The Christ Hospital Joint & Spine Center has rapidly become known as a national destination for the most advanced joint & spine care available.
Orthopedic surgeon Marc C. Schneider, M.D., discusses using a new technology to offer patients guided personalized surgery for their total shoulder replacements. ExactechGPS® is the latest advancement in technology that provides surgeons with real-time visual guidance and alignment data in total shoulder surgery. The technology’s preoperative planning tool allows surgeons to plan their cases in advance of the surgery through a virtual simulation. Surgeons can then execute their plan in real time during the surgery based on a 3-D anatomical model of the patient’s shoulder, making adjustments as needed.
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GPS Technology for Total Shoulder Replacements
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Learn more about Marc C. Schneider, MD
Marc C. Schneider, MD
Marc C. Schneider, MD earned his medical degree from Case Western Reserve University, completed his residency at the University of Cincinnati Hospitals, and trained under Dr. James Andrews at the American Sports Medicine Institute in Birmingham, AL. Dr. Schneider is board-certified in orthopaedic surgery and sports medicine, is a member of the American Sports Medicine Fellowship Society, a fellow of the American Academy of Orthopaedic Surgery and has been named a "Top Doctor" by Cincinnati Magazine.Learn more about Marc C. Schneider, MD
Transcription:
GPS Technology for Total Shoulder Replacements
Melanie Cole (Host): Out topic today is GPS technology for total shoulder replacement and my guest is Dr. Marc Schneider. He’s an orthopedic surgeon with The Christ Hospital Health Network. Dr. Schneider, explain a little bit about what’s been done as far as shoulder replacement in the past and what are you seeing that’s different now?
Marc C. Schneider, MD (Guest): Well, there’s been a lot of advances in technology for shoulder replacement implants over the last several years or last decade or so as there is increased volume of these procedures being done. It has really been amazing what we are seeing now. And the latest advance that we are using here at The Christ Hospital is called GPS technology. And it’s just really amazing that we are able to get live input while we are actually doing the surgery to see inside the patient and to customize the procedure to the patient’s individualized anatomy.
Melanie: So, then tell us about Exactech GPS and what shoulder procedures are you using it for?
Dr. Schneider: So, the GPS technology is used for shoulder replacement procedures, but there are two different kinds of shoulder replacement. There is an anatomic total shoulder replacement and a reverse total shoulder replacement. So, the anatomic shoulder replacement is used for just pure arthritis. Whether it is osteoarthritis or rheumatoid or other inflammatory arthritis type processes. But the reverse total shoulder is a total shoulder replacement that’s indicated when not only is there arthritis in the shoulder, but there is a rotator cuff deficiency or rotator cuff problem associated with the arthritis.
Melanie: So, then how does guided personalized surgery work and why don’t you start with the reverse total shoulder arthroplasty or replacement. How does that work for you and tell us about what’s involved for the patient?
Dr. Schneider: So, the GPS technology is in part computer navigation where there is a preoperative plan that’s acquired based on CAT scan technology. So, we have the patient undergo a CT scan which is just a type of x-ray in three dimensions, so we are able to reconstruct the patient’s individualized anatomy in three dimensions and so that comes up with – allows us to come up with a good game plan for the surgery. So, we are able to figure in advance, what kind of sizes and implants and augments that we might need to use as orthopedic surgeons going into the actual procedure. And then during the procedure itself, there is on a computer screen the game plan. We can see it in three dimensions on the high definition screen live in the surgery. And then as we are actually doing the surgical procedure; we are able to see through the use of infrared cameras, there is no additional x-ray exposure for the patient; through these infrared cameras we are able to see the guidance of actually doing the surgery. When we are drilling holes into the bone or putting screws and putting the implants into the patient; we are able to actually see what we are doing in three dimensions. So, typically, when you – it sounds like a little carpentry, but when we drill holes into bone, we can only see the entry point into the bone. But through the use of this 3-D technology; we are actually able to see where the screw is being guided into the bone. It’s like x-ray vision inside the patient.
Melanie: Speak about the benefits for the patient as far as preserving their natural anatomy or unique clinical challenges that are addressed that this can help with.
Dr. Schneider: Well so not all patient anatomy is the same and not all arthritis is the same. So, sometimes there are different structural changes in the bone particularly on the socket part of the joint, what’s called the glenoid, part of the scapula or wing bone of the patient. And so, based on where there is bone loss, sometimes we need to use different kind of implants than just the standard off-the-shelf type implants. So, we get a better idea – better visualization as to what the most proper, best fitting implant is going to be for that particular patient and then to make sure that we are putting it in the proper position. So, this technology allows us to be accurate within one millimeter or about one and a half degrees. So, that’s much more than we can just do by using the eye alone. Surgery is always kind of somewhat art and somewhat science, so this makes it more of a scientific reproducible accurate procedure.
Melanie: Now what about for the surgeon Dr. Schneider, what are the benefits and is there a great learning curve and as far as fatigue, does it reduce some of that for you during a lengthy procedure?
Dr. Schneider: Well, a total shoulder replacement isn’t as lengthy as what you might think. As the technology has evolved, most of these procedures are able to be done in say an hour or an hour and a half. I mean it varies from patient to patient. So, the fatigue isn’t so much a part of it, but increasing the accuracy of being able to put the implants into the proper position and being able to see in three dimensions is really amazing technology. In terms of the learning curve; it’s very easy technology to use and as I said, when we are doing the procedure, I mean looking at the screen right above the patient and within the surgical field, it’s just very easy and reproducible and really adds a unique dimension to the surgery that’s never been available before.
Melanie: So, doctor, what does current research indicate for future developments? Where do you see this kind of technology going as far as joint surgery?
Dr. Schneider: Well, this is very unique. I mean computer navigation has been around for a long time and so that part of the technology isn’t necessarily unique and new but being able to get live feedback and live images as we actually are doing the surgery; that is what is very unique. And so currently it is used for anatomic total shoulder and reverse total shoulder technology but there are some patients with very unique deformities or congenital deformities or who have fractures or other kind of unique pathologies. So, I think the indications over time will be able to expand not only to the shoulder but to other joints like the hip and knee, but as I said, this is very unique even though it is a shoulder GPS technology, it’s something that is not available even with other type joint replacements at this time.
Melanie: So, just let other physicians know in summary, what you would like them to know about the Exactech and the GPS guided shoulder surgery and when it’s important to refer to the specialists at The Christ Hospital Health Network.
Dr. Schneider: Well the thing about the GPS technology is that we are the only hospital system, only institution in the tri-state region who has used this technology. It’s really cutting edge. It really enhances the procedure for the surgeon and of course the patient. I mean ultimately, improving outcomes for patients in terms of the longevity of the components that we put in there; we want these shoulder replacements to last a long, long time. And this kind of technology can allow for these kinds of improvements.
Melanie: Thank you so much Dr. Schneider for being with us today. It’s really fascinating information and such cool technology and thank you for sharing your expertise with us today. You’re listening to Expert Insights, Physician Views and News with The Christ Hospital Health Network. More information on Dr. Schneider and all of The Christ Hospital physicians is available at www.tchpconnect.org, that’s www.tchpconnect.org. This is Melanie Cole. Thanks so much for listening.
GPS Technology for Total Shoulder Replacements
Melanie Cole (Host): Out topic today is GPS technology for total shoulder replacement and my guest is Dr. Marc Schneider. He’s an orthopedic surgeon with The Christ Hospital Health Network. Dr. Schneider, explain a little bit about what’s been done as far as shoulder replacement in the past and what are you seeing that’s different now?
Marc C. Schneider, MD (Guest): Well, there’s been a lot of advances in technology for shoulder replacement implants over the last several years or last decade or so as there is increased volume of these procedures being done. It has really been amazing what we are seeing now. And the latest advance that we are using here at The Christ Hospital is called GPS technology. And it’s just really amazing that we are able to get live input while we are actually doing the surgery to see inside the patient and to customize the procedure to the patient’s individualized anatomy.
Melanie: So, then tell us about Exactech GPS and what shoulder procedures are you using it for?
Dr. Schneider: So, the GPS technology is used for shoulder replacement procedures, but there are two different kinds of shoulder replacement. There is an anatomic total shoulder replacement and a reverse total shoulder replacement. So, the anatomic shoulder replacement is used for just pure arthritis. Whether it is osteoarthritis or rheumatoid or other inflammatory arthritis type processes. But the reverse total shoulder is a total shoulder replacement that’s indicated when not only is there arthritis in the shoulder, but there is a rotator cuff deficiency or rotator cuff problem associated with the arthritis.
Melanie: So, then how does guided personalized surgery work and why don’t you start with the reverse total shoulder arthroplasty or replacement. How does that work for you and tell us about what’s involved for the patient?
Dr. Schneider: So, the GPS technology is in part computer navigation where there is a preoperative plan that’s acquired based on CAT scan technology. So, we have the patient undergo a CT scan which is just a type of x-ray in three dimensions, so we are able to reconstruct the patient’s individualized anatomy in three dimensions and so that comes up with – allows us to come up with a good game plan for the surgery. So, we are able to figure in advance, what kind of sizes and implants and augments that we might need to use as orthopedic surgeons going into the actual procedure. And then during the procedure itself, there is on a computer screen the game plan. We can see it in three dimensions on the high definition screen live in the surgery. And then as we are actually doing the surgical procedure; we are able to see through the use of infrared cameras, there is no additional x-ray exposure for the patient; through these infrared cameras we are able to see the guidance of actually doing the surgery. When we are drilling holes into the bone or putting screws and putting the implants into the patient; we are able to actually see what we are doing in three dimensions. So, typically, when you – it sounds like a little carpentry, but when we drill holes into bone, we can only see the entry point into the bone. But through the use of this 3-D technology; we are actually able to see where the screw is being guided into the bone. It’s like x-ray vision inside the patient.
Melanie: Speak about the benefits for the patient as far as preserving their natural anatomy or unique clinical challenges that are addressed that this can help with.
Dr. Schneider: Well so not all patient anatomy is the same and not all arthritis is the same. So, sometimes there are different structural changes in the bone particularly on the socket part of the joint, what’s called the glenoid, part of the scapula or wing bone of the patient. And so, based on where there is bone loss, sometimes we need to use different kind of implants than just the standard off-the-shelf type implants. So, we get a better idea – better visualization as to what the most proper, best fitting implant is going to be for that particular patient and then to make sure that we are putting it in the proper position. So, this technology allows us to be accurate within one millimeter or about one and a half degrees. So, that’s much more than we can just do by using the eye alone. Surgery is always kind of somewhat art and somewhat science, so this makes it more of a scientific reproducible accurate procedure.
Melanie: Now what about for the surgeon Dr. Schneider, what are the benefits and is there a great learning curve and as far as fatigue, does it reduce some of that for you during a lengthy procedure?
Dr. Schneider: Well, a total shoulder replacement isn’t as lengthy as what you might think. As the technology has evolved, most of these procedures are able to be done in say an hour or an hour and a half. I mean it varies from patient to patient. So, the fatigue isn’t so much a part of it, but increasing the accuracy of being able to put the implants into the proper position and being able to see in three dimensions is really amazing technology. In terms of the learning curve; it’s very easy technology to use and as I said, when we are doing the procedure, I mean looking at the screen right above the patient and within the surgical field, it’s just very easy and reproducible and really adds a unique dimension to the surgery that’s never been available before.
Melanie: So, doctor, what does current research indicate for future developments? Where do you see this kind of technology going as far as joint surgery?
Dr. Schneider: Well, this is very unique. I mean computer navigation has been around for a long time and so that part of the technology isn’t necessarily unique and new but being able to get live feedback and live images as we actually are doing the surgery; that is what is very unique. And so currently it is used for anatomic total shoulder and reverse total shoulder technology but there are some patients with very unique deformities or congenital deformities or who have fractures or other kind of unique pathologies. So, I think the indications over time will be able to expand not only to the shoulder but to other joints like the hip and knee, but as I said, this is very unique even though it is a shoulder GPS technology, it’s something that is not available even with other type joint replacements at this time.
Melanie: So, just let other physicians know in summary, what you would like them to know about the Exactech and the GPS guided shoulder surgery and when it’s important to refer to the specialists at The Christ Hospital Health Network.
Dr. Schneider: Well the thing about the GPS technology is that we are the only hospital system, only institution in the tri-state region who has used this technology. It’s really cutting edge. It really enhances the procedure for the surgeon and of course the patient. I mean ultimately, improving outcomes for patients in terms of the longevity of the components that we put in there; we want these shoulder replacements to last a long, long time. And this kind of technology can allow for these kinds of improvements.
Melanie: Thank you so much Dr. Schneider for being with us today. It’s really fascinating information and such cool technology and thank you for sharing your expertise with us today. You’re listening to Expert Insights, Physician Views and News with The Christ Hospital Health Network. More information on Dr. Schneider and all of The Christ Hospital physicians is available at www.tchpconnect.org, that’s www.tchpconnect.org. This is Melanie Cole. Thanks so much for listening.