In 2003, The NYU Hospitall for Joint Diseases Department of Orthopaedic Surgery established a state-of-the-art Laboratory for the Study of Minimally Invasive Surgery at the Manhattan Veterans Affairs Medical Center. The project was aided by a generous donation from the Peter Walker Trust, an organization whose purpose is to further research in orthopaedics.

The major focus of the lab is the development and evaluation of a new computer-assisted surgical technique for total knee replacement. The goal of the technique is the ability to carry out orthopaedic procedures through small incisions yet maintain a high accuracy in the alignment of the components and reduce the time taken compared with conventional techniques. The key instrument is the design of an electronically instrumented linkage which attaches to the femur and tibia and, with the help of computer software and imaging, enables the surgeon to place slotted cutting jigs directly on to the femur and tibia in the correct position.

Studies on surface-guided total knee concepts, with low profile for small incision surgery, and with original geometrical features which will guide the motion to closely replicate the motion characteristics of the anatomic knee are also being conducted at the Lab. Several projects using knee activity simulators have provided the data for obtaining factors such as optimal patella tracking and high flexion. At present a crouching simulator is being constructed which will test the new knee concepts in biomechanically demanding activities.

Collaboration with the Shoulder Service and the Sports Medicine Departments have led to innovative studies on the stability consequences of the Hill-Sachs lesion, and on the conditions for maintaining stability of the biceps tendon in the intertubercular groove. Special test equipment linked to graphical software to reconstruct 3-dimensional images of relative bone geometry has been applied to these studies. Finally, the shoulder work has further expanded in a study of the mechanics and stability of the reverse shoulder implants which are gaining in surgical application for cases of severe instability. A purpose-built rig will elevate the arm and measure muscle and joint forces as well as the micromotion at the component-bone interfaces to assess long-term fixation.

Director: Peter S. Walker, PhD