By Peter Curcione, D.O.
Medicine and science are constantly evolving. Technology in all fields of medicine are ever improving.
With the growth and advances in computer science the changes happen much more rapidly. In the coarse of my practice as an Orthopedic Surgeon, I see these advances on a regular basis. Some make no sense, others may improve things very little, still others get over-hyped, only to stay in vogue for a short time and then fail to live up to the promises. This is proven over time with the various implant recalls that we’ve witnessed over the last several years.
Since March, I’ve been using a pressure sensing device to assist me in Knee Replacement Surgery at Lehigh Regional Medical Center. It was recently profiled on one of the daytime TV talk shows as the” GPS ” Knee. In the past I’ve tried the various computer assisted technologies. These advances have mostly focused on the alignment of the limb. I found that the extra cost needed for the technology did not provide any significant added benefit. As it turned out, my ability to match the computer readings were about the same. The technology that I write of today uses the computer in a different way. In order to do the “Perfect” Knee Replacement, we must not only re-establish the proper alignment of the limb , but we must establish the proper ligament balance to the joint. We’ve never been able to actually quantify this balancing until the Orthosensor device has come to market. This tool has a little micro sensor embedded in each trial implant so that before the real final components are implanted we can assess the ligament balance and rotation. The necessary balancing techniques can be made with the sensor in place and real time numbers show up on a screen.
I can then make the incremental adjustments until the proper balance is achieved. Rather than relying on my tactile feel and “guesswork” (albeit educated), I can now be sure that I have optimized the result.
During the coarse of my career I have had the honor of helping thousands of patients through joint replacement surgery. Before using the Orthosensor I thought I was an accurate technician. My patients were happy for the most part. Yet there still was a small group that although there were no complications they were not entirely happy with their outcome. The company reports a 97% percent patient satisfaction rate in their trials. The majority of historical knee replacement studies show about 85% satisfaction rates. Anecdotally, I have seen a difference in my patients. They are less stiff and recover their range of motion quicker. It was initially amazing to me how such subtle changes in ligament balancing affect the pressure numbers. Our tactile sensation cannot provide us with this kind of precision. I firmly believe that the more accurately we can balance a Total Knee Replacement the better the outcome for the patient. Having real-time data while in the operating room allows us to provide this to the patient. There is really no question that when the patient leaves my operating room, and I’ve used the Orthosensor, I’ve optimized the procedure. After all, the numbers don’t lie.
When you see on the screen that the pressure numbers are acceptable, you have the concrete evidence of a properly balanced knee. If you have knee pain due to arthritis and have been contemplated a knee replacement, consider this technology, I think its here to stay.
Peter Curcione, D.O.
www.bone-fix.com
239-368-8277