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VISIONAIRE patient-specific instruments for a knee made to measure
How can the desire for individualization be combined with the demand for standardized processes and cost savings? The new VISIONAIRE technology from Smith & Nephew provides an answer for knee arthroplasty.
The VISIONAIRE technology starts with the individual instrumentation of knee endoprostheses. On the basis of a knee MRI and a whole-leg X-ray, patient-specific cutting blocks are made for the distal femur and the proximal tibial cut.
For a knee endoprosthesis "like a glove"
This innovative procedure allows knee endoprosthetic restoration literally "made to measure": Based on the images, the resection planes and the positioning of the femoral components are precisely aligned with the mechanical leg axes and the clearly identified landmarks. Osteophytes are taken into account in the design of the cutting blocks because they are an important component the current patient anatomy and essential for the precise fit of the instrument on the bone.
The surgeon always has the last word
The production of the cutting blocks follows a precisely defined process: the surgeon uploads the MRI and X-ray images as well as the necessary patient-specific data to a secure Smith & Nephew server. The engineers analyze all the data and create a 3D design model of the cutting blocks. With a detailed, preoperative proposal, the CAD model is sent to the surgeon for review and approval. It is important that the doctor always decides on the execution: Depending on the anatomical requirements, the user can change the parameters of the axis and rotational alignment according to his ideas. Once the design has been finalized, the patient-specific cutting blocks are made from medical nylon and delivered sterile. After 3 - 4 weeks at the latest, the VISIONAIRE cutting blocks are in the clinic, labeled with the patient's name, the side to be operated on, the implant size and the knee system used to prevent confusion. During the procedure, it is possible to switch to conventional instruments at any time.
Benefits for doctor, administration and patient
The advantages of the precisely fitting instruments are obvious. Every minute of surgery is cash. For the user, VISIONAIRE means significant time savings with reproducible, identical or even improved quality of the surgical result, since many of the previously necessary surgical steps are superfluous. For the house there is additional potential for increasing efficiency: the reduced time and instrument requirements increase the operating theater throughput, sterilization and reprocessing costs decrease and storage can be minimized. For the patient, the risk of complications is reduced, since the extramedullary alignment means that there is no opening of the medullary canal. Blood loss and the risk of infection also decrease due to the shortened duration of the operation.
The VISIONAIRE technology will initially be available for the JOURNEY ◊ BCS knee system and for the GENESIS ◊ II knee system from mid-2010. We are already working on an extension for other bicondylar Smith & Nephew knee systems and for uni- and bicompartmental joint replacement.
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