By offering a cost-efficient and work flow-oriented CT-free software module, BrainLAB has rounded off its VectorVision hip system. While the CT-based software provides the detailed anatomical information needed for complex hip cases, the leaner CT-free module focuses on the data necessary for routine joint replacement.
"The CT-free hip software from BrainLAB allows us to smoothly integrate image-guided surgery into our clinical work flow", stated Dr. Michael Swank, Medical Director of the Joint Replacement Center at the Jewish Hospital in Cincinnati, Ohio. "During the operation, the system allows us to control all parameters relevant to a successful clinical outcome such as positioning information regarding the implant, leg length and patient mobility. Based on this data we are now able to place the implant with higher accuracy, which is likely to increase its life span. Before finalizing the surgery, we can verify the exact position of the implant and simulate the resulting range of motion of the patient's leg, which allows us to give clear instructions for post-operative physiotherapy. While helping the patient regain as much mobility as possible, this feature at the same time reduces post-operative complications such as early joint dislocation."
By intra-operatively acquiring a number of anatomical landmarks and surface points, VectorVision CT-free hip creates a three-dimensional model of the patient's hip, which, compared to conventional 2D x-ray images, allows for better orientation in the patient's anatomy. The surgeon acquires these points by sliding a special instrument across the bones. The resulting model matches the patient's individual anatomy precisely in those areas that are relevant for accurate joint placement, such as femur head and cup. The rest of the model is generic and represents the average shape of the human hip as calculated from a quantitative analysis of existing data, while still showing all axes and angles required for a highly accurate implantation.
Navigation leaves the surgeon in total control of the procedure at all times. Like a GPS-system in a car, the surgical navigation system suggests the best path to the chosen destination. It leaves the surgeon in the driver's seat and allows him to make his own decisions during each step of the procedure.
The VectorVision navigation system contains a database of the most commonly-used hip implants and, based on the acquired data of the patient's hip, is able to suggest the ideal size of the prosthesis. By indicating ideal angles for cup insertion, the system helps the surgeon to reinstate the patient's original position of the femur and to reproduce the according ligament situation. Conventionally, the surgeon had to guess the correct angle of the cup by measuring it with the naked eye against a fixed plane such as the operating table. The success of this step depended largely on the surgeon's experience and there was no possibility to verify the result during the operation. The VectorVision software allows for more reproducible results, helping less experienced surgeons to achieve the correct cup insertion angle and enabling all surgeons to verify the results.
By intra-operatively comparing the new joint in place with the pre-operative situation the system provides all the information necessary for achieving optimal leg length, thus helping to avoid one of the most common failures in hip surgery, namely an unacceptable difference in leg length.
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 and 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 about 1300 systems installed in over 50 countries, BrainLAB is among the market leaders in image-guided medical technology. Having achieved revenues of 126 million USD in FY 2003 BrainLAB now works with distributors in over 70 countries and has 15 offices across Europe, Asia, North and South America. More BrainLAB news can be found in the VMW April 2004 article Michigan's Community Health Center installs BrainLab's VectorVision sky for image-guided surgery