Imagine every day and every step is filled with pain. That's the case for many who are in need of knee replacement surgery. Now doctors are using a computer to help them perform a different procedure on the knee, one in which patients experience less discomfort, and recover from sooner.

Computer-assisted surgery helps surgeons align the patient’s bones and joint implants with a degree of accuracy not possible with the naked eye. Computers used during orthopaedic surgeries offer visual mapping to help doctors make crucial decisions before and throughout the operation. The objective is to combine the precision and accuracy of computer technology with the surgeon’s skill to perform surgery. An advantage is that the doctor has greater “vision” when it counts -- during surgery. This supports decision-making and enhances the surgeon’s flexibility The Ci System captures the patient's unique anatomy and translates it to a computer screen, providing an unobstructed view of the patient's knee joint.



Visual Mapping of Knee Joint

The Ci System’s lightweight, wireless computer system is used with a small camera array. A digital model is produced that serves as a map for each operation. The cameras take data via infrared signals from reflectors placed on the patient’s body and on specially designed surgical instruments. The computer uses the data to track the exact position of the patient and the instruments on a monitor. The combination of computer visualization and special surgical instruments allows doctors to align the implant with greater precision than when doing the procedure with the naked eye.

Doctors typically undergo special training to use computer assisted technology. DePuy Orthopaedics, Inc. refers to this category of surgery as iOrthopaedics, or Intelligent Orthopaedics, and requires users of their computer navigated system, the CiTM System, to go through one of their training centers before use.
The life of a new joint depends on weight, activity level, age and other factors. Each patient responds differently. The most common adverse events include loosening, wear of components, osteolysis, infection, fracture, dislocation and tissue reaction. Some of the Indian Patients, being on the heavier side require perfect component alignment because even a slight malalignment not apperent to the naked eye will severly shorten the life span of the artificial joint due to eccentric loading of the joint. This can be compared to the tyre of a car where part of the tyre threads wear out earlier due to lack of computerized wheel alignment. This causes the plastic insert of the artificial joint to wear out earlier and the joint may loosen in a few years time. Another benefit is that this procedure, unlike the conventional knee replacement does not require the surgeon to insert metal rods in the long bones during the surgery and is thus safer, as chance of fat embolism is rare.
Advocates of the technology say they expect the use of computer-aided surgery to spread rapidly in the next decade because of the following potential benefits:
support for the doctor in pre-operative planning
intra-operative flexibility to adapt the plan based on the data shown during the surgery
improved surgical accuracy and consistency
improved lifespan of knee joints
New Survey Reveals Surprising Attitudes About Joint Replacement
Half of Surgery Candidates Waiting for More Advanced Procedures, Despite Poor Quality Of Life; Orthopaedic Surgeons See Integrated Computer Assisted Surgery Systems as Wave of the Future
Warsaw, IN (May 3, 2004) - DePuy, Inc., a Johnson & Johnson company, today released the results of a Harris Interactive® survey showing that, when asked about joint replacement, nearly half of surgery candidates said they were holding off on surgery because they were waiting for more advanced surgical techniques. Computer assisted surgery (CAS) may be their answer, as two-thirds of orthopaedic surgeons polled said CAS represents a significant advancement in the field, and more than half believe integrated CAS systems represent the future.
Additional Survey Findings
Patients
When all osteoarthritis patients were asked specific questions about joint replacement surgery more than 60 percent (61) reported a concern over the need for additional procedures following surgery. 60 percent were afraid of incorrect joint alignment associated with surgery. 56 percent were concerned about the length of the recovery period. Nearly 50 percent (49) were concerned about the pain associated with recovery. Seventy-two percent of osteoarthritis patients are looking for a treatment approach that is better than what they are currently following. More than 80 percent (83) want their physicians to offer them the latest treatment approaches available. When deciding what treatment approaches to follow, osteoarthritis patients are most likely to be influenced by a treatment's ability to ease pain (87 percent) and increase motion (83 percent).

Surgeons
Four out of 10 orthopaedic surgeons (41) report that fear of joint dislocation impacts how often they recommend joint replacement surgery. Over 60 percent (62) reported that precise joint alignment offered by an integrated CAS system is a considerable or major improvement in the field. Although orthopaedists may be very or extremely concerned about the possibility of incorrect joint alignment, over two thirds (67) report this complication rarely impacts how often they recommend surgery. Over one third (37) of orthopaedic surgeons would be more likely to recommend a patient for joint replacement surgery if an integrated system were available in their practice.
Survey Methodology
This survey was conducted online with baby boomer patients (531) and orthopaedic surgeons (106) residing in the U.S. between March 2 and 8, 2004. Qualified patients were between 50-65 years of age, diagnosed with osteoarthritis by a medical professional and never had joint replacement surgery.
Qualified surgeons were board certified in orthopaedic surgery, in practice between two and thirty years, spending at least 50 percent of time in direct patient care and treating at least five osteoarthritis patients a week. In order to project to the universe of orthopedic surgeons, weighting targets were applied. These targets were drawn from the current AMA master file of practicing orthopedic surgeons in the U.S.

COMPUTER – ASSISTED KNEE SURGERY IS SAFER

COMPUTER – ASSISTED KNEE SURGERY IS MORE PRECISE

COMPUTER – AIDED KNEE SURGERY IS THE FUTURE OF JOINT REPLACEMENTS