New software helps SW Florida orthopedists
__By Andi Atwater
__Therese Zartarian just wants to walk without pain.
__The 61-year-old Fort Myers Beach resident underwent total knee replacement surgery Thursday, a 40-year-old procedure designed to bring back mobility to a damaged knee deformed by arthritis.
__But Zartarian’s surgery was anything but routine.
__Under the knife — and hammer, screwdriver and saw — of Fort Myers orthopedic surgeon Dr. Bo Kagan, Zartarian became one of a handful of Americans and the first Lee County resident to benefit from computer-assisted surgery using 3-D animation for near-100 percent accuracy.
__The software, called ORTHOsoft and developed in Montreal, Canada, could transform the way orthopedic surgeons do their jobs.
__“If this type of technology improves patient results, then it’s worth it,” said Kagan, one of five U.S. doctors participating in a pilot study of the navigational software “If it improves the longevity of the prosthesis so people don’t have to come back and get it redone, that’s even better.”
__When a patient goes under the knife, it all boils down to accuracy.
__The better aligned the implant; the longer it lasts, potentially deferring a repeat operation by at least 20 years.
__Before now, a patient with hip or knee replacement surgery might wear it out in as little as one year to five years. Some of that has to do with materials. The other is precision.
__“The old way, there’s a certain amount of guesswork that goes into it, a certain amount of inaccuracy. Despite our best efforts we can’t make it perfect,” Kagen said. “With the computer, the degree of accuracy is almost perfect.”
__The software allows surgeons to cut and set within a tenth of a degree and eliminates, for example, the need for a rod to be inserted down the length of a femur to determine proper alignment.
__During Thursday’s 2-hour surgery, a series of instruments that hold specially designed probes sentsignals back to a computer receiver, which then translated the data into a 3D image of Zartarian’s knee and leg.
__The on-screen image then recorded the patient’s knee movement angles so that Kagan could align Zartarian’s bones to healthy degrees before cutting and drilling into them and securing the implant.
__“We used to say, ‘Well, it looks like it’s parallel, it looks like it’s in place,’” he said, moments before he made a femoral cut into the old bone.
__An experienced doctor using only hand instruments can expect 3 to 5 degrees of inaccuracy, Kagansaid. As tiny an amount as that is from perfection, the result causes uneven wear and tear that shaves off years from the implant’s usefulness.
__Zartarian may be fully recovered inside of two months. She’ll be taking her first few steps today.
__“I am so thrilled. It is amazing technology,” Zartarian said Thursday in recovery at Southwest Florida Regional Medical Center, which provided the extra staff, operating room time and accommodations for the new procedure. “I can’t wait to be able to walk around the block.”
__Medical robotics and computer-assisted surgery software are the brainchild of biomedical engineers,who develop computers, electronic equipment and instruments that enhance a surgeon’s dexterity and ability to see and gather information.
__Patrik Garceau helped create the OTHOsoft program and served as a technical guide in the operating room.
__“The computer helps them see much more than they could before,” he said. “There is a big learning curve but this went very well today.”
__As these new technologies progress, science fiction becomes a reality.
__Today, surgeons are using navigational software to accurately plan and place hip and knee implants, precision hardware to eliminate hand tremors in microsurgery and optical devices to minimize incisions and speed up patient recovery.
__The American Academy of Orthopedic Surgeons estimates that computer-assisted surgery will be involved in about 25 percent of all orthopedic surgeries within the next five to seven years.
__“Does technology improve our ability to provide better?” said Dr. William Tipton, director of medical affairs for the academy. “The answer is yes. You’ve got to go down these roads to find out what it does.”
__The ORTHOsoft program has been used in Europe for the last three years and only now is making headway in the United States, company officials said.
__Garceau said surgeons have completed more than 7,500 operations using the 3D imaging, and expects the accuracy level to have widespread appeal.
__“The challenge is, can we make it friendly enough that people will use it routinely?” he said. “That is our goal.”
__Originally published Feb. 27, 2004 in the Fort Meyers News-Press.