Raju S. Ghate, M.D.

Using standard X-ray images to create 3D digital bone models and patient-matched guides for aiding implant positioning and sizing in total knee arthroplasty.

Computer assisted surgery (Abingdon, England) 2021 12

Authors: Massé V

Abstract
X-Atlas™ is a new imaging technology intended to advance the state of the art in patient-specific instrumentation. It uses standard AP and lateral radiographs instead of CT or MRI scans to create 3D bone models, which can be used to perform pre-operative surgical planning and fabricate TKA personalized guides. The aim of this study was to validate X-Atlas™ and evaluate the accuracy of personalized guides created with this imaging technology. Its ability to predict implant size was also determined. The accuracy of the X-Atlas™ imaging technology was evaluated by comparing the landmarks of X-Atlas™ 3D Bone models to MRI-reconstructed bone models. The accuracy of PSI guides created with X-Atlas™ (X-PSI™ guides) was evaluated during a validation study (16 specimen knees) and a clinical study (50 patients; Health Canada #CSU2015-12K). Optical navigation was used to measure positioning accuracy. In addition, the ability of X-Atlas™ to predict implant size was assessed. The accuracy of the X-Atlas™ imaging technology was below 0.87 and 1.28 mm for the femoral and tibial landmarks, respectively. The accuracy of X-PSI™ guides to reproduce the pre-operative planned HKA was within ± 3° in 100% and 86.1% of cases, for the laboratory and clinical study respectively, which was significantly better than historical data for conventional instrumentation. X-Atlas™ was able to predict implant size to ± 1 size in 95.6% and 100%, for the femur and tibia component respectively. The X-Atlas™ imaging technology demonstrated excellent accuracy for reconstructing a 3D bone model. The results show that PSI guides created with X-Atlas™ (X-PSI™ guides) provide greater implant positioning accuracy than conventional instrumentation, without the requirement of advanced imaging. Furthermore, the X-Atlas™ imaging technology could effectively predict implant sizing, potentially reducing the number of instrument trays and improving surgical efficiency.

PMID: 33721547 [PubMed - as supplied by publisher]
Component sizing in total knee arthroplasty: patient-specific guides vs. computer-assisted navigation.

Biomedizinische Technik. Biomedical engineering 2012 Apr 10

Authors: Yaffe MA, Patel A, Mc Coy BW, Luo M, Cayo M, Ghate R, Stulberg SD

Abstract
Patient-specific guides (PSG) and computer-assisted navigation (CAN) are technologies that have been developed to improve the accuracy and reproducibility of total knee arthroplasty (TKA). The purpose of this study is to compare the methodology by which a PSG system and an intraoperative navigation system (CAN) perform an anatomical registration and correctly predict femoral component size in TKA.
One hundred and eleven PSG TKA were performed, 30 of which were concurrently evaluated with CAN. PSG-predicted and CAN-predicted femoral component size were compared with the actual component selection. The process by which PSG and CAN determines component sizing was evaluated.
The PSG system was both more accurate and more precise than the CAN navigation system in predicting femoral component size in TKA.
In this study, the surgeon's final component selection was more likely to be in accordance with the PSG rather than the CAN sizing algorithm. This study suggests that intraoperative surface registration may not be as accurate as preoperative three-dimensional magnetic resonance imaging reconstructions for establishing optimal femoral component sizing.

PMID: 22868780 [PubMed - as supplied by publisher]
A monoblock porous tantalum acetabular cup has no osteolysis on CT at 10 years.

Clinical orthopaedics and related research 2011 Feb

Authors: Moen TC, Ghate R, Salaz N, Ghodasra J, Stulberg SD

Abstract
Aseptic osteolysis has been the single most important factor limiting the longevity of a THA. A great deal of attention has been focused on the development of implants and materials that minimize the development of osteolysis. The monoblock porous tantalum acetabular cup was designed to minimize osteolysis, but whether it does so is unclear.
We evaluated the incidence of osteolytic lesions after THA using a monoblock porous tantalum acetabular component.
We retrospectively reviewed 51 patients who had a THA using a monoblock porous tantalum acetabular cup. At a minimum of 9.6 years postoperatively (average, 10.3 years; SD, 0.2 years; range, 9.6-10.8 years), a helical CT scan of the pelvis using a metal suppression protocol was obtained. This scan was evaluated for the presence of osteolysis.
We found no evidence of osteolysis on CT scan at an average of 10.3 years.
Osteolysis appears not to be a major problem at 10 years with this monoblock porous tantalum acetabular component, but longer term followup will be required to determine whether these findings persist.
Level IV, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.

PMID: 20809172 [PubMed - as supplied by publisher]
Posterior approach: back door in.

Orthopedics 2005 Sep

Authors: Gerlinger TL, Ghate RS, Paprosky WG

Abstract
Minimally invasive THA is a controversial topic in adult reconstruction. While early reports championed this new technique for faster return of function, decreased hospital stay, and less pain, these findings are being questioned. More recent reports have highlighted increased complication rates during the surgeon's learning curve and noted a lack of benefit compared with a standard incision. This article describes the senior author's technique for a minimally invasive posterior approach and emphasizes the importance of patient selection and a team approach. The size of the incision should never dictate the quality of the THA nor place the long-term results at risk. Incision length and degree of visualization are dictated by the needs of the specific surgeon as well as the patient's morphology. In appropriate patients, using a team approach and the described minimally invasive posterior approach can lead to a shortened hospital stay and rapid functional recovery without increasing the risk of complications.

PMID: 16190057 [PubMed - as supplied by publisher]

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January 26, 2022

Doctor was attentive. He was a good listener and did not rush me.

January 24, 2022

There is absolutely no problem with Dr. Ghate. My husband and I both liked him and felt confident with him. Our problem is with Northshore System. You can never reach or talk with your doctor. If I have surgery and after need to speak to my doctor, I can't. Would not want to go to & urgent care.

January 22, 2022

Very polite and informative.

January 16, 2022

This team will be highly recommended by me.

December 30, 2021

I asked if I could get shots to support the cartilage.. In both knees to deal with joint locking in the right & weakness in the left. I told this to the PA when she came in first. Dr. Ghate came in with the shot equipment & I told him how the shot in right knee in 2015 had kept it from locking had kept me going till now. That shot was to build the cartilage. When I read the report it said he had given me pain shots. I have yet to contact him about that as I'm dealing with some problems with where the squamous cell carcinoma was in 2018.

December 15, 2021

Dr. Ghate is the best!

December 02, 2021

This is my second knee to be replaced first one was seven years ago

November 07, 2021

I really appreciated Dr. Ghate's time and explanations. I did hear this first appointment is usually done over iPhones and at first was told that because I didn't have an iPhone (I have a Galaxy) then the first follow-up appt would be a regular phone call. I was EXTREMELY grateful that Dr. Ghate changed that to be an appt in-office. I personally don't understand how a TKR follow-up would be ok to do on the phone. For example, the steristrips were still in place and because Dr. Ghate saw that and asked when they were put on, I could take them off right then in front of him. Also, he observed my walking, which I don't know how that could be accomplished over the phone. So again, I must say I am EXTREMELY grateful my appt was in person and Dr. Ghate was both very thorough and also efficient.

October 26, 2021

I expected a post-examination e-mail from Dr. Ghate. I assumed he would, having looked over the Information he had gathered, told me what I could expect: how long before the cortisone shot would produce a result of some kind. I should say that there has been some Improvement In my knee, but the basic kneed problem - Intermittent pain when I walk (my knee hurts less often than before the shot, but It still produces moderate pain). That is, if I walk more than a block I have to walk somewhat slowly and have to be careful to avoid movement that might set off the pain. I'm not complaining about the course of recovery, I'm complaining about having to try to interpret for myself what the pain in my knee is telling me (I'm not a doctor, I've never had an injury quite like this before).

October 04, 2021

Was disappointed that Dr. Ghate couldn't see the actual incision since dit was a tele-visit only. For a post-op visit an in-person inspection would have been preferred.

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Raju S. Ghate, M.D.

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Using standard X-ray images to create 3D digital bone models and patient-matched guides for aiding implant positioning and sizing in total knee arthroplasty.

Component sizing in total knee arthroplasty: patient-specific guides vs. computer-assisted navigation.

A monoblock porous tantalum acetabular cup has no osteolysis on CT at 10 years.

Posterior approach: back door in.

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