Diagnostics & Imaging Week

As the population ages, more and more people in the Baby Boomer generation are utilizing orthopedic surgery to keep their bodies in top operation longer, taking advantage of new technologies to do just that. And new orthopedic technologies are getting a boost via new computer technologies.

Supplying front-line original equipment manufacturers (OEMs) are companies like Cedara Software (Mississauga, Ontario), an independent developer of medical software technologies and part of Merge Healthcare (Milwaukee). Cedera this week reported the introduction of a new version of its OrthoWorks ProPlanner with new automated featurees.

The automation is designed to streamline planning of orthopedic procedures via integration into existing imaging platforms, such as Picture Archiving and Communication Systems (PACS).

“These procedures right now are being planned essentially manually by taking X-rays and then with a pen, a marking pen, just actually measuring the sizes [of implants] that are needed and then fitting them in by drawing them on the acetates,” Loris Sartor, president of Cedara, told Diagnostics & Imaging Week.

Because the current method for pre-surgical planning is completed manually, the process is “prone to error” and “time consuming,” Sartor said.

OrthoWorks has been on the market for about four to five years in “various forms,” she said, and has been “well received” by Cedara’s customers, which include OEMs. Sartor said the continued progression of OrthoWorks has been an “iterative process” that has involved its collaborative partners, including orthopedic surgeons.

In the previous version, a surgeon would select whatever implant he or she wanted to utilize from an implant family and place it on the image screen before manually determining where to place it surgically.

The new version of OrthoWorks ProPlanner makes this unnecessary, identifying the correct location and determining placement automatically.

As to whether the new version is more accurate due to the automation, Sartor said, “I would just say it improves consistency . . . .”

Cedara said that OrthoWorks ProPlanner combines image manipulation and automation with an architecture designed for integration and customization according to OEM specifications. By supporting not only surgical planning, but also templating, archiving and distribution, the system offers a “digital solution” for joint arthroscopy, trauma and deformity correction, among other types of procedures.

The system is built with what Cedara calls its ImageSnap Technology. It automates steps such as “image stitching,” which — in instances where the anatomy cannot be see in one image — multiple images can be fused together. Image stitching might be required in procedures such as total knee replacement and spine surgery.

Another example, in a hip replacement procedure, the ProPlanner automatically overlays a suggested implant size and position on the image. At that point, a surgeon would be able to “accept, reject or revise” the automated planning recommendations.

ProPlanner also includes and automatically reports such items as images, measurement, templated implants and patient demographics, giving the surgeon the ability to add technical notes to the report.

The system also supports digital computer-aided detection-based templates from all major implant manufacturers. Sartor described that accomplishment as a “challenge.”

“We have agreements with all the major vendors, constantly updating our libraries and make them available to all our customers,” he said.

Cedara said that Tallahassee Orthopedic Clinic (Tallahassee, Florida) has tested the ProPlanner recently with its PACS in an effort to enable surgeons to plan surgeries more efficiently.

“ProPlanner’s automatic templating makes hip planning less time-consuming and tedious and has proven useful in helping me select the right implant,” said orthopedic surgeon Robert Thornberry, MD, of Tallahassee Orthopedic. “Workflow and the organization of case information also are improved with the ProPlanner reporting features.”

Sartor said the key difference in the new version of OrthoWorks ProPlanner is that it can be integrated into existing PACS solutiosn through Cedara’s C4 (Cedara Clinical Control Center) integration platform.

In other news from the company, Cedara unveiled an agreement with Biotronics3D (London) granting Biotronics 3D a license to market C4-enabled versions of its 3Dnet Suite family of 3D visualization software.

Biotronics3D will distribute C4 enabled Biotronics3D applications to OEMs that are adopting the C4 framework and other C4 clinical application modules from Cedara and its other partners.

The C4 (Cedara Clinical Control Center) platform is a software framework that enables a host application to obtain plug-and-play access to an array of application modules after completing a one-time integration.

C4-enabled plug-in modules can be launched from any C4-enabled host, a PACS or clinical workstation for example. The growing portfolio of C4 enabled plug-in modules now includes three Biotronics3D applications (3D Virtual Colonoscopy, 3D General Diagnostic and 3D angiography) and Cedara’s own C4 enabled applications, including I-ReadMammo, PET/CT and OrthoWorks Pro Planner. C4-enabled I-ReadMammo and C4-enabled PET/CT are “works-in- progress,” the company said.

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