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General Orthopaedics

Ushering the Era of Non-Implant Specific Instruments for Knee Arthroplasty

International Society for Technology in Arthroplasty (ISTA)



Abstract

Current projections point to a large increase in the number of arthroplasty surgeries over the next 20 years. Implant manufacturers typically offer each hospital multiple sets of instruments dedicated to one of their implant system models. Each set includes over 100 mechanical alignment and other instruments (jigs), typically housed in multiple trays. These instruments increase engineering and production costs to the manufacturer, the training burden for surgeons, and increase costs for the hospital for sterilization, training and other logistics. Patient specific instruments addresses some of this burden but involve scaleability, potential liability and speed challenges in that some of the custom jigs design and all its manufacture is delayed and removed from the surgeon, and cannot be changed during surgery.

This talk is about a revolutionary freehand navigated bone cutting technology for joint replacement surgery without implant specific mechanical jigs, without expensive and cumbersome robots, and optionally also even without external navigation tracker equipment. It facilitates navigated freehand bone cutting with real-time 3D graphical feedback. It transforms the traditional orthopaedic power instruments (eg. sagittal saws, drills) into “smart instruments” which can track themselves in 3D around the surgical scene, and optionally prevent the surgeon from deviating from the planned cuts. In bench experiments, this cutting-edge technology promises faster, cheaper, easier and more accurate bone cuts. It assists the surgeon naturally with miniaturized electronics and intelligence on-board the same powered bone cutting instruments they are highly used to.

Joint replacement surgery is highly successful currently, but this technology is intended to make it easier, faster, cheaper and better. A solution that increases benefits to the patient and surgeon alike, while reducing infection risks and costs, may transform patient care in an overburdened field which is expected to grow in the coming years.


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