AN ORTHOPOD'S PLAYGROUND Christopher Bensen, MD, toured the AAOS exhibit hall floor and found plenty of cool new gadgets designed to make orthopedic surgery safer and more efficient.

At this year's American Association of Orthopaedic Surgeons conference in sunny Orlando, Fla., I saw several devices designed to make your surgeons and staffers' lives easier. An orthopod's goal is always efficiency, and many of the latest innovations help you achieve that standard. Here are a few of the coolest gadgets that your docs will be buzzing about.

Medacta
GMK Efficiency Single-Use Knee System
As more outpatient facilities look to add total knee replacements to their caseload, a problem often arises: Reprocessing the procedure's big, heavy instrument trays can be too tough for smaller centers with limited sterile processing capabilities. To solve that problem, Medacta has created a single-use knee system.

The GMK Efficiency system replaces the average 6 to 9 trays required for total knee replacements with a single set of tools made from medical-grade composite technopolymers. The tray arrives sterilized and ready to go, reducing the risk of cross-contamination associated with reusable instruments. It also could make set-up time quicker and easier on your OR staff — the instruments are considerably lighter than standard metal trays.

The system does cost more than reusable instruments, but a company rep says that it ends up being cost-effective since you're eliminating costs both associated with reprocessing and delayed or cancelled cases caused by reprocessing problems. And while the whole system is disposable, it's also certified carbon-neutral for those looking to stay green. Experienced surgeons may not like the plastic feeling of the instruments, but it's a great idea for those with lower volumes of knee cases or surgery centers just starting out with total joints.

Integrated Endoscopy
Nuvis Single-Use Rigid Arthroscope
The single-use trend is picking up steam in orthopedics. The Nuvis is a first-of-its-kind disposable arthroscope that features a molded glass lens, which gives off comparable image clarity to that of standard arthroscopes. The light source is an LED bulb located in the tip of the scope, which eliminates the need for delicate fiber optic cords that can be easily damaged.

While the scope may not be practical for use in all of your cases, the company says its real benefit is as a handy backup device for those times your scope breaks down. Arthroscopes need regular maintenance — sometimes unexpectedly — which can add major delays to the surgical schedule. If you suddenly find one of your scopes not working correctly, you can simply grab this 30-degree-angle scope off of the shelf, plug it in and get to work.

It's cost-effective, too, especially when you compare it to the costs of cancelling a case. A rep says that you can purchase a starter kit that includes 10 ready-to-use arthroscopes, a single reusable power supply and a perfect-fit cannula with trocars for around $3,500.

Stryker
1588 AIM (Advanced Imaging Modalities) Platform
With 4K on the way, and 8K not too much further behind, the push for more and more pixels can be tough to keep up with. As a result, Stryker has turned its attention to enhancing the images you already have with new, sophisticated software.

The 1588 AIM surgical imaging platform combines 5 different image enhancement technologies useful for a range of specialties. For orthopedics, the platform's Clarity modality lets surgeons see through fog and debris for better visualization, while its Dynamic Range Enhancement mode brightens dark and posterior compartments of joints to make them easier to see. There's also a desaturation setting to change the colors of the screen, and infrared and near-infrared visualization used more frequently in general surgery, gynecology and urology.

The software also connects to Stryker's SDC3 technology, which is a cloud-based system that lets each surgeon create a customized OR environment. Instead of your nurses having to fine-tune every device setting before a procedure, the surgeon can come into any OR with Stryker technology, log into the system and hit a single button to change all the settings to his liking. The system also has other fun touches, like voice control and a compatible iPad app, which makes the annotation of surgical images and post-op communication with patients much easier.

Stryker
Crossblade Series Cutters
This new line of cutters features 7 different models, each with a different size, strength and cutting blade. One of the most notable members of the Crossblade series is a cutter that features a proprietary dual-edge tip. When the cutter rotates one way, it cuts using a toothed edge; the other way cuts with a smooth edge.

This design could help increase efficiency in the OR. The smooth end works like a burr to efficiently resect bone, while the toothed end can remove soft tissue like a shaver. While it won't completely replace the need for a burr, it could help you save precious seconds in the OR and reduce the number of blades you need to open during the case. Additionally, the series features the Tomcat HC blade for aggressive soft tissue resection, the Aggressive Max blade for fast resection through tough ligaments, and the Smooth Bite blade designed for clean cartilage debridement and tissue removal.

The CrossBlade Cutters are compatible with Stryker's Formula handpiece, which features shaver blade recognition technology. That means that once you insert the cutter blade or burr into the handpiece, it recognizes which tip is being used and activates the appropriate settings automatically, a nice addition that boosts OR efficiency.

Depuy Synthes
Variable Angle Locking Hand System
The tiny screws and plates you use to stabilize the fracture make fixing hand fractures a tedious process. This new system, though, is a game changer. Traditionally, surgeons screw in small plates to hold the fractured hand bones together. Original designs use standard screws, which are inserted at a 90-degree angle and cannot lock into place. This means that the tip of the screw could move slightly after insertion. To make it sturdier, some manufacturers place threads on the head of the screw to lock it into the plate, reducing this unwanted motion. The Variable Angle Locking Hand System lets the surgeon insert the screw into the plate at any angle up to 15 degrees offset and have it lock into place, providing more options during surgery. The surgeon can now fine-tune the operation to the patient's anatomy, since he's no longer required to position plates and screws strictly perpendicular to the bone.

The system also includes instrumentation designed to make the surgical team's lives easier. The forceps used to hold the bone and plate in place now feature an access hole, so docs can continue to position the plate and actually drill through the forceps to fixate it. Additionally, the different screws and instruments are color-coordinated, so a surgeon can simply say to his tech that he needs the blue screw and corresponding instrument, instead of requesting specific sizes that can be easy to mix-up with these tiny instruments.

Zimmer Biomet
Oxford Partial Knee Microplasty Instrumentation
With total knee replacements booming in popularity for outpatient facilities right now, it's easy to overlook the partial knee replacement, though it's often an easier procedure and has a quicker recovery time for patients.

Zimmer Biomet's Oxford Partial Knee system features a unique unicompartmental implant that's been a longtime favorite of docs. The implant has an ultra-low wear rate and is very forgiving to insert, so the surgeon can be off a few degrees and still have great outcomes. However, the procedure has historically relied on surgeons to freely make cuts in the bone without much guidance to insert the implant.

While the implant itself has remained relatively unchanged for years, Zimmer Biomet's updated microplasty instrumentation is designed to make the procedure more accurate and easier for surgeons. The system now includes femoral drill guides to provide a precise alignment of the femoral component, and size-specific femoral instrumentation to allow for more precise bone removal. The new technique also allows for minimal tibial resection and limited recuts, helping to preserve the patient's bone and potentially improve outcomes. OSM

7 MORE FINDS
Look What Else Caught Our Eye

Take-home Sequential Compression Device
The VPulse from Breg is a 3-in-1 DVT prevention system that uses cold therapy, wound compression and sequential compression to help prevent blood clots in patients recovering from surgery at home while also relieving pain and inflammation. In addition to being a take-home sequential compression device, the system includes motorized cold therapy with accompanying water bottles, so patients can ice their surgical site without the hassle of switching out ice cubes or gel packs. The VPulse also features a removable data card, which records patient compliance for physician monitoring. The company says it hopes to reduce hospital DVT-related readmissions after total joint surgery, especially as bundled payments become the norm.

An App to Engage With Patients Before and After Surgery
The Twistle App (twistle.com) interacts with patients pre- and post-operatively, and lets physicians monitor recovery remotely. Physicians can set up programs to ask patients specific care questions, depending on the procedure. After the patient downloads the app, they'll receive prompts before surgery asking them the compliance questions, like if they've used their CHG wipes that day. After surgery, the app can send patients follow-up questions about their pain, can sync to their Fitbit monitors to track post-op activity and can even let patients snap photos of their surgical wounds so docs can see how they're healing.

Patient-specific Implants Shipped to You
Conformis has expanded its line of patient-specific total knee implants with iTotal PS, a posterior-stabilized device. While its previous knee implants were cruciate-retaining and kept the patient's posterior-cruciate ligament intact, this posterior-stabilized prosthesis lets the surgeon remove and replace the ligament. That can make surgery simpler and more efficient, the company says. The system works similarly to its other implants: Patients first undergo CT scans of their hip, knee and ankle, which are then sent to the company. Conformis then uses 3D printing to create the patient-specific implant and cutting blocks, and ships the devices to the facility — along with all of the tools needed to complete the surgery — in a single box.

Blood-repellent Surgical Site Markers
One of the biggest surgeon complaints about orthopedic navigation systems is that the metal markers used to indicate the surgical site can be difficult to assemble and can become covered with blood and tissue, disrupting the navigation's imaging. To address those challenges, Brainlab created ClearLens instruments, which are single-use, blood-repellent markers. They come preassembled and simply snap onto the navigation system, saving set-up time in the OR. Since they repel bodily fluids, they allow for continuous and consistent navigation, so the surgeon can see the bone and soft tissue in real time with few interruptions.

New Lumbar Total Disc Replacement Implant
The ActivL Artificial Disc from Aesculap is the first lumbar total disc replacement implant to be launched in more than 10 years, says the company. Instead of undergoing spinal fusions, which can be painful and unsuccessful, patients can receive this prosthesis in a one-level lumbar disc replacement surgery. The disc features cobalt chromium endplates that affix to the patient's vertebrae with bone-sparing spikes for better stabilization. It's a great procedure for 23-hour stays, a rep says, and has a 45-minute skin-to-skin procedure time, depending on the skills of the surgeon.

Sterilize 300 Pounds Worth of Instruments at Once
The Cube MTS300 from Steris/IMS is an oversized rigid sterilization container set to change how you reprocess instrument-heavy cases like total joints. It eliminates the need to individually wrap and sterilize up to 12 trays. Instead, you simply insert the trays into The Cube, which is then sterilized as a unit. It can hold up to 300 pounds worth of instruments, has a dry time of 30 minutes and stays sterile for up to 30 days. When you need the instruments for the case, you simply wheel The Cube into the OR, unload the trays and it's ready to go.

3D Motorized C-arm With Small Footprint
The RFD3D C-arm from Ziehm is a first-of-its-kind 3D motorized C-arm that gives your docs clearer, more accurate images in a small and convenient model. The C-arm's flat panel reduces the dose of fluoroscopy and produces an easy-to-read rectangular image. The system features 2D and 3D imaging capabilities while only having the OR footprint of standard C-arm models. The 3D imaging also allows surgeons to see the angles of hardware insertion more clearly, making it ideal for use in orthopedics, spine and trauma surgery.

— Kendal Gapinski