In April 2023, Humber River Hospital (Humber) completed their 1000th knee replacement case using ROSA® – a robotic surgical assistant developed by Zimmer Biomet that enables surgeons to carry out knee replacement procedures with greater precision. The number of knee and hip replacements completed in Canada has increased every year for the last decade. This trend shifted with the emergence of the COVID-19 pandemic, where many joint surgeries were cancelled, creating surgical backlogs. With many patients waiting for surgical care, increased efficiency and shorter hospital stays became a priority. Through donor support, Humber was the first Canadian hospital to acquire ROSA for surgical knee replacements, as Dr. Sebastian Rodriguez-Elizalde performed the first surgery in October 2020.
ROSA’s advanced imaging and planning software allows surgeons to create a personalized and precise surgical plan based on the patient’s unique anatomy. ROSA does this by providing real-time feedback to surgeons during the procedure, allowing them to make adjustments as needed. There are subtle variations in the knees of each patient, and rather than treating all cases the same as is done in traditional knee replacements, ROSA can customize measurements made to a specific knee. This robotic technique results in decreased post-operative pain, shorter hospital stays, and quicker recovery times for patients.
“Traditionally, we used to do knee replacements very much formulaically, where everyone got a cut at a certain degree and received a standardized approach” says Dr. Sebastian Rodriguez-Elizalde. “ROSA has allowed us to personalize knee replacements, and now we can plan each patient’s surgery ahead of time. It makes a lot of us re-think what we know from over 50 years of knee replacement philosophy.”
Dr. Martin Heller, an orthopaedic surgeon at Humber, was one of the first surgeons to use ROSA in the Department of Surgery. “Like most innovative technology, it encourages the surgeon to re-think their approach to patient care and build on previous experience” says Dr. Heller. “Personally, I found that after a brief adaptation period, ROSA allowed me to significantly improve the way I did knee replacements, and that is after doing them in standard fashion for more than 30 years.”
Claude Vezina, Humber’s 1000th patient to undergo a ROSA procedure, required knee replacement surgery due to limited ambulation. As a retiree, he enjoys hunting, fishing, and working on his property. However, his mobility was diminished as a result of chronic pain. Performed by Dr. Rodriguez-Elizalde and a team of Humber’s outstanding surgical staff, Claude’s procedure was a success. “I am already ambulating and feel no pain at this time” explained Claude, less than four hours after his surgery. “I am feeling encouraged to go out and continue my healing.”
Claude expressed not only his satisfaction with the procedure, but his hope for the future of robotic technologies like ROSA. “Our society is getting older, our joints are getting weaker as we age, and we are living longer” says Claude. “Hips and knees are extremely important for mobility, without them, you’re extremely limited. I am very happy to have made this decision and hope others will do the same.”
Since the implementation of ROSA at Humber, the same robotic technology has been acquired among other hospitals. As a teaching centre, Humber has taught many institutions and surgeons ROSA robotic techniques. Overall, there are less than one dozen surgical robots across the country, two of which are found at Humber.
By implementing innovation during COVID-19, ROSA assisted Humber in challenging the status quo to support new ways of addressing surgical backlogs and improve patient outcomes. Since then, Humber has acquired a second ROSA and has six trained surgeons using this technology, which is immensely beneficial to the entire patient population that they serve. In the skilled hands of physicians at Humber, ROSA is revolutionizing orthopaedics in Canada. The hope is to share this knowledge to hospitals across the country, as Humber remains at the surgical forefront and eager to push boundaries, enabling a better quality of surgical care.