VIRTUAL REALITY

TECHNOLOGY IN ORTHOPEDICS

A new era of cutting-edge medical technology, that of Virtual Reality  (VR), officially available from 05/08/2020 to the Greek patient, by Dr. Stavros Alevrogiannis, Medical Director and Chief Surgeon at Robotic Knee & Hip Surgery  Clinic at METROPOLITAN GENERAL HOSPITAL.

Virtual Reality belongs to the field of Artificial Intelligence (AI) and is a milestone achievement in Orthopedics ensuring the next day of individualized care and treatment of the orthopedic patient.

Excellent clinical outcome and state-of-the-art technology are key areas that appeal to both patients and physicians. These are the main reasons why patients have so far shown great interest and enthusiasm for operations with the help of high-precision robotic systems. In reality, however, if one asks the patient, despite the initial enthusiasm, he has some insecurity and would prefer the human role to have the dominant role in the operation. The surgeon is the doctor he trusts and he has full responsibility for the surgical outcome.

The needs of the global market led the “race” of orthopedic technology in virtual reality applications to work harmoniously with the surgeon to achieve excellent results.

The rapid development of virtual reality technologies has the potential to lead to an ideal form of human-machine interface-collaboration.

Virtual Reality (VR), as state-of-the-art wireless technology, has created, with the use of innovative software, an artificial 3D simulated environment, allowing the user to fully immerse to a world of simulation. VR has a unique ability to reproduce surgical scenarios and environments while enhancing skills in an efficient and cost-effective way. Due to the lack of realism, however, it cannot be used in real conditions of surgery but mainly to inform the patient in an interactive environment.

This was the main reason Augmented Reality (AR) was created, which generally refers to the integration of additional information or graphics in relation to the user interface in real time. AR focuses on the interaction of work in the real world, rather than in a completely artificial environment. Most AR solutions are based on external navigation systems, however their use is limited to routine surgery and training of new surgeons.

Mixed Reality (MR), allows the user to simultaneously perceive the natural environment around him and digital elements (virtual objects) presented through a special mask of glasses (Hololens, Smart Glasses). This technology gives the user the illusion that digital objects and physical objects coexist in the same space. In this way the placement of the user-surgeon is attempted in a realistic environment, using digital visual and audio components as well as navigation systems, tactile feedback controllers, and complementary motion sensing options. It attempts to offer the user-surgeon realism through very high levels of multi-sensory fidelity, including visual, psychomotor and cognitive ability through the decision-making of the user-surgeon.

Do not forget that vision, touch and sound are what surgeons rely on most easily during their surgeries. Their ability to assess the state of their senses has been taught and improved through their medical education, as well as through the experience gained during clinical practice, due to the plethora of their surgeries. In recent decades, digital technologies used in artificial intelligence have been developed to interact with the human senses. This “digital” virtual reality is transferred to the surgeon’s logic through a digital interface. Interfaces include an image for the eyes, a sound for the ears and pressure for touch. In this way the surgeon visually checks the overlap of virtual reality on the patient’s real anatomy, hears a specific sound and feels the vibration in his hands as soon as the images are completely identical.

VIRTUAL REALITY IN PATIENT CONSULTATION

During patient consultation before surgery, a common phenomenon observed worldwide is the lack of communication between patient and doctor. One reason for the lack of communication is the asymmetry and complexity of the information transmitted from the doctor to the patient. Especially for arthroplasties, it is difficult for patients and their families to have an intuitive understanding of the procedures that will be performed in the operating room through the speech of the doctor. Virtual reality devices using “Smart Glasses” activate technologies with virtual simulation of the patient joint and the operating room itself. Patients have the ability to understand in an interactive environment their type of arthritis, the osteophytes that afflict them, deformity of the patient’s axis in three-dimensional X-ray or computed tomography images, details that can promote effective communication with the patient and knowledge given to them by the doctor as well as to attend later parts of their surgery in virtual reality.

VIRTUAL REALITY IN PATIENT CONSULTATION

During patient consultation before surgery, a common phenomenon observed worldwide is the lack of communication between patient and doctor. One reason for the lack of communication is the asymmetry and complexity of the information transmitted from the doctor to the patient. Especially for arthroplasties, it is difficult for patients and their families to have an intuitive understanding of the procedures that will be performed in the operating room through the speech of the doctor. Virtual reality devices using “Smart Glasses” activate technologies with virtual simulation of the patient joint and the operating room itself. Patients have the ability to understand in an interactive environment their type of arthritis, the osteophytes that afflict them, deformity of the patient’s axis in three-dimensional X-ray or computed tomography images, details that can promote effective communication with the patient and knowledge given to them by the doctor as well as to attend later parts of their surgery in virtual reality.

This system is already available for our patients at the Robotic Knee & Hip Surgery Clinic at METROPOLITAN GENERAL HOSPITAL and  Dr. Stavros Alevrogiannis who is the Medical  Director of the clinic.

VIRTUAL REALITY IN EDUCATION (RESIDENT DOCTORS)

  • It is an easily accessible and realistic simulation of the surgical procedure. The training hours of specialist Orthopedic Surgeons in the United States and the European Union have been reduced by at least 5 times compared to conventional model and cadaver training.
  • Surgical experience combined with sophisticated decision making in the surgical field, leads to a higher level of technical ability, reducing the learning curve.
  • VR enables learners, through a cognitive assessment process, to analyze, critique technical and surgical decision making and improve their surgical experience through technical errors that are not harmful for real patient .
  • These systems have the added benefit of continuous uninterrupted availability, with available guidance provided through direct measurements of learner’s performance, the ability to repeat surgery in virtual time and measure clinical outcomes on calibrated scales with full evaluation scales.

VIRTUAL REALITY IN ORTHOPEDIC SURGERY- INDICATIONS

  • Knee, hip, shoulder arthroplasties
  • Bone & soft tissue tumors
  • Comminuted long bone fractures
  • Knee & hip osteotomies
  • vertebrae fixation with accurate & safe placement of screws
  • Vertebroplasty
  • Arthroscopies of shoulder, knee, hip.

KNEE ARTHROPLASTY WITH VIRTUAL REALITY SYSTEMS

In recent years, special emphasis has been placed on the creation and use of a virtual reality surgical platform for total knee arthroplasty.

Such a system has just received and will work in our Robotic Knee & Hip Surgery Clinic at METROPOLITAN GENERAL HOSPITAL.

This system is an innovative and effective tool that offers exceptional precision in performing osteotomies and placement of prosthetic materials, through an individualized surgical plan per patient.

Especially nowadays, as surgeons and health systems try to recover from delays during the COVID-19 and plan new ones with the existing pandemic, operating efficiency and as little hospitalization as possible will become even more important than before.

The surgeon is allowed to visualize surgical actions and information in real time, directly on the surgical field. This improves the user experience and helps the surgeon stay focused on the surgical field at all times, having all the measurements in front of his eyes.

The use of new technology improves the efficiency and accuracy of total knee replacement and offer personalized programming and execution. The patient addresses his surgeon, is informed and understands the surgical plan in a virtual form and enjoys the benefits of the latest form of technology that goes beyond even robotic systems, without having to pay a lot of money. This new platform will excite patients who will have excellent results, rapid recovery and day care hospitalization.

Virtual reality as a technology in knee arthroplasty is the ultimate advancement in relation to traditional surgeries, in relation to surgical navigation systems but also in relation to robotic arm systems  that only monitor the relative movement of bones. The truth is that we have found a way to ensure the kinematics of the knee through a three-dimensional imaging of the morphology of the patient’s bones and soft tissues, on an individual level. It is really impressive that the patient can be aware of his own medical problem and the surgical plan through the virtual representation provided by the “special glasses” of the specific surgical system.

After all, the restoration of the knee kinematics on an individual basis is achieved at such a level that no other existing robotic or navigation system can provide.

Virtual reality as a technology in knee arthroplasty is the ultimate advancement in relation to traditional surgeries, in relation to surgical navigation systems but also in relation to robotic arm systems  that only monitor the relative movement of bones. The truth is that we have found a way to ensure the kinematics of the knee through a three-dimensional imaging of the morphology of the patient’s bones and soft tissues, on an individual level. It is really impressive that the patient can be aware of his own medical problem and the surgical plan through the virtual representation provided by the “special glasses” of the specific surgical system.

After all, the restoration of the knee kinematics on an individual basis is achieved at such a level that no other existing robotic or navigation system can provide.

ADVANTAGES :

  • state-of-the-art technology with artificial intelligence,
  • personalized surgical plan,
  • elimination of postoperative pain,
  • reduction of surgical time,
  • immediate mobilization of a patient,
  • day care hospitalization ,in most cases,
  • satisfactory range of motion (ROM) of the joint,
  • accuracy in osteotomies,
  • precision in implant placement,
  • excellent knee kinematics,
  • low cost per operation from the respective robotics,
  • excellent clinical result

Dr. Alevrogiannis can assess your condition and condition, either in his office or at the Metropolitan General.