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ARVIS offers orthopedic surgeons a wearable AR headset used during surgery to help accurately place hip and knee implants

July 22, 2022

WILMINGTON, Del.–(BUSINESS WIRE)–Today, Enovis (NYSE: ENOV), an innovation-driven medical technology company, announced the commercial launch of ARVIS^® (Augmented Reality Visualization and Information System) with over 200 cases successfully completed in the U.S. This FDA-cleared system is the only proprietary, real-time, hands-free augmented reality (AR) technology precisely engineered for orthopedic surgeons, so they can visualize precision guidance when performing hip and knee surgery with the support of AR.

AR technology is a form of orthopedic surgical guidance technology that helps surgeons place and align implants during surgery. Unlike other traditional robotic systems that require additional staff, ARVIS is a self-contained, wearable surgical guidance device controlled by the surgeon that can either be worn on an ARVIS headband or compatible with the helmets already worn in surgery. ARVIS is designed to ensure surgeons can focus on their patient – not a screen across the room – by empowering them with a hands-free view of the procedure.

“ARVIS was designed to provide surgeons with better information, more confidence and an enhanced surgical experience that integrates seamlessly into their procedural workflow without the need for obtrusive and unnecessary equipment,” said Louie Vogt, President and General Manager of Enovis Surgical. “ARVIS is significantly smaller, but powerful and precise, with a more economical price than large robotic systems.^1,2 In turn, it can be adopted and scaled by a wide array of ambulatory surgical centers and hospitals, meaning more access to more patients wishing to experience the benefits of a technology-assisted knee or hip replacement.”

ARVIS is the first system with proprietary hardware designed to assist surgeons in precisely placing hip and knee joint replacements, to help improve joint replacement recovery outcomes. ARVIS is more sustainable and environmentally friendly than other technologies as well, due to the elimination of single use plastic instruments and consumables requiring disposal. It is AR-supported surgery, through the eyes of the surgeon.

Hip or knee replacement is the standard treatment for osteoarthritis, the most common form of arthritis and the most common cause of disability in adults. Osteoarthritis involves degradation of the joint through the breakdown of cartilage, including articular cartilage and subchondral bone, according to the Mayo Clinic.³

“Having knee or hip replacement is a big decision for any patient. ARVIS provides me real-time feedback at the operative site and guides me as I make cuts and check measurements to ensure that the angles are correct for the best fit and alignment. The screens are located within my line of sight, so I never have to take my eyes off the patient,” said Dr. Michael Nett,⁴ Chair of Orthopedic Surgery, South Shore University Hospital in Bay Shore, NY. “ARVIS gives me further peace of mind as I’m placing small components that can make a big difference for the long and short-term arthritis relief my patients expect and deserve. It’s a game changer.”

ARVIS AR Technology was acquired by Enovis subsidiary, DJO, LLC, as part of its acquisition of Insight Medical Systems on July 5, 2022. ARVIS is compatible with Enovis’ innovative EMPOWR™ Hip and Knee product offerings including EMPOWR™ 3D, Porous and Partial Knee, EMPOWR Acetabular^® and Dual Mobility, along with compatible femoral stems.

For more information, visit enovis.com/arvis.

References:

1. Novak, Erik J., Marc D. Silverstein, and Kevin J. Bozic. “The cost-effectiveness of computer-assisted navigation in total knee arthroplasty.” JBJS 89.11 (2007): 2389-2397.
2. Macario, Alex. “What does one minute of operating room time cost?” Journal of clinical anesthesia 4.22 (2010): 233-236.
3. Osteoarthritis – Symptoms and causes, Mayo Clinic, 2022: Osteoarthritis – Symptoms and causes – Mayo Clinic
4. Dr. Michael Nett is a paid consultant for Enovis Surgical.

About Enovis

Enovis Corporation (NYSE: ENOV) is an innovation-driven, medical technology growth company dedicated to developing clinically differentiated solutions that generate measurably better patient outcomes and transform workflows. Powered by a culture of continuous improvement, global talent and innovation, the Company’s extensive range of products, services, and integrated technologies fuels active lifestyles in orthopedics and beyond. For more information about Enovis, please visit www.enovis.com.

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by: Keni Mac, Sponsored by Colorado Springs Orthopaedic Group

Posted: Jul 22, 2022 / 02:20 PM MDT

Updated: Jul 22, 2022 / 02:20 PM MDT

In today’s Medical Minute, Orthopedic Joint Replacement Surgeon, Dr. Ted Stringer, with Colorado Springs Orthopaedic Group, dives into the the innovation of joint replacement over time. He explains that today’s advanced technology has improved the medical world greatly. Stringer says “digital” is the future of medical procedures.

Visit CSOG’s website to learn how you can schedule your next appointment.
Click here: CSOG.net.

“How long will it take for me to recover from a total hip replacement surgery?” That’s the No. 1 question patients ask Dr. Logan Cooper, a fellowship-trained total joint and reconstructive specialist and orthopedic surgeon at East Falls Orthopaedics. Thanks to an advanced, minimally invasive approach to total hip replacement surgeries, Dr. Cooper assures patients that recovery is quicker than ever. 

“It’s a difficult question to answer because every person is different and there’s not a clear moment when a person can declare they’ve recovered. So, I tell patients that 80 to 90 percent of recovery occurs during the first 6 weeks; then it takes several months to get that last 10 to 20 percent,” Dr. Cooper said. “But the good news is that research and literature consistently show a quicker and easier recovery for patients who undergo an anterior approach to total hip replacement.” 

An anterior approach means the surgeon accesses the damaged ball-and-socket joint by entering from the front of the hip. With the frontal entry point, the surgery is minimally invasive, only requiring one small incision and muscle-sparing, as surgeons don’t need to cut through muscle at all. 

“Because I don’t cut muscle to access the hip joint, patients have a less painful recovery and they can tolerate activities earlier and have fewer restrictions post-operatively,” Dr. Cooper explained. 

Benefits of an anterior approach to hip replacement surgery include:

• Earlier hospital discharge, with some patients returning home the same day
• Less postoperative pain
• Faster recovery times
• More functionality during recovery at home
• Lower risk of a persistent limp after surgery
• Lower risk of hip dislocating after surgery 

During the procedure, an orthopedic surgeon replaces the patient’s worn-out or damaged bone and cartilage with a prosthetic implant made of metal, ceramic and hard plastic. The surgery takes a few hours, and patients begin walking with assistance on their new hip soon after they’re awake and alert. 

One caveat with the anterior approach to total hip replacement surgery: Patients need a surgeon trained, experienced and confident with the more complex method. 

“It’s a difficult procedure to learn. Make sure your orthopedic surgeon is trained and comfortable with an anterior approach, and that he or she performs the surgery frequently enough to stay comfortable with it,” Dr. Cooper said.

For example, Dr. Cooper dedicated years to specialized training and additional education focused on the anterior hip replacement approach so that he can offer superior surgical care to patients. As the specialized joint replacement orthopedic surgeon at his clinic, he performs multiple anterior approach hip replacements every week.

“I received training in the approach from the first year of residency through my fellowship, so I’ve become very comfortable with it and am extremely pleased with my patients’ results,” Dr. Cooper said.

Results confirm that patients who undergo total hip replacement surgery with an anterior approach walk away with renewed quality of life and less pain.

“It’s so gratifying to me and the patient to see such immediate results. I treat people who have suffered chronic pain in the hip for so long that it becomes debilitating. They come to me unable to participate in activities that bring them joy in life. Then the same day we do surgery, those patients tell me how much better they feel and that their troublesome arthritic pain is gone,” Dr. Cooper said.

Arthritic damage is the most common reason people need a total hip replacement. Although arthritic pain typically worsens over time, physicians can provide patients with a variety of helpful treatment options to alleviate pain before considering surgery.

“That’s why I prefer it when a patient comes to see me as soon as they begin having hip pain,” Dr. Cooper said. “We can start with non-surgical conservative care like physical therapy, anti-inflammatory medication and weight loss. There’s not a one-size-fits-all treatment plan. It’s best to tailor our approach to an individual’s situation and needs.”  

If you’re ready for relief from hip pain, schedule a consultation with Dr. Cooper at East Falls Orthopaedics, by calling 208-535-4580.

Healthy patients can expect to go home just one or two days after knee or hip replacement surgery following the introduction of an Enhanced Recovery Joint Replacement (ERJR) program in Canberra.

Orthopaedic surgeon Dr Damian Smith and his team from InMotion Orthopaedics and Physiotherapy are working with hospitals to offer patients the short-stay option.

Dr Smith says patients are keen to get home to their families and their own beds following surgery, and the new program provides them with that opportunity.

Two Canberra patients have already been through the pilot program, coming out the other side with a new lease of life.

Dr Smith says with good preoperative preparation and postoperative support, healthy patients can be discharged from hospital the day after surgery and begin their road to recovery.

“Patient preparation, communication and a great medical and family support network is crucial to the success and optimisation of care,” he says.

“We hold sessions with patients before surgery, which includes preoperative conditioning and strengthening exercises, education and familiarisation with mobility aids.

“The day after the operation, the patient is assessed and, if they are ready and want to go home, they will be fully prepared mentally and physically, and will know what they need to do, such as exercises and using crutches.”

Dr Smith says communication with all parties is essential, and his team has been working closely with hospitals to develop the program, which is being rolled out in Canberra this month.

“Underpinning the success of these programs is the involvement and communication of a multidisciplinary team, including the surgeon, the anaesthetist, allied health, hospital admissions and nurses,” he says.

With waiting lists growing and more people seeking joint replacements, the short-stay program will benefit patients, as well as reducing health costs to the broader community.

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According to the Australian Orthopaedic Association National Joint Replacement Registry, there were more than 51,000 total hip replacements and more than 66,000 total knee replacements carried out in 2019, and Dr Smith says, with an ageing population, demand for these procedures is expected to increase.

He says advances in surgical techniques, anaesthetics and optimisation of pain management has enabled the development of ERJR programs which “aim to improve patient recovery and minimise complications from prolonged hospital stay”.

“Several studies have shown no significant difference in complication or readmission rates with short-stay replacement surgery,” says Dr Smith.

“One study showed a 50 per cent reduction in minor complications and no difference in major complications to traditional longer hospital stay joint replacement programs.”

However, not all hip and joint replacement patients will be eligible for the short-stay option.

They must not have any significant co-morbidities or physical or mental health conditions that would prevent early mobilisation; they must have a body mass index (BMI) below 40; and must have a suitable home environment, which includes being close to a hospital, and having a relative or friend available to assist with care.

Dr Smith says patients opting for ERJR will not be “shunted out the door” after surgery. They can leave hospital when they feel confident.

The program doesn’t change the cost for private hospital patients, and Dr Smith believes it could reduce public health costs as well as waiting lists if it is rolled out to public hospitals in the future.

To find out more about the Enhanced Recovery Joint Replacement program, contact the team at InMotion Orthopaedics.

“There’s great momentum across the AAOS family of registries,” said William J. Maloney, MD, FAAOS, chair of the AAOS Registry Oversight Committee. “The number of anatomical areas and procedures covered continues to grow and the data being submitted by participating sites is paving the way for improved orthopaedic outcomes in the United States. We are pleased to publish these clinical insights from the AJRR and the SER and look forward to seeing continued growth and increasingly impactful analyses in the years ahead.”

AJRR 2020 Annual Report Supplement
Data presented in the 2020 AJRR Annual Report Supplement were submitted to the AJRR by 1,110 institutions through June 2020, covering procedures from 2012 to 2019. For the second consecutive year, the supplement includes reporting of device-specific cumulative percent revision estimates, drawn from the registry’s unique linkage with Centers for Medicare and Medicaid Services (CMS) claims data. In addition, analyses in the 2020 supplement were expanded to include many more devices than the 2019. This year’s analysis also examines cumulative, all-cause revision at target timepoints with further stratification of devices based on fixation and bearing descriptions.

This report found all hip device constructs included in analysis had a cumulative percent revision of less than 2.7% at one year and less than 4.6% at final follow-up for each respective device. Knee device constructs included in analysis were found to have less than 2.5% cumulative percent revision at three years and less than 3.7% at final follow-up for each respective device

To read and download the 2020 AJRR Annual Report Supplement, visit the AAOS’ website.

Shoulder & Elbow Registry Second Annual Report
The SER includes representatives from the American Shoulder and Elbow Surgeons (ASES), the American Orthopaedic Society for Sports Medicine (AOSSM), the Arthroscopy Association of North America (AANA), and the American Society for Surgery of the Hand (ASSH). The SER collects shoulder and elbow procedural data in the United States to establish survivor curves, track revisions, and support orthopaedic care and best practices. The program’s latest annual report represents submitted shoulder and elbow procedures dating from 2015 through 2020.

“The AAOS Shoulder and Elbow Registry is one of the most important endeavors being undertaken in shoulder and elbow surgery,” said SER Steering Committee member Stephen F. Brockmeier, MD, FAAOS. “This data will drive future clinical care, answer critical questions and contribute to research in the field, and dramatically enhance our ability to provide optimal outcomes for our patients. As can be seen in the 2020 SER Annual Report, the Registry data continues to accumulate at a rapid pace, and new procedures are added for study each year.”

To date, there are more than 112 SER participating facilities including hospitals, private practices, and ambulatory surgical centers spanning 35 states across the United States. To read and download the complete 2020 SER Annual Report, visit the AAOS’ website.

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AAOS Registry Program
The AAOS Registry Program’s mission is to improve orthopaedic care through the collection, analysis, and reporting of actionable data. The American Joint Replacement Registry (AJRR), the Academy’s hip and knee replacement registry, is the cornerstone of the AAOS’s Registry Program, and the world’s largest national registry of hip and knee joint replacement data by annual procedural count, with more than 2.4 million procedures contained within its database. Additional registries include the Fracture & Trauma Registry, the Musculoskeletal Tumor Registry (MsTR), the Shoulder & Elbow Registry (SER), and the American Spine Registry (ASR), a collaborative effort between the American Association of Neurological Surgeons (AANS) and the AAOS.

About the AAOS
With more than 39,000 members, the American Academy of Orthopaedic Surgeons is the world’s largest medical association of musculoskeletal specialists. The AAOS is the trusted leader in advancing musculoskeletal health. It provides the highest quality, most comprehensive education to help orthopaedic surgeons and allied health professionals at every career level best treat patients in their daily practices. The AAOS is the source for information on bone and joint conditions, treatments, and related musculoskeletal health care issues, and it leads the health care discussion on advancing quality.

https://www.aaos.org/

Hip and knee replacements can get you back to an active life in a jiffy. Keep this in mind: You are an important factor in determining the end result of surgery. A new hip or knee joint does not work on its own.

But a critical part of the recovery process begins after finishing the last physiotherapy appointment. “You’re already involved in an exercise program,” says physiotherapist Michele Hribar, PT. “Now you have to continue the rest of your life.”

The Importance of Exercising After Joint Replacement Surgery

It is essential to build muscles around the new hip or knee to keep the joint in tip shape. Hribar recommends continuing the specific exercise routine that you have already established with your physiotherapist.

“You really have to optimize the exercises to strengthen the supporting muscles,” Hribar says.

Fitness in general is also important, especially because knee or hip pain before surgery may have prevented you from doing enough activity. This may have caused weakness or limitations in areas other than the affected joint.

“Now that the joint is in better shape, you have a chance to improve and maintain overall fitness,” Hribar says.

You also need to exercise for balance, which can be affected after surgery.

The best exercises after joint replacement

Your workout routine should be a combination of aerobic activity and strength, flexibility and balance exercises. With a walking or cycling program it is not enough for any of the muscles needed for mobility and balance.

Some good news too: when this new hip or knee is put into operation, the activities may seem easier to do. “After surgery, these exercises should be better tolerated because of the relief of joint pain,” Hribar says.

Below are recommendations for sweating in two categories:

Aerobic activities

Aerobic activities make the heart beat faster. To get the ticker to pump, try walking, cycling, or using an elliptical machine. By variety, alternate the different activities. Consider using trekking poles to walk outdoors if you have difficulty maintaining balance and stability.

Once you have fully recovered from joint replacement, you should be able to do virtually any activity you have done before surgery. However, most surgeons do not recommend running.

Before giving up any activity you enjoy, Hribar suggests that you talk to your doctor or physiotherapist. You may be able to return to some higher impact activities or find ways to modify them.

“We’re able to get people back to playing pickle or doubles tennis, even though individual tennis is harder,” Hribar says.

Aim to try to achieve at least 30 minutes of aerobic activity most days of the week.

Exercises of strength, flexibility and balance

Muscle mass and bone density naturally decrease with age. To slow down this process, it is important to have a complete exercise routine.

Strengthening exercises after a hip or knee replacement should include exercises aimed at the quadriceps (four muscles in the front of the thigh), gluteals (three muscles that form the buttocks), and hip abductors (responsible muscles). to move the thigh to the side)).

Try to do focused strength and balance exercises two or three times a week. To build and maintain flexibility, exercises such as hamstring stretches and heel cord stretches should be part of your daily routine.

Find joy in exercise

Hribar points out that there are activities that combine aerobics, balance, strengthening and flexibility. Examples are dance, yoga, tai chi and pool exercises, which can also be social, with face-to-face classes opening once again after the pandemic and online options also available.

“You can make it fun,” Hribar says.

Click here for more info on how to recover after joint replacement surgery.

 

If you have experienced joint pain due to arthritis, you may be wondering if you need a knee or hip replacement. When considering a joint replacement surgery, there are some ways to determine if you are ready to talk to your orthopedic provider.

Chad E. Smith, MD, orthopedic surgeon at the Norton Orthopedic Institute, suggests thinking about the following three factors:

Pain

Does hip or knee pain come and go? Does it occur only during intense activity? Or is it constant and interferes with everyday life?

If the pain comes and goes, you may not be ready for surgery. The good news: There are some non-surgical ways to get relief. These may include taking nonsteroidal anti-inflammatory drugs (NSAIDs), steroid injections, or physical therapy.

Age and activity

Then think about your age and activity level. If you are active and would like to stay active for many years, a hip or knee replacement may be possible. Surgeons perform joint replacements on younger patients than in the past, however, surgery will not normally be considered until age 50. In addition, unless X-rays show moderate to advanced arthritis in the knee or hip, non-surgical treatment will be recommended.

Weight and health in general

Finally, how is the rest of your health, including your weight? Carrying extra weight is an important factor in knee or hip pain. Surgeons typically do not perform knee replacements in patients with a body mass index greater than 40, as they increase complications during and after surgery.

However, there are physiotherapy programs designed to help you lose weight, while also supporting and aiming to improve painful joint. Your healthcare provider can help you find a physical therapy or weight loss program that fits your needs.

Do you have heart disease or diabetes? Is your diabetes controlled with an adequate level of hemoglobin A1C? Chronic medical conditions need to be optimized before surgery.

You will also want to make sure you are mentally prepared for a couple of difficult weeks after surgery.

Can pain be overcome during physiotherapy while working to strengthen and move the new joint.