BrainLAB offers higher accuracy for total knee replacements using CT-free image-guided surgery

Westchester 25 November 2003BrainLAB Inc., an innovator of Image-Guided Surgery (IGS) and stereotactic radiosurgery systems, presents first results on improved accuracy of implant positioning with VectorVision CT-free knee. VectorVision CT-free knee is a new navigation system that enables surgeons to verify each step of the knee replacement procedure in real time and to use the resulting new data to optimize their planning of the surgery. This way, possible deviations between the planning and the actual treatment results of the total knee replacement (TKR) can be corrected on the spot and misplacements of the prosthesis avoided.


Since mechanical surgical instruments are precisely guided to a pre-planned target position, VectorVision CT-free knee helps achieve reproducible results. By serving as a comprehensive source of information, the navigation system supports surgeons in making informed decisions, thus enabling safer surgery and improved clinical outcomes. Additionally, with BrainLAB's new navigation software, surgeons benefit from all of the advantages provided by computer-assisted navigation without time-consuming preparations.

To produce good and long lasting results in total knee replacements, exact positioning of the implant and precise alignment of the leg axis are required. Using BrainLAB's VectorVision image-guided navigation system and the new CT-free knee software, total joint replacement surgery can be optimized. Deviations of the leg's axis after the placement of the prosthesis can be avoided and the life span of an implant prolonged.

"Over the last 18 months, I have performed more than 150 imaged-guided total knee replacements", stated Dr. Michael Swank, Freiberg Orthopaedic & Sports Medicine Group at The Jewish Hospital in Cincinnati, Ohio. "The future of orthopaedics is in image-guided surgery as it provides immense benefits to both the patient and health care providers. The difference between operating with computer-assisted image-guidance and traditional mechanical instruments is like the difference between travelling using a map or a global positioning satellite."

"In the traditional method, you try to guess where you are in relation to where you want to be, but in the computer-assisted method, it tells you exactly where you are when you are there. This increased information allows the surgeon to perform every step of the operation more precisely and ultimately improve the results for the patient. In performing surgery with VectorVision, the result has been increased precision that makes the vision of a single total knee replacement in a patient's lifetime one step closer to reality", explained Dr. Swank.

Since implant planning with VectorVision CT-free knee is based on intra-operatively acquired anatomic landmarks, the system does not require expensive and time-consuming CT-data acquisition. Dr. Swank recently completed a comparison study of the patient results for CT-free knee replacements versus CT-based surgery. The initial results showed that using BrainLAB's CT-free technology saved time for the patient and surgeon both before and during total knee replacement surgery.

On an average, the use of the CT-free technology saved 25 minutes per case compared to CT-based surgery, for both pre-operative planning and surgical time. Results of Dr. Swank's study show that CT-free navigation is a cost-efficient alternative to CT-based total knee replacement, which provides the advantages of increased precision over traditionally mechanical instruments.

VectorVision CT-free knee does not require pre-operative planning and uses anatomical landmarks to determine the mechanical leg axis. It also uses points relevant for the positioning of the implant, which are acquired at the beginning of the procedure with a special pointer. The surgeon then collects additional surface points on the patient's femur and tibia. From these points, VectorVision intra-operatively calculates a three-dimensional image of the knee to be treated, which is then adapted to the patient's individual anatomy. This three-dimensional representation provides most of the information that can be found in a CT and by far exceeds the quality of standard two-dimensional X-ray images.

Based on this data, the system automatically calculates the ideal size and position of the implant. Then, the surgeon can navigate cutting blocks to perform the cuts with highest precision. Each cut is immediately digitized and can be compared to the plan. Even if there are only minimal deviations, the plan can be updated after each individual cut. As such, leg axis, prosthesis position, and ligament balancing can be intra-operatively checked, corrected and documented on-line.

"Orthopaedic surgery is taking a significant leap forward with new technologies that enable doctors to improve clinical results", stated Stefan Vilsmeier, BrainLAB CEO. "VectorVision CT-free knee is part of a new and innovative generation of software-based navigation tools that dramatically enhance the overall quality of care to patients."

The clinical benefits associated with image-guided surgery continue to drive its acceptance and growth worldwide. VectorVision forms the central platform for image-guided surgery and supports neurosurgical, orthopaedic and ear, nose and throat procedures. The system works without wires and allows surgeons to integrate their own instruments into the operating procedure. Using VectorVision, surgeons can follow the movements of their instruments on the computer screen in real time during surgical procedures.

BrainLAB, a privately held company headquartered in Munich, Germany, was founded in 1989 and is specialized in the development, manufacture, and marketing of medical technology for radiosurgery/radiotherapy, orthopaedics, neurosurgery, and ENT. Among the products developed by BrainLAB are software and hardware components for image-guided surgery, components for linear accelerators in radiotherapy as well as integrated systems for stereotactic radiosurgery.

With revenues of more than 100 million USD in fiscal year 2002 and 750 navigation systems installed around the globe, BrainLAB is among the market leaders in image-guided surgery. BrainLAB employs over 500 people worldwide. The company works with distributors in over 70 countries and has 15 offices throughout Europe, the United States, Asia, and South America.

Leslie Versweyveld

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