Latest Trends in Orthopedics

LATEST LOCAL TRENDS IN

ORTHOPEDICS

SUBMITTED BY:

BACOSA, BERNADETTE B.

BSN 4A

BONE BANKING

• Also known as “TISSUE BANKING”

• enables medical experts to use bone from a non-related donor to replace or repair the diseased bone part of another person

Bone Bank• refers to the facility that retrieves,

processes, stores and distributes these bones for safe clinical use.

• equipped with an ultra-low temperature freezer that allows bone and other biologic tissues to be stored at a temperature of -80° Celsius.

• This temperature reduces the immune response between the transplanted bone and the recipient. After a potential donor passes the required rigid screening tests, bones are retrieved under sterile conditions, properly packed, and stored.

Retrieval, processing, storage and distribution of

bone from a non-related donor (allograft bone) for

use in:• A. Limb-saving surgeries in

selected cases of benign and malignant bone tumorsB. Reconstructive pediatric orthopedic surgeriesC. Spine and joint fusion surgeriesD. Complete primary and revision total joint replacements

• Available only in St. Luke’s Medical Center here in the Philippines adhering to the policies and protocols recommended by the American Association of Tissue Banks and the Asia-Pacific Association of Surgical Tissue Banking

FITBONE TECHNOLOGY

• St. Luke's Medical Center's Institute of Orthopaedics and Sports Medicine showcases the latest technology in limb lengthening and strengthening.

• Wittenstein intens GmbH, the manufacturer of Fitbone instruments, in partnership with Munich Hospital, chose St. Luke's as one of five medical institutions in Asia authorized to perform this breakthrough procedure.

- originally intended to correct shortened or deformed limb bones caused by injury, disease or other causes like congenital defect.

• Today, it is the latest technology in limb lengthening and strengthening. Through this technology, an individual can gain up to 180 mm in height in about six months.

• can be applied to "stretch" both the upper and lower bones of the legs and even the bones of the upper arm, allowing the patient to achieve an increase in height.

• Patients should at least be 17 years old and in good health.

• helps patients with limb length inequality and limb deformities (shortened or deformed limb bones caused by injury, disease or congenital) to correct defects that require angular correction and/or lengthening; and those who desire to gain additional height for cosmetic reasons.

• The Fitbone procedure is much safer to use and simpler to perform compared to the conventional bone extension surgery methods known today. Unlike the external frame that is bulky and seen on the outside, the Fitbone is placed intramedullarily or inside the bone.

• It uses a steel implant that gradually lengthens when activated by a wireless control unit. The device is inserted into the hollow of a bone that has been cut crosswise. The device, activated by the remote control unit, increases in length at 1 mm a day. The bone's cut ends grow and fuse eventually.

• It takes about two to three hours per limb to complete the operation and a period of three to five days is allowed for pain and swelling to subside. Rehabilitation can start as early as one week from the day of operation since the fixation is stable. When the desired length is reached, it would take about three months more for the bone to gain its normal strength.

COMPUTER NAVIGATED SURGERY

• available only in limited centers around the world and St. Luke’s Medical Center was the first in the Philippines that acquired it for orthopedics

• introduced in 2004 and has been in use for surgeries involving the brain and spine, head and neck region, and joint replacement.

• technology being used in computer-assisted navigation surgery is similar to the location and directional tracking systems being utilized in air and sea transportation, i.e. GPS system.

• The Vector Vision System is equipped with two cameras that function as satellites that detect images over the operating field. The anatomy of the operative site is assessed and a three-dimensional image is generated into the computer, either computed-tomography or fluoroscopy-based.

• As the surgeon utilizes various instruments, the camera calculates their position – accuracy and precision – and transfers data into the computer. Values are generated from placement of these instruments thus decreasing surgical errors.

TWO MAIN ADVANTAGES

• Safety for the patient and surgeon

• high surgical success rates.

COULD BE USED IN:

• Spine surgery- allows the surgeon to perform osteotomies, vertebroplasties, scoliosis correction and pedicle screw placement in spine trauma and degenerative conditions with greater accuracy and precision – thus, reducing radiation exposure

• Computed tomography, fluoroscopy or combined images are generated from the computer giving the surgeon comprehensive information and three-dimensional view of the spine. This enhances the orientation and widens the view for surgical approaches. Pre-calibrated instruments enable the surgeon to navigate more precisely and efficiently to calculable target positions with minimal exposure.

TOTAL KNEE REPLACEMENT

• a patient-specific bone model is created intra-operatively providing a template for determining the amount of bony resection on the femur and tibia, positioning of the implants and assessing alignment of the mechanical axis.

• With these advantages, surgical errors are detected and corrected earlier during the surgery thus improving outcomes.

TOTAL HIP REPLACEMENT

• With a three-dimensional template of the hip, ideal implant size and position can be precisely determined and accurately placed thus increasing confidence of the surgeon. Image-guided leg length control and analysis of range of motion prevents and minimizes post-operative complications such as limb shortening and dislocations.

TRAUMA

• visualization and manipulation of multiple fluoroscopic images across different planes simultaneously greatly reduces the over-all number of images needed for surgery. Motion of fracture fragments is viewed in real time aiding the surgeon in reduction.

• The optimal size and position of various fixation devices such as intra-medullary nails, compression plates and inter-locking screws are planned prior to their placement. These help reduce operative time and radiation exposure.

Center for Joint Replacement Surgery (CJRS)

• the only center in the country that caters primarily to joint replacement surgical cases involving the hip, knee, shoulder and ankle joints.

• utilizes state-of-the-art mechanized systems, like power tools and intraoperative imaging modalities, which result in high success rates and long-term favorable results with few or no complications.

Replacing a diseased hip joint

- a diseased hip joint can now be replaced with an artificial joint which relieves stiffness and pain, as well as allows normal movement to once again become possible.

Total hip replacement

• is a surgical procedure for re

placing the hip joint• will provide complete or nearly

complete pain relief in 90 to 95 percent of patients. It will allow patients to carry out many normal activities of daily living.