Precision comes to knee surgery

Computer-based system dramatically improves accuracy

Published: Monday, Aug. 2, 2004 10:25 p.m. MDT
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OREM — For six months Jamie Garner could not stop the agonizing pain that had invaded his knee.

Concerns for his health grew as the pain caused by rubbing of bone and cartilage continued to increase.

But hopes for relief for the 61-year-old Springville resident were short-lived after his Jan. 28 surgery.

Within weeks, the pain was back and this time with a vengeance. The excruciating pain raced throughout his entire leg.

Seven months after his first operation, Garner was heading back to the operating room again.

But this time, the approach would be different.

"I was a little nervous about it (the surgery)," Garner said, "but after the doctor talked to me about it (a new procedure), he told me just how it worked and it calmed me down a bunch."

Garner was Dr. Kirt Kimball's third patient to receive surgery using Ci System, a computer assisted surgery (CAS) method.

Kimball has been instrumental in pioneering the new technology in Utah. He first became interested in Ci System earlier this year and worked aggressively to bring the technology to Utah Valley.

The Ci System was introduced in March by DePuy, a Johnson & Johnson company, at the American Academy of Orthopaedic Surgeons conference in San Francisco.

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There are now 25 units up and working in the United States.

"We just saw a wonderful opportunity to take what is already a very successful procedure, that being total knee surgery, and really take it to the next level with tools that can enhance what they (surgeons) do to deliver ultimate value to the patient," said Gordon Van Ummersen, vice president of marketing for DePuy.

Ci System is a collaboration between DePuy and BrainLAB, a Munich, Germany, company that is arguably the world leader in the medical industry in terms of imaging and navigation technology, Van Ummersen said.

The unit cost — $180,000 — includes the computer, all the hardware, an infrared camera, computer stand, software, instruments and training.

Ci System is the first totally integrated, customizable, computer assisted surgical package for total knee replacement.

"This is the first application of computer assisted surgery in orthopaedics," Kimball said. "This technology enables me to do it far more precisely than we could ever imagine."

Ci System provides surgeons with a three-dimensional computer image during each step of the surgery. Using that data, Kimball said, he is able to more accurately align implants during knee replacement procedures.

Kimball said in the past, he had to rely on mechanical alignment guides as he tried to make sure components were properly inserted.

While the new technology adds another 10 minutes to the one hour surgery, it dramatically improves accuracy to within a tenth of a millimeter, Kimball said.

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Dr. Kirt Kimball, middle left, holds a "pointer," which has optical trackers that map out parts of a patient's bones and generates an image of the area on computer, right. (Stuart Johnson, Deseret Morning News)
Stuart Johnson, Deseret Morning News
Dr. Kirt Kimball, middle left, holds a "pointer," which has optical trackers that map out parts of a patient's bones and generates an image of the area on computer, right.