Optimizing Accuracy, Improving Outcomes

Washington Health has a well-deserved reputation for innovative and transformational care, from clinical trials to advanced techniques and new technologies. On Wednesday, Feb. 26, orthopedic surgeon Alexander Sah, MD, FAAOS, will present an online Health & Wellness seminar, “New Technology for Robotic Knee Replacement.”

A Fremont native, Dr. Sah is medical co-director of Washington Health’s Institute for Joint Restoration and Research and works tirelessly to advance the science and technology of anterior hip and knee replacement procedures through research, education, and clinical outcome improvements. Washington Health’s long history of cutting-edge medical care was a big reason he decided to join the medical staff in 2008. Another was coming back home to follow in his father’s footsteps: Benn Sah, MD, served Washington Health and the Tri-City Area for more than 40 years as an otolaryngologist— head and neck surgeon.

“I learned from watching my father that the patient always comes first,” he said. “I was drawn to orthopedic surgery to live that motto and help people reclaim their quality of life by relieving pain, renewing activities, and restoring function. I am gratified to see this happen for my patients on a daily basis.”

Now it’s his turn to bring that same level of care to patients, using pioneering joint replacement technology to transform lives. Dr. Sah has been on the leading edge of anterior hip and knee replacement surgery nationally since completing orthopedic residency and a yearlong fellowship in minimally invasive knee and hip surgery, where he learned how to use new surgical techniques and technology for outpatient joint replacement surgery and advanced pain management. He’ll be discussing new robotic technology in knee replacement surgery at the Health & Wellness seminar on Feb. 26.

Dr. Sah’s knee replacement surgery generally takes less than an hour, and patients are routinely up and walking within hours, going home the same day, or within a day of surgery. He said this helps patients recover faster, with less pain and swelling, and they are better able to return to regular activities more quickly.

“New techniques and technology are essential to our joint program and the reason why patients travel long distances to come here,” Dr. Sah explained. “Robotic-assisted surgery has been performed since 2000, but the machines are bulky, have line-of-sight issues, and force surgeons to change their workflows. We are very fortunate at Washington Health to have a first-of--its-kind hand-held wireless robotic device designed to enable accurate and precise implant placement. With this technology, surgeons can use their preferred protocols and workflows, optimizing accuracy and improving outcomes in knee replacement procedures.”

Dr. Sah is the first surgeon to use the Think Surgical TMINI™ robot to perform knee replacement surgery, and has the most experience in the nation. He teaches other surgeons how to use the technology and lectures throughout the country. Dr. Sah noted that the hand-held device, developed in Fremont, gives him unrestricted patient access while CT-based three-dimensional surgical planning and a proprietary surgical workflow allow him to fine-tune implant placement during surgery in real time. The device can be used with a variety of implant types, letting the surgeon choose the best implant for each patient.

“I don’t have to change the surgery to adapt to the robot,” Dr. Sah said. “I’m using the robot to adapt to the way I perform surgery. I am able to personalize the procedure for each patient, from planning the surgery virtually using a CT scan before surgery, to fine-tuning adjustments in the operating room.”

For Dr. Sah, that precision is what makes this type of surgery so exciting. “The pre-op CT scan gives us 90% of the information we need to replace the damaged knee with incredible accuracy,” he explained, “but you don’t get the fine details until you’re in surgery and assessing knee ligament balance in real time. With the robot, I can assess soft tissue balance and adjust the implant size and placement to best suit each patient. I can use the robot to plan and perform the reconstruction that will recreate the knee exactly how it needs to be for each patient.”

According to Dr. Sah, robotic-assisted surgery takes the same amount of time as non-assisted surgery. The difference is in the outcomes. Patients recover faster, have smoother rehabilitation and report greater satisfaction with their new knees.

“Nearly a million knee replacements are done in the United States every year,” Dr. Sah emphasized. “Joint replacement is elective, quality-of-life surgery for people whose lives have been impacted by damage to knees or hips, resulting in pain that limits their ability to do the things they love. Part of my role with patients is educating them about their options, from medications to injections, to physical therapy to surgery. We make sure we have tried all the nonsurgical treatments before we move on to surgery.”

Dr. Sah continued, “Robotic-assisted knee replacement is growing rapidly nationally. The biggest hurdle to the process was having the right robot at the right time, and now that we have both, I think robotic technology is going to grow even faster. This technology allows us to optimize accuracy and improve outcomes for patients across the spectrum, allowing them to live fuller, richer lives. That’s why we do what we do, and are proud to be leaders in the field.”

Tune in at 5 p.m. on Feb. 26 to the Health & Wellness seminar, “New Technology for Robotic Knee Replacement,” to find out more about Dr. Sah’s work. View this seminar at facebook.com/WashingtonHealth1 or YouTube.com/@Washington_Health.