LATEST LOCAL

TRENDS IN
ORTHOPEDICS

SUBMITTED BY:
BACOSA, BERNADETTE B.
BSN 4A
 BONE BANKING
• Also known as “TISSUE BANKING”

• enables medical experts to use bone

from a non-related donor to replace or
repair the diseased bone part of
another person
Bone Bank
• refers to the facility that retrieves,
processes, stores and distributes
these bones for safe clinical use.
• equipped with an ultra-low
temperature freezer that allows
bone and other biologic tissues to
be stored at a temperature of -80°
Celsius.
• This temperature reduces the
immune response between the
transplanted bone and the recipient.
After a potential donor passes the
required rigid screening tests, bones
are retrieved under sterile
conditions, properly packed, and
stored.
 Retrieval, processing, storage and
distribution of bone from a non-
related donor (allograft bone) for
use in:
• A. Limb-saving surgeries in
selected cases of benign and
malignant bone tumors
B. Reconstructive pediatric
orthopedic surgeries
C. Spine and joint fusion surgeries
D. Complete primary and revision
total joint replacements
• Available only in St. Luke’s
Medical Center here in the
Philippines adhering to the
policies and protocols
recommended by the
American Association of
Tissue Banks and the Asia-
Pacific Association of
Surgical Tissue Banking
FITBONE TECHNOLOGY

• St. Luke's Medical Center's

Institute of Orthopaedics and
Sports Medicine showcases the
latest technology in limb
lengthening and strengthening.
• Wittenstein intens GmbH, the
manufacturer of Fitbone
instruments, in partnership
with Munich Hospital, chose
St. Luke's as one of five
medical institutions in Asia
authorized to perform this
breakthrough procedure.
- originally intended to correct
shortened or deformed limb
bones caused by injury,
disease or other causes like
congenital defect.
• Today, it is the latest technology
in limb lengthening and
strengthening. Through this
technology, an individual can gain
up to 180 mm in height in about
six months.
• can be applied to "stretch" both
the upper and lower bones of the
legs and even the bones of the
upper arm, allowing the patient to
achieve an increase in height.

• Patients should at least be 17

years old and in good health.
• helps patients with limb length
inequality and limb deformities
(shortened or deformed limb
bones caused by injury, disease
or congenital) to correct defects
that require angular correction
and/or lengthening; and those
who desire to gain additional
height for cosmetic reasons.
• The Fitbone procedure is much safer
to use and simpler to perform
compared to the conventional bone
extension surgery methods known
today. Unlike the external frame that
is bulky and seen on the outside, the
Fitbone is placed intramedullarily or
inside the bone.
• It uses a steel implant that
gradually lengthens when
activated by a wireless control
unit. The device is inserted into
the hollow of a bone that has
been cut crosswise. The device,
activated by the remote control
unit, increases in length at 1 mm
a day. The bone's cut ends grow
and fuse eventually.
• It takes about two to three hours per
limb to complete the operation and a
period of three to five days is allowed
for pain and swelling to subside.
Rehabilitation can start as early as one
week from the day of operation since
the fixation is stable. When the desired
length is reached, it would take about
three months more for the bone to
gain its normal strength.
 COMPUTER NAVIGATED
SURGERY
• available only in limited centers
around the world and St. Luke’s
Medical Center was the first in the
Philippines that acquired it for
orthopedics
• introduced in 2004 and has
been in use for surgeries
involving the brain and spine,
head and neck region, and
joint replacement.
• technology being used in
computer-assisted navigation
surgery is similar to the location
and directional tracking systems
being utilized in air and sea
transportation, i.e. GPS system.
• The Vector Vision System is
equipped with two cameras that
function as satellites that detect
images over the operating field.
The anatomy of the operative site
is assessed and a three-
dimensional image is generated
into the computer, either
computed-tomography or
fluoroscopy-based.
• As the surgeon utilizes various
instruments, the camera
calculates their position –
accuracy and precision – and
transfers data into the computer.
Values are generated from
placement of these instruments
thus decreasing surgical errors.
TWO MAIN ADVANTAGES

• Safety for the patient and

surgeon
• high surgical success rates.
COULD BE USED IN:
• Spine surgery- allows the
surgeon to perform osteotomies,
vertebroplasties, scoliosis
correction and pedicle screw
placement in spine trauma and
degenerative conditions with
greater accuracy and precision –
thus, reducing radiation exposure
• Computed tomography, fluoroscopy
or combined images are generated
from the computer giving the
surgeon comprehensive information
and three-dimensional view of the
spine. This enhances the orientation
and widens the view for surgical
approaches. Pre-calibrated
instruments enable the surgeon to
navigate more precisely and
efficiently to calculable target
positions with minimal exposure.
TOTAL KNEE REPLACEMENT

• a patient-specific bone model is

created intra-operatively
providing a template for
determining the amount of bony
resection on the femur and tibia,
positioning of the implants and
assessing alignment of the
mechanical axis.
• With these advantages,
surgical errors are detected
and corrected earlier during
the surgery thus improving
outcomes.
TOTAL HIP REPLACEMENT
• With a three-dimensional template
of the hip, ideal implant size and
position can be precisely
determined and accurately placed
thus increasing confidence of the
surgeon. Image-guided leg length
control and analysis of range of
motion prevents and minimizes
post-operative complications
such as limb shortening and
dislocations.
 TRAUMA
• visualization and manipulation of
multiple fluoroscopic images across
different planes simultaneously
greatly reduces the over-all number
of images needed for surgery. Motion
of fracture fragments is viewed in real
time aiding the surgeon in reduction.
• The optimal size and position of
various fixation devices such as
intra-medullary nails,
compression plates and inter-
locking screws are planned prior
to their placement. These help
reduce operative time and
radiation exposure.
Center for Joint Replacement
Surgery (CJRS)
• the only center in the country that
caters primarily to joint
replacement surgical cases
involving the hip, knee, shoulder
and ankle joints.
• utilizes state-of-the-art
mechanized systems, like power
tools and intraoperative imaging
modalities, which result in high
success rates and long-term
favorable results with few or no
complications.
Replacing a diseased
hip joint

- a diseased hip joint can now be

replaced with an artificial joint
which relieves stiffness and pain,
as well as allows normal
movement to once again become
possible.
Total hip replacement
• is a surgical procedure for re
placing the hip joint
• will provide complete or nearly
complete pain relief in 90 to 95
percent of patients. It will allow
patients to carry out many normal
activities of daily living.