Over the last year, there has been quite a bit of interest in computer-assisted orthopedic surgery. This is a technique where input from a computer helps guide the surgeon for placement and alignment of implants in total knee and hip replacement. It got its start in Europe over ten years ago. It gradually spread to the United States, and interest has been increasing significantly over the last three years. One of the driving forces behind surgeons pursuing computer-assisted surgery is a desire to minimize the malalignment and improper placement of total joint replacement components, which can be a leading cause of failure.
The technique involves use of infrared beams that are reflected off of instruments placed on the patient. These beams give information to a computer that creates an image of the hip or knee that can then be used for planning and actual directing of bone cuts, implant placement, and alignment of the implants used in joint replacement. The early results for these computer-assisted cases demonstrated that the average alignment for total knee replacements was similar to our traditional techniques but that the number of cases that fell outside the optimal alignment was reduced. Similar results have been noted for placement of the socket portion of total hip replacements.
With the excitement over smaller incision surgery, the mating of computer-assisted technology with smaller incisions to help the surgeon “see,?” where perhaps his direction vision is obscured because of the smaller incision, has been an exciting potential opportunity for computer-assisted surgery. More recently, there has been a lot of marketing by hospitals and surgeons surrounding computer-assisted surgery.
While we are hopeful that computer-assisted surgery will help improve the overall results and ensure accurate placement of implants even when small incisions are used, we do not have long-term data to yet prove many of these expectations.
At Valley Medical Center, we have been using computer-assisted orthopedic surgery techniques for over three years. We are part of a multi-center study comparing the outcome of computer-assisted knee replacement versus traditional knee replacement. We are reporting our preliminary results at the International Computer Assisted Orthopedic Surgery Meeting in Montreal, Canada this summer. Our results show an improvement in alignment and component placement but as of yet, do not demonstrate that there will be a shortened hospital stay or some of the other claims that have been made by facilities in the recent past.
When you as a patient evaluate new technologies and the applicability of those technologies to your care, you want to determine how much experience a particular facility has in using these techniques and technology, whether or not there has been any scientific evidence that they are better, and what are the potential long-term benefits of these techniques and technologies.