Tuesday, November 14, 2006

computer assisted surgery in orthopaedics ?

Computer navigation or computer assisted surgery (CAS) is the major new thing in orthopaedics.

What is computer navigation or CAS ?

As the name suggests, the surgeon uses the computer to help him in surgery. This is done with the help of sensors which are placed at specific points on the part to be operated. For eg. the knee. These sensors send information via infra red rays to the computer. With this information the computer reconstructs a visual of the patients anatomic part. On the visual, the computer guides the surgeon on how much to cut the bone? at what angle? where to place the implant? etc.

What are the advantages of computer navigation ?

With CAS, the accuracy of the surgery increases. For example, in a total knee replacement, the accuracy of the placements of the components is better with CAS.
CAS also enables the surgeon to perform the same surgery through a smaller incision (minimally invasive surgery)

Are there any disadvantages ?

Though accuracy is better with CAS, whether this translates into better functional results or improves long term survival of the joint (in cases of joint replacement) is still to be proved.
Besides the technique requires expensive instrumentation and has a learning curve. CAS usually increases surgery time.

I cannot afford computer navigation, is my surgery doomed ?

CAS is still in its infancy. An experienced surgeon will achieve acceptable accuracy with conventional instrumentation. CAS today is an option not a necessity.

When is CAS most useful ?

It is especially useful in cases of bony deformities, retained hardware or when convential instrumentation cannot be used to gain proper alignment.

CAS is useful in which orthopaedic surgeries ?

It is most useful and currently used in total or unicondylar knee arthroplasty & hip arthroplasty. Surgeons have started using it to guide placement of pedicular screws in spine surgery. It is becoming popular in fracture care

If you have any further questions on CAS, send them to me at orthindia@gmail.com

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