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Precision Robotic S.I. Surgery Improves Outcomes By Laura Freeman
Alabama Bone And Joint Clinic neurosurgeon Winston Capel MD is pleased with the results he’s seeing with robotic S.I. joint surgery “The S.I. joint is involved in about 75 percent of the back pain cases we see,” Capel said. “When the problem progresses to the point where conservative measures no longer bring relief, it may be time to consider surgery. The difficult part of this decision is that the chances for easing the pain and giving your patients a meaningful improvement in quality of life depends in large part on getting exactly the right placement for the implant. The anatomy can be complicated and it’s different in each patient.
“With traditional methods, you have to rely on x-rays and your own skills and experience, and hope the patient gets the good outcome you want. The implants cost around $3,000 each, so it’s something you need to get right the first time.” Capel has found that getting it right the first time is simpler when he can do much of the more difficult work in advance using calculations from data input directly from the actual patient’s own imaging to preplan and guide the surgery. “We explained to Brookwood Medical Center that the precision we get with robotics is becoming the standard of care for spinal surgery,” he said. “We’ve been impressed with the results we see using the Mazer surgical robot at Brookwood. (CONTINUED ON PAGE 4)
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Total Ankle Replacements Today By Jane Ehrhardt
“If you have a patient with a severe deformity or odd anatomy, you can actually have custom implants made now,” says John Kirchner, MD about the total talus procedure. Kirchner, an orthopedic foot and ankle specialist with Southlake Orthopaedics has performed around 400 total ankle replacements over his career and says the advancements keep coming. Total ankle replacements began in the 1980s. But the first ones loosened easily and were abandoned. “In the early 2000s, it resurfaced with an implant that started restoring more natural anatomy, range of motion, and
preserving a mobile joint itself,” Kirchner says. However, if not set in perfectly, it resulted in loosening and subsidence, where the implant actually sinks into the bone. But 2006 brought a breakthrough. “The way you cut the bone changed,” Kirchner says. “Instead of making just one big flat cut on the bone, we were doing angled cuts.” Then came patient-specific cut guides, and a new generation of replacements came about. The personalized cutting blocks, based on CT scans and built-in 3D printers, are pinned in place on the patient to guide the saw blade as it cuts the bone. “You have much more pre(CONTINUED ON PAGE 4)
John Kirchner, MD
www.birminghammedicalnews.com
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