Robotic-Assisted Knee Replacement Surgery at Lehigh Valley Orthopedic Institute

Surgeons with Lehigh Valley Orthopedic Institute use robotic technology to assist in replacing the body’s largest joint – the knee.

The Orthopedic Institute utilizes multiple robotic systems – VELYS™ Robotic-Assisted Solution from DePuy Synthes, a subsidiary of Johnson & Johnson, Stryker’s Mako SmartRobotics™ System and Zimmer Biomet's ROSA® Knee System – at select hospitals across Lehigh Valley Health Network (LVHN). Robotic technology can assist a surgeon in precision cutting and balancing during surgery.

“The robot is an assistant that helps the surgeon fine-tune a knee replacement,” says orthopedic surgeon, Eric Lebby, MD, Chief, Division of Orthopedic Surgery, Lehigh Valley Orthopedic Institute. “A car works best when the wheels are in perfect balance and alignment. A computer helps the mechanic better align the wheels. The robotic system helps the surgeon fine-tune and balance the knee replacement. The robot can make a great surgeon even better.”

Dr. Lebby says the robotic system gives surgeons more information, which translates to greater precision. Since each person’s anatomy is different, joint replacement surgery is not a one-size-fits-all endeavor. “This is another instrument to better produce superior results,” he says.

“The robotic system helps the surgeon fine-tune and balance the knee replacement. The robot can make a great surgeon even better.” – Eric Lebby, MD, Chief, Division of Orthopedic Surgery, Lehigh Valley Orthopedic Institute

Not every patient undergoing joint replacement will require robotic-assisted surgery. LVHN surgeons performed nearly 5,000 joint replacement surgeries last fiscal year (July 1, 2020-June 30, 2021), with the majority being partial- or full-knee replacements. That total is expected to increase in the current fiscal year (July 1, 2021-June 30, 2022), though volume in both years was likely slowed slightly by the COVID-19 pandemic.

Orthopedic Institute surgeon Thomas Meade, MD, says he’s been exploring orthopedic robotics technology for about the last decade. Though early versions were bulky and didn’t improve outcomes, Dr. Meade says it was evident the technology was here to stay. “The industry is ready now, and we were determined to bring it to LVHN and the Orthopedic Institute,” he says.

“This is all about improved patient outcomes,” Dr. Meade says. “Robotic-assisted surgery does not speed up a joint replacement procedure, but benefits include less tissue damage, lower pain scores and a quicker recovery. There is more precision, as well as more consistency and fewer outliers.”

Orthopedic Institute surgeon Jonathon Brown, DO, says surgery is a precision art, and anything that can improve precision is a win. “By being more precise, we can tailor the operation more closely to the needs of the patient and can theoretically improve outcomes and satisfaction.”

Orthopedic Institute surgeon Christopher Ferrante, MD, says the surgeon still is the one coming up with the plan for the surgery, customized for each patient’s anatomy. Robotics, he says, has the potential to standardize some aspects of the surgery, including how to make cuts more precise and exact.

Though not many patients currently ask for robotic-assisted joint replacement surgery, Dr. Ferrante says it’s something that has momentum and will be mainstream in the not-too-distant future.

Robotics or not, the orthopedic surgeon, like an architect designing a building, still lays out the vision for completing a joint replacement.

“All of our doctors are outstanding,” says Dr. Lebby. “We’re taking what is a very good situation now and making it even better.”