Is 3-D technology enabling ‘one-click’ knee surgery?
As medical innovation rapidly improves current practice, new technologies have the capacity to replace well-established procedures. Additional questions are therefore being raised within the orthopaedics and traumatology community about the extent to which innovative procedures are changing the conditions in which surgery is performed. How quickly is change winning over the OR reality? What are the differences in outcome for the patient?
For our upcoming annual meeting in Barcelona, innovation and new technologies are put forward as the 2018 Congress main theme.
Prof. Justin Cobb, head of elective surgery at Imperial College Healthcare NHS Trust and academic orthopaedic surgeon at the Imperial College London, will present two related Instructional Lectures around the topic of 3-D printing and patient-specific treatment in knee surgery. These presentations will focus both on the use of novel techniques for high tibial osteotomy and for unicompartmental knee replacement.
Cobb is also director of the MSk Lab based at Charing Cross Hospital which comprises a multidisciplinary team of surgeons, physiotherapists, sport scientists and software engineers, as well as magneticians and technicians who are working on musculoskeletal health and conditions related to degeneration and impaired mobility. The MSk Lab develops new tools and technologies to improve the clinical outcomes of patients undergoing joint replacement surgery. Using software tools developed in the MSk Lab, Cobb’s team has been able to go beyond a visual appreciation and automatically calculate the angular dimensions of the different elements of the knee, comparing these to the normal range.
The procedure starts by extracting data from the patient’s scans to build patient-specific models on the computer and allowing the surgical team to perform an initial virtual surgery. Surgical correction of the abnormal angulation can be achieved by osteotomy or arthroplasty. On the screen, the surgeon can choose the extent of correction and the precise site of the correction. Alternatively, joint damage can be restored by relining the affected compartment with either a partial or total knee replacement. The exact position, orientation and size of the knee replacement device can be selected, and the cutting guides designed automatically.
One technology which seems to significantly transform the way the musculoskeletal medical field is evolving is 3-D printing. A 3-D printer can print out not only a perfect model of a painful knee, but also the optimal instruments needed to perform surgery on that knee. The cutting guides are 3-D printed overnight. A suite of patient-specific instruments ensures accurate reproduction of the virtual surgery by fitting perfectly in place on the patient’s joint. These possibilities represent a huge revolution as surgeons can benefit from the robotic-like accuracy with a fraction of the cost of using robotics.
Instructional Lectures - Friday 1 June 2018
3-D Printing and Patient-specific Treatment:
High Tibial Osteotomy – 10:00 to 10:30
Unicompartmental Knee Replacement - 10:30 to 11:00
The burden of joint diseases continues to grow, but costs of the corresponding treatments have remained unchanged. Dealing with worn joints is nowadays a societal issue and the trends show it will become increasingly difficult to sustain as more people wish to remain active for longer.
Motion is an essential part of everyone’s life. Using each person’s preferences as a metric makes it easier to understand how people function, how they walk and how their activities affect joint function and impact the progression of joint diseases.
The impact of these technologies incurs when calculating the costs of the complete procedure to achieve but more importantly, when measuring the benefits of people’s quality of life by reducing pain and suffering.
The instructional lectures related to 3-D Printing and Patient-specific Treatment in Knee Surgery are part of the core scientific program of the 19th EFORT Congress and are open to fully registered attendees. Guidelines and fees to sign-up are available on our registration platform. Visit the 2018 congress website on a regular basis.