New technology boosts shoulder surgery precision at Mediclinic Worcester

The Arthrex Virtual Implant Positioning (VIP) System is a new tool that helps make shoulder replacement surgeries more accurate and tailored to each patient. 

For almost a year, it’s been improving outcomes for both surgeons and patients at Mediclinic Worcester.

Innovation in orthopaedic surgery

“Joint replacements are nothing new, but we’re now using software to make them more accurate,” says Dr Peter O’Farrell, a leading orthopaedic surgeon at Mediclinic Worcester who specialises in upper-limb and hand surgery. Dedicated to optimal patient care, he is constantly upskilling himself. The fulfillment that comes with practising medicine comes with using evolving medical technology to better help patients. To this end, he uses the Arthrex VIP System, a tool that supports the hospital’s commitment to modern, high-quality care.

By using advanced virtual planning, the system helps surgeons deliver the best possible outcomes. For example, with robotic-assisted knee replacement surgeons can complete all their planning before the procedure. During the operation, a computer helps guide them to make highly precise cuts. “That’s exactly where we’re heading with shoulder replacement surgery,” Dr O’Farrell says.

“The VIP System utilises a CT scan of the patient’s shoulder and then, using computer technology and AI, it creates the area where it thinks the implant should be. This allows the surgeon to pre-plan the operation on a 3D model.”

This system doesn’t involve 3D printing, as the 3D modelling is all done on the computer, he adds. “You can do all the work before the surgery so that you know exactly where to insert implants and screws and how much of the bone to cut off.”

Surgical advantages

Before, shoulder arthroplasties involved making a cut, looking inside, and trialling a few jigs to find the right place for the implant. This was to see which one worked best and whether the soft tissues were balanced, Dr O’Farrell explains. If changes were needed, they were made during the surgery by cutting or loosening tissues. The whole process relied heavily on the surgeon’s experience.

“The process is a lot more precise and guided with the VIP System, because you've already done all the 3D modelling. It’s basically the equivalent of 3D-printing the whole anatomy and running through the entire procedure beforehand. We create a 3D model of the patient’s shoulder – what it looks like before surgery, and what it should look like afterwards. So, when you operate, you know what your best-case scenario should be.”

Thanks to the new system, the correct implant can be designed in advance. Surgeons get thorough training to use the system effectively and achieve the best results. Because it works so well, Dr O’Farrell now uses it for all his shoulder replacement patients.

Better patient outcomes

Patients who need shoulder replacements – often due to arthritis, bad falls especially in older patients, or injuries – usually suffer from a lot of pain. But because this system improves accuracy, they tend to feel better faster and are more satisfied with the results, says Dr O’Farrell.

He points to the improved quality of life for patients who undergo successful shoulder arthroplasties. “I get patients who say they can’t brush the back of their hair, or they need to use the other arm to clean themselves when they go to the bathroom. It’s those things that people don’t think about until they can’t do them. If you say to someone, I can get you to stage where you can brush your hair again, they’re interested.”

The VIP System takes out a lot of the guesswork, Dr O’Farrell explains. “The software gives you an idea of how your postoperative X-ray is going to look, so you know in advance what you will see, and which implant will fit best. That means fewer surprises and less need to make adjustments during the surgery.”

This also cuts theatre and anaesthetic time and reduces both potential complications and costs. “The gold standard for any joint replacement is not to have a joint open for more than an hour. After that, your risk of complication increases, which could exacerbate existing pain.”

World-class surgeries

Ultimately, the VIP System brings shoulder replacements at Mediclinic Worcester up to the same standard as those performed at top international orthopaedic hospitals. “Surgeons at those centres do these procedures more often simply because they have more capacity,” Dr O’Farrell explains.

“This technology, which those top hospitals also use, helps close the gap and gives our patients results similar to what they’d get at a leading orthopaedic hospital in the United States. It’s only going to make us better.”