Armed with a notebook instead of a checkbook, I was there to look, not to buy, to window-shop at the world's largest collection of orthopedic devices, all there on dazzling display at last month's American Academy of Orthopaedic Surgeons meeting in Las Vegas, aisle after aisle of cool new products I'd love to have in my ORs. Here's some of what I thought about some of what I saw.
Stryker | Precision
Oscillating Tip Saw, System 7
Having used the Precision before, I was interested in checking out its latest version, which offers the familiar features I've come to like, but with stiffer cartridges and new sizes for more control. Unlike other oscillating saws, only the tip of the Precision moves, giving you less "throw" with a cleaner cut. With the new generation of the saw, a company rep says that there's also reduced metal debris about 84% less than other saws. Three cartridges are available for the saw: 2 variations of a 105 mm cartridge and a new 90 mm cartridge, which would be great for smaller procedures like shoulders. The smaller size would also work well with disposable jigs when doing total knees, since it would be more precise when using the guides. I can see this saw being ideal for outpatient total joints.
Stryker | Clarity Video Enhancer
Clarity is Stryker's entry into the flood of new imaging platforms promising more resolution. But instead of just adding more pixels, Clarity helps you see beyond your biggest visualization barriers smoke, debris and fog without having to remove the instrument to wipe it off. The Clarity is a single console designed to work with your existing video system, so you don't need a whole new platform. The system uses 3 algorithms one to clarify, one to sharpen images and one to enhance colors to give you a better picture.
ConforMIS | iTotal CR
ConforMIS is known for its individually sized and shaped arthroplasty products. Its latest total knee replacement implant is the iTotal CR (cruciate-retaining). Here's how it works: You first send a CT scan of the patient's hip or knee to the company, which uses those images to design the femoral and tibial components to match the patient's anatomy. The company says the iTotal CR offers a superior fit to off-the-shelf implants, and eliminates underhang or overhang problems that can leave patients complaining of pain or lack of free motion. It also reduces the number of intraoperative steps and requires only 1 tray of reusable instruments.
It's also convenient that the implant, along with the other supplies you need for the surgery, arrives in a single box that's been designed for your patient, simplifying case set-up. Each box includes a disposable jig designed from the patient's CT scan, along with sterilized instruments and a choice of polys.
Maquet | Universal Carbon Fiber Frame
While the Universal Frame is the next generation of the company's spinal frame, the newest version is designed to work for a larger spectrum of cases. The frame is made of 2 carbon fiber bars and a stainless steel support foot. It also features 4 body supports with SFC padding that can be adjusted to fit your patient laterally, vertically and horizontally, letting you tailor the table to the patient.
The frame can be used with nearly all Maquet tables and is used to support the positioning of patients in supine, prone and lateral positions. It is also ergonomically friendly, since its low minimum height can let a surgeon work seated if necessary, and you only need 1 person to configure it. While optimal for spinal surgery, its versatility across other specialties could be a big benefit for busy facilities.
Innovations | Intellisense Drill
Designed to eliminate the risk of plunge through when drilling through bone, the Intellisense Drill uses real time depth measurement to stop surgeons from passing through a bony cortex. The drill features audible alerts that let a surgeon know when he's getting too close to plunging through the bone, helping to avoid soft tissue injuries.
The drill doesn't only increase safety, but also efficiency. The drill's internal sensor connects with software to identify the depth and screw size of holes to tenths of a millimeter, saving time by eliminating the need for the surgeon to manually measure the hole.
All of the information from the drill is transmitted to an easy-to-use touchscreen system, which keeps track of all of the holes you've drilled and their sizes. The company also says it offers a variety of drill bits to fit nearly all manufacturers' screws. The drill seems like it would be especially helpful for residents and new surgeons, while veteran docs will like its ergonomic design and ability to eliminate manual measurement of screw holes.
Arthrex | SynergyUHD4 Imaging Platform
This highly anticipated endoscopic system features the world's first autoclavable 4KUHD surgical camera. The image management system offers 4 times the resolution of standard HD, letting you see even more clearly during your arthroscopies.
A company rep says the jump from HD to 4K is even greater than standard to HD, and it certainly looks like the improved imaging could help your depth perception in surgery. The system offers 4 times the resolution and 4 times the color reproduction compared to standard HD. It also features an intuitive tablet controller, allowing you to tailor and store settings for each surgeon and procedure at your facility.
It's not only the visualization that's impressive. The system has network capabilities, letting it connect to your facility's Ethernet. This could be very useful, since I could record still images and video, annotate them and send them directly to the patient. I can also send PDFs of the surgery directly to patients' records, eliminating the hassle and clarity issues that come with printing and scanning.
Steris | OT 1000 Series Orthotable
This versatile orthopedic table designed for an anterior approach to total hips features Steris's SWAN (simple, weightless articulation) technology. The technology lets a single person easily lower, move and rotate the leg positioners. During movement, the safety lock engages immediately upon release, so a patient's legs can't be dropped. The table is made of carbon fiber and features a laterally sliding tabletop for better imaging access. It's also ergonomically friendly to your staff, as the table can come with an auto-drive function that lets a single person move the table.
Schaerer Medical | Rotex
Table Extension by Condor
The Rotex Table Extension is a universal attachment to be used during anterior hip replacement. The extension is about two-thirds the cost of a hana table, a company rep says, and is universal to fit on any table. It features a 34-inch extension and flexion operated by a footswitch, allowing a surgeon to control rotation, abduction, adduction and traction. One of its best features is that it is tall and slim when folded up for easy transport and storage.
Mizuho | Trios Spine and Imaging Top
The newest spine table from Mizuho features a tower and ratchet system, which eliminates the T-pins traditionally used for positioning patients in the prone position. This not only makes it easier to position the table, says the company, but also lets you keep a patient on the table while you reposition him. Because the tower and ratchet system use a crossbar with a 1-click mechanism, it's easy to lower and raise the table, eliminating the risk of dropping the table. Trios also features powered floor locks, a tabletop mounting interface and a new streamlined 180-degree rotation mechanism for anterior/interior spinal procedures.
Brainlab | TraumaCad Mobile
TraumaCad is nothing new I've been using it for several years. But, as more of the healthcare industry moves to mobile technology, Brainlab's newest update brings a more convenient platform to the surgical planning system. Now available for the iPad, TraumaCad is able to help you pre-operatively plan for hip and knee replacement surgery.
The app features highly accurate measurement tools and wizards, as well as templates that are meant to help you prep and plan your surgery. You just have to place a patient's information into the app and the technology does the heavy lifting like aligning implants and assembling components to calculate leg length discrepancy and offset.
The app can be used with Brainlab's Quentry imaging sharing service, so those involved with the surgery, like vendors and your materials manager, can see upcoming surgeries and the implants and supplies needed. The newest version is even easier and more intuitive to use, even if you haven't used TraumaCad before. The hip version of the app is currently available and the company says a knee version will be on the market shortly.
DJO Global | Exprt Precision System
Typically, a knee revision arthroplasty is expensive and requires a lot of equipment usually 8 trays' worth. DJO's newest system reduces that number to 2. By eliminating unnecessary equipment and streamlining supplies, company reps say the result is a cost reduction of 40% to 70% from a traditional system. The smaller system also requires less labor for setting up cases, giving you a faster turnover. The company says they got down to the 2 trays by working with a team of experts to define what was really needed during knee revision cases. The result is a toolkit that is less wasteful, less time-consuming and something your surgeons will find useful. The system's been used in about 25 cases so far, with the company saying patients, surgeons and facilities are happy with the results. It seems like a great fit for outpatient environments, since I think it would work well for uncomplicated cases.
Zimmer | TotalShield
Surgical Helmet System
The newest helmet from Zimmer is designed to give your surgeons a better view while making sure they're comfortable. The helmet includes a single lithium-ion battery designed to give you up to 20 hours of battery life. The helmet also has a built-in battery life indicator, so you always know how much charge is left. These features help to ensure you don't have a dead battery mid-procedure. The helmet features 8 airflow ports to distribute cool air inside the hood. It has a panoramic view, which improves your visualization and reduces the "tunnel effect" of some other helmets. It also features a bright LED light to better illuminate your surgical view. The helmet is used with hoods and togas that meet tough durability standards, so you know you're protected during fluid-heavy procedures.