dr. Vicuna completed an interventional cardiology and cardiology fellowship at Indianapolis area for eight of the last 10 years, and was twice recognized as one of
the University of Illinois Chicago Medical Center in Chicago, IL, and a cardiovascu- the top innovators in medicine in the Indianapolis area.
lar magnetic resonance/cardiac CT fellowship at William Beaumont Hospital in He has spoken at national and international conferences, including medical edu-
Royal Oak, MI. Dr. Vicuna completed an internal medicine residency at the cational events at University of New South Wales in Australia and the World
University of Illinois Chicago Medical Center. He graduated medical school from Congress of Hydrocephalus in New Zealand.
Cayetano Heredia University, Medical School in Lima, Peru.
E-mail Your Physician Appointments to
Palm Beach Gardens Medical Center editorial@southfloridahospitalnews.com

Names New Medical Director of

Bariatric Program

Palm Beach Gardens Medical Center appoints John Bacha,
D.O., as its new medical director of the bariatric program.
Dr. Bacha is a board certified general surgeon who special-
izes in bariatric procedures. Dr. Bacha received his bariatric
and robotic training at Wayne State University and the Dr. John Bacha
University of Miami. He then completed his residency
through Michigan State University at Macomb-Oakland Hospital in Madison
Heights, Michigan. He earned his medical degree from Lake Erie College of
Osteopathic Medicine in Erie, Pennsylvania. He received his bachelor’s degree from
Penn State University, graduating with honors in Biology.

South Florida Hospital News southfloridahospitalnews.com September 2017 27