|Year : 2018 | Volume
| Issue : 2 | Page : 55-56
Knee replacement surgery imbibes aviation technology
Department of Orthopedics, Apollo Hospital, New Delhi, India
|Date of Web Publication||5-Jul-2018|
Apollo Hospital, New Delhi
Source of Support: None, Conflict of Interest: None
Knee replacement is a well-established procedure and has brought relieved to millions of people. Efforts are on to increase the survival replaced joint. If the implant is positioned in perfect position, they will last for a very long time. Gyroscope and accelerometer are used in aviation technology and in our smartphone for locating exact position. This technology has now been used in knee replacement giving perfect positioning of the implant.
Keywords: Accelerometer, computer navigation, gyroscope, knee replacement
|How to cite this article:|
Gulati Y. Knee replacement surgery imbibes aviation technology. Apollo Med 2018;15:55-6
| Introduction|| |
Thousands of aircraft take off and land every day after hours of safe flying high up in the air. Aviation industry uses a gyroscope based on angular momentum principle to earmark aircraft position precisely. Same principles have now been imbibed in achieving a perfect alignment for knee implants.
Precise positioning of knee replacement implant is critical for short-term as well as long-term success to achieve pain-free movements with normal gait pattern. This can serve patient proximity to two decades. Imprecise positioning can loosen the bond between bone and replaced implants very quickly and can lead to pain and failure requiring repeat surgery.
Gyroscope and accelerometer principle has been used in India for knee replacement for about 1½ years with resounding success. If we can trust thousands of aircrafts carrying hundreds of thousands of people with this technology, it would be quite obvious that we could trust it for implant positioning. Beauty of the situation is that engineers and surgeons have combined to create this wonder which is not only accurate, user-friendly reproducible but also economical.
| Scope of Knee Replacement|| |
Close to two million knee replacements are done in the USA every year and figures though the modest in India is rising steadily. As of now, about 100,000 knee replacements are done in India every year.
| Why Knee Replacement?|| |
Knee pain is very common in people above the age of 50 years because of age-related wear and tear. It may occur much earlier in patients affected by rheumatoid arthritis and other connective tissue disorders. It is very important to distinguish between the two types of arthritis as the later one is “red flag arthritis” and may destroy the joints may quickly. Disease-modifying and biological agents are available to nip this menace in the bud if early diagnosis is done.
Whether it is age related or inflammatory type of arthritis, end point is gross damage to the joint leading to continuous pain and difficulty in walking. Even though early arthritis should be managed by medical treatment such as physiotherapy, analgesic drugs, cartilage regenerating agents, and weight reduction, it is the end point arthritis associated with disabling pain that needs knee replacement.
Only about 2% of people above the age of 55 years affected by knee arthritis require knee replacement and others can be managed by nonoperative treatment. This is a quality-of-life operation, and the patient should choose its timing depending on the extent of pain and disability.
| Advantages of Modern Technology|| |
Now, with the availability of high-tech techniques, patients can be assured of high degree of success. Gyroscope-based i-Assist computer navigation helps a surgeon locate center of hip, knee, and ankle joint in real time on the operation table. He/she then places the implants at 90° to the line joining these three joints, thus avoiding any shear stress at bone–implant interface. Implants are positioned close to patients own anatomy which can differ from person to person. Gyroscope-based navigation not only helps in perfect placement of implants but also reduces risks of serious complications such as bone marrow particles or blood clots traveling to lung and brain causing problems due to embolization and stoppage of blood supply to those parts. Furthermore, with this technique, blood loss is significantly reduced and single knee replacement can almost always be done without any blood transfusion.
This technique is very user-friendly and requires a computer-like a small laptop and two pods. Now, handheld system is also available with no outside computer requirement. This works with Wi-Fi and does not have the problem of line of vision which used to get obstructed with earlier systems based on infrared.
This is a portable system and can be carried in a small briefcase.
After knee replacement, patients can expect to walk with support within a day and without support in 3–4 weeks if one knee is done and 6 weeks if both knees are done together.
| Summary|| |
Navigation represents the next step in intelligent instruments offering significant benefits to patients, health-care providers, and health systems. The innovative technology supports more streamlined and personalized knee replacement procedure though simple reproducible, quick, and economical method.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.