The new, sophisticated computer navigation system provides surgeons with an accurate three-dimensional virtual picture of the surgical area on a computer screen in front of them as they proceed with the operation.For the first time anywhere in the world, orthopedic surgeons at Hadassah University Hospital-Mt. Scopus in Israel have performed hip replacement surgery with the assistance of a computer navigation system.
Hip replacement – known as hip arthoscopy – is considered the treatment of choice for painful, end-stage arthritis and more than 150,000 procedures are performed in the United States each year. Hip replacement, a significant and complex orthopedic procedure, is increasingly in demand as populations age and the hip joint becomes more brittle.
Two giant foreign companies – Zimmer and Medtronics – developed the pioneering hardware and software for the operation and they chose Hadassah to perform the surgery because of its orthopedists’ expertise in computer-assisted surgery, including the removal of shrapnel from the bodies of terror victims.
In Zimmer’s annual report to stockholders this week, the head of Zimmer specifically mentioned the first use of this advanced technology in Israel. Hadassah came out ahead of medical centers in England and Germany, but the technology will later be sent to a handful of prestigious centers in the US and Europe.
“We are proud that world leaders such as [the two companies] chose Hadassah as a site for these special machines,” Prof. Iri Liebergall, head of Hadassah’s two orthopedics departments, said.
To date, Hadassah’s orthopedic surgeons have performed four hip replacement operations using the computer navigation system at Hadassah’s Center for Joint Replacement. Liebergall, Chairman of Hadassah’s Departments of Orthopedics, and Dr. Yoav Matan, Head of the Joint Replacement Unit at Hadassah-Mt. Scopus, head the 12-person operating room team.
“These sophisticated technologies enable us to significantly improve the quality of life of the patient after the surgery, in terms of independent movement capability and hospitalization time,” Liebergall said.
The breakthrough was presented at a press conference at the Mount Scopus hospital last week with 53-year-old agronomist Amram Weiser of Kibbutz Yad Mordechai – the fourth patient who was later due to be discharged – showing his agility.
“I am completely indebted to them,” said Weiser, who suffered from a rheumatoid condition and was in great pain before the surgery.
Until recently, hip replacement surgery was a major procedure for the patient and the surgeons. To reduce the impact of the operation on the patient, doctors sought ways to minimize the incision. This necessitated their receiving some image of the anatomy of the patient, using a fluoroscope machine.
The new, sophisticated computer navigation system provides surgeons with an accurate three-dimensional virtual picture of the surgical area on a computer screen in front of them as they proceed with the operation. Special sensors attached to the patient’s body transmit data to the computer indicating the location of the hip joint relative to the space at the site.
A fluoroscope machine provides the basis of the virtual picture through the transmission of an x-ray image of the hip to the computer. The data and the virtual picture on the computer screen guide the surgeons in positioning the replacement through a display of the exact coordinates of the surgical site and angle at which the implant should be placed.
According to the virtual picture and data that appear on the computer screen, surgeons now know in advance exactly where to enter the hip, where to position the replacement and are aware of their location inside the hip at every stage of the surgery. This complex procedure is conducted through a minimal incision of 2 inches.
The accuracy supplied by the technology, Liebergall said, means that long-term results can be improved and dislocation rates, loosening and leg-length discrepancies can be eliminated or reduced.
“The technology does not perform the surgery like a robot; we do the work, but it is an excellent tool to perform the operation most accurately,” Matan told The Jerusalem Post. “It will also help us teach less-experienced orthopedic surgeons much more quickly how to perform the surgery without having to rely only on their judgment.”