Innovations in Orthopedics

Like some of you, I had planned to canvas the booths in the exhibit hall at the American Academy of Orthopaedic Surgeons Annual Meeting in Orlando in March. Even though the meeting was canceled, I looked into many of the innovative products that were scheduled to be on display. Here are several that caught my attention and have the potential to be promising additions to cutting-edge orthopedic ORs. OSM

Arthrex

NanoScope

Continual refinement in the manufacturing of arthroscopic cameras and image display technology drives the value of Nanoscope. A shockingly small camera means better access to difficult locations in complex joint spaces and better image capture technology means better three-dimensional rendering of actual pathophysiology, both of which yield better clinical decision-making and less morbidity to patients. As good as pre-op MRI images are, all surgeons have at some point been surprised by what they actually found in joint spaces during arthroscopy procedures. The company touts the system’s portability, saying it provides surgeons with the ability to perform minimally invasive arthroscopy in the OR, can be used as an adjunct to traditional arthroscopy in a procedure room, and even has diagnostic applications in the physician’s office. Imaging systems such as this will lead to in-office diagnostic arthroscopy, better outcomes and happier patients.

Insight Medical Solutions

Arvis

Arvis is a soon-to-be-available product that essentially adds a heads-up display to the face shield of the surgeon’s clean air helmet. Much like the heads-up displays in automobiles that provide information such as route guidance projected onto the windshield, allowing the driver to keep his eyes on the road, Arvis can display surgical case information in the surgeon’s field of view, preventing breaks in concentration or loss of orientation in the joint. When paired with spatial navigation and visual-tracking technology, the possibility of augmented reality projections could lead to improved implant and hardware positioning by syncing up the surgeon’s view with the display currently seen on navigation software already in use. Though very new and unproven, this technology has enormous promise to narrow the range of errors typically seen in highly technical procedures done by variably skilled surgeons.

Karl Storz

Quadriceps Tendon Harvesting System

The workhorse grafts for ACL reconstruction have traditionally been for hamstring or patella tendon autografts. However, surgeon interest in quadriceps tendon autograft has increased lately due to its generous cross-sectional area and patient tolerance of the harvest site defect. Karl Storz introduces this new quadriceps tendon harvesting system in order to improve the reliability and ease of harvest, particularly when using a minimally invasive technique. Storz promotes the ability of the system to accurately control all six surfaces of the graft — proximal, distal, medial, lateral, superficial and deep — which is critical to achievement of satisfactory outcomes. Competitive pricing is the most effective product strategy to make inroads in the outpatient surgery market, and doing so will be key to the success of this new addition.

Match Grade Medical

Speedloc Ankle Distraction System

The Speedloc Ankle Distraction System promises to solve the most common complaints with current ankle distractors: the loss of tension, bulkiness and limited adjustability. For the surgeon who is unsatisfied with their present ankle distractor system, Speedloc is worth a look. The company says surgeons will be thrilled with the tension feedback and ease of adjustment the system delivers. Time will tell if the frequent user will agree. There is no doubt, though, that a device that minimizes hassle and is reliable is worth considering.

Medtronic

Kyphon Assist Directional Cannula

Kyphoplasty as a treatment for pain secondary to vertebral body compression fracture has been widely used for only about two decades, so continued refinement of the technique and tools remains a key interest for surgeons who perform the procedure. Medtronic’s Kyphon Assist Directional Cannula, the latest version of the company’s Kyphon system, boasts better control of cavity creation, increased volume capacity and increased safety while retaining the familiar One-Step access system. Because the normal anatomic trajectory of the pedicle is not parallel to the vertebral end plates, the addition of directional control should improve clinical results and minimize complications by matching vertebral morphology to the placement of the balloon. As long as the Kyphon Assist’s cannula mechanism is reliable both in deployment and retraction, this new capability should be of great value.

Orthoscan

TAU 2020 Mini C-arm

Squarish, shallow depth detectors are all the rage in full-size and mini C-arms, but the new Orthoscan mini C-arm shows that bigger could be better. The detector measures a full 20 cm by 20 cm — the largest in the mini C-arm space — which theoretically provides the cost and convenience of a full-size C-arm with the radiation dosage of a mini C-arm. This unit also boasts modern, upgraded controls and a large, high-resolution touchscreen monitor. I don’t think I’ll ever use my rickety old mini C-arm again without demanding that my ASC buy one of these gems.

Stryker

Zip

Zip is an adhesive surface wound closure system that uses sequential miniature zip ties to achieve wound closure without the local areas of high tension seen with adhesive bandages, which often cause blisters. The marketed value to the surgeon is a quicker wound closure method that costs less, has fewer complications and results in higher patient satisfaction. At least some of these benefits have been validated in peer-reviewed studies that compared Zip with staples in both orthopedic and cardiac patients. For surgeons who are unhappy with some aspect of their wound closure routine, Zip is worth a look and deserves consideration.

Total Joint Orthopedics

Klassic One

TJO's Klassic One system promises a comprehensive single tray system that can be used in 90 percent of total joint procedures. The system comes with specialized instruments, eliminating the need to create a custom tray of customized or disposable instruments for individual cases. That's certainly a money saver, making this system a popular option among managers of ambulatory surgery centers. A single ancillary tray supports the other 10 percent of primary hip and knee replacement instruments. The trays in this system would also satisfy surgeons, who want the correct tools and systems for their cases 100 percent of the time. The company touts Klassic One as a system that eliminates waste and extra steps, thereby streamlining the surgical technique, is less expensive than a typical eight-try implant system, and requires no additional imaging, templating, disposables or other patient-specific modifications.