Total knee replacement procedures have been performed since the
1960s and significantly restore function and reduce pain for most
patients.
Despite this success, surgeons in years past were dissatisfied
with the prosthetics’ variable life span, which primarily
depended on two factors: the wear and tear the knee was exposed to,
and the precision with which the replacement components were
initially fitted by surgeons, who had no option but to rely on the
“naked eye” to make their calculations.
In the mid-1990s, UB professor of orthopedic surgery Kenneth
Krackow, MD, an internationally renowned expert in lower-joint
reconstruction and replacement, developed a technology that
circumvented this reliance.
“Many surgeons, myself included, were making judgments
that were not as precise as they could be because we had no
specific data on which to base those decisions,” recalls
Krakow, who also serves as head of orthopedic surgery at Kaleida
Health.
Krackow had the idea to take existing motion-analysis equipment,
such as that being used in the aircraft and motion picture
industries, and adapt it to improve the then-standard total-knee
replacement procedure.
After obtaining the equipment, he worked with UB orthopaedic
research fellows in his lab to make software and hardware
adaptations to it.
Krackow’s graduate education in mathematics and his
interest in computer science and inventing all naturally coalesced
to drive his research.
“One of the reasons I chose orthopaedic surgery as a field
was my expectation that orthopedics was a discipline in which I
could invent,” he notes.
By 1997, a prototype was ready for the operating room and
Krackow performed the first computer-assisted total knee
replacement. In an article he and his group published in the
journal Orthopaedics, they described how the new system enabled
surgeons to make precise decisions on the alignment and orientation
of instruments, the location and depth of bone cuts and the
placement of knee implant components.
A few years later, Krackow partnered with the medical products
manufacturer Stryker Company. The company further refined the
equipment, and they now market it as the Stryker Navigation System:
Knee Module.
In October 2001, Krackow performed the first computer-assisted
total knee replacement outside of Europe using the Stryker
Navigation System and the first FDA-approved total-knee replacement
procedure in this country. Since then, he has introduced the
procedure to orthopedic surgeons worldwide, both in person and via
satellite broadcasts from Buffalo General Hospital.
Comment(?)
