How cryoanesthesia and robots are helping stem the opioid epidemic

NJ Spotlight News | August 10, 2017 | Health Care
A Saint Barnabas orthopedic surgeon is the first in the state to use a new joint replacement surgery.

One of the leading contributing factors to New Jersey’s opioid scourge is prescription painkillers. Both Gov. Chris Christie and the attorney general have put blame on irresponsible opioid prescribing. But what if doctors could find a way to perform surgeries using alternative methods that cause less pain, shorter recoveries, less prescriptions needed? Correspondent Michael Hill reports on one doctor’s effort to stem New Jersey’s drug addiction crisis.

Sixty-one-year-old Donald Chervenak is walking 40 hours after knee replacement surgery at Saint Barnabas Medical Center.

Amazing is a word his surgeon, Dr. Michael Rieber, chief of Saint Barnabas’ Joint Institute, would use to describe new state-of-the art technologies for knee and other joint replacement. The orthopedic surgeon says he and his team are the first in New Jersey to use the MAKO robot for precision surgery.

For instance, they did a CT scan of Chervenak’s knee to see the damage, planned how much to remove and exactly where to replace it.

“While we do the surgery, we have a robotic arm here that will match exactly what we’re doing and it prevents you from veering off your plan. It controls everything that you’re doing in surgery,” Reiber said.

The team can watch the live movement of the multi-million dollar robot to make sure it’s completed its course.

“It’s not a fad. You’ve seen the other computer-assisted joint replacements being done, it didn’t work, they’re not precise. This new software is incredible and it really does work,” said Reiber.

He says that means quicker recovery, combined with a new approach before surgery. Saint Barnabas gave cryoanesthesia to Chervenak, who had arthritis so bad he could barely walk. Two weeks before surgery, he received cold therapy to freeze the nerves around the knee to block pain for up to two months.

“After the procedure was performed, leaving the office, I was in very good condition,” said Chervenak, “I could walk. Well, it didn’t resolve, but it was much, much better.”

Rieber says he began using cryoanesthesia before surgery within the last few months. He says the benefits after surgery are immediate from day one.

“He’s taken very few painkillers. He’s awake, alert, able to participate in therapy,” Rieber said.

“There is definitely some pain post-op, so I occasionally need a pain pill, usually before therapy sessions,” said Chevernak.

Rieber says that’s the goal of cryoanesthesia, to minimize pain and recovery and minimize the use of addictive narcotics.

“Post-op, if you’re taking narcotics, you’re sedated, you’re tired, you’re not motivated. The pain will stop you from rehab. ‘I’ll do it tomorrow. I’ll do it later,’ you hear all the time because they’re in too much pain today,” he said.

Rieber, a team surgeon for the New Jersey Devils, said the cryoanethesia combined with the robotic surgery will produce the kind of results surgeons have longed for — accurate joint replacement and patients with minimal pain and mobile within hours.

“I couldn’t imagine anything being better than where I am now,” said Chevernak.

Just what Rieber and the team ordered.

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