2016-17 Sentara Orthopedics Annual Report

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Sentara Surgical Innovations

Surgical & Procedural Innovations

The care teams at Sentara strive to improve patient care by developing adopting and implement the most sophisticated and proven techniques, technologies and protocols. Our commitment to advancement in orthopedic care ensures a distinguished patient experience. Our innovative approach is multifaceted.

Rapid Recovery Protocols

Sentara orthopedic care teams continue to evaluate methods of care that help patient to recover more quickly. Along with the surgical precision and innovation, there are numerous practices that are effective in helping our patients progress through recover and back to enjoying everyday activities:

  • Preoperative education to prepare patients and their caregivers to set expectations and goals for recovering from surgery.
  • Encouraging patients to be at their best physical health prior to any elective surgery by stopping smoking, starting pre-surgery exercises to strengthen muscles for recovery after surgery, and preparing the home as a  clean, health place to recover.
  • Exchanging addictive opioids for multi-modal pain management, including non-addictive pain medications, day of surgery physical therapy that gets patient up and moving, and an attentive care team that helps patients to keep ahead of post-surgical pain.  When pain is at a tolerable level, patient are more able to move, participate in therapy and reduce the risk of developing a blood clot.
  • Something as simple as having elective surgery patients to wear their own clothes in the hospital give patients the sense of normalcy that motivates them to get up and moving.

Robotic-Assisted Surgeries

Over the past years there has been the development of robotic-assisted technologies that are focused on using the increasing the precision of certain types of orthopedic and neurological surgeries.  Some of the technologies combine the use of CT scans to help prepare the individualized plans for surgery.   

For orthopedic and spine surgeries, Sentara currently has robotic-assisted surgical equipment systems that are available for surgeons to implement for spinal surgeries, total hip replacements, partial knee replacements,  and in 2017 the added capability for robotic assisted total knee replacements.

Muscle-Sparing Procedures:

Several shoulder procedure are muscle sparing including the mini-stem and the stemless shoulder replacement.

  • Subscapularis total shoulder replacement technique: This muscle-sparing approach for total shoulder replacement preserves the subscapularis muscle, reduces the risk of tendon failure, provides fewer postoperative restrictions and potentially shortens rehabilitation time.
  • Mini-stem and stemless shoulder replacements that do not violate the bone canal.
  • Direct anterior approach hip replacement (also known as Jiffy Hip* in some markets) continues to grow, 39.5% growth from 2016 to 2017 third quarter with 926 direct anterior approach hip replacements.  This minimally invasive advancement in hip replacement surgery uses a direct anterior (frontal) approach and does not require muscle or tendon detachment. It is available at most Sentara OrthoJoint Center® locations.
  • Subvastius knee replacement: This minimally invasive total knee arthroplasty reconstructs or replaces the joint while sparing the quadriceps muscle, leading to a quicker recovery.

*Registered trademark of Mitzuho Orthopedic Systems, Inc. 

Specialized Surgical Procedures:

Surgeons practicing at Sentara facilities have adopted cutting-edge, minimally invasive surgeries for total joint replacement surgery, fracture care and arthroscopic surgery. Smaller incisions preserve the patient’s natural soft tissue blood supply, result in less postoperative pain and lead to quicker healing. These surgeries include:

  • Bone preserving implants for shoulder replacement surgery
  • Less invasive implants for fracture care
  • External fixator to correct complex lower extremity deformity (see Natashia’s story)

Sentara Ortho Client Connection icon Natashia

“I’ve been working with doctors for 30 years. My vitamin D-resistant rickets gave me bowed legs and kept me from growing over 4’-5.’’ My last two surgeries used the Orthofix TrueLok Hexapod external fixator to change the length and shape of my legs. Now I’m 4’-8’’.”