Most of us tap the GPS on our mobile phone when we’re driving to an unfamiliar location. Advanced technology called ExactechGPS – introduced recently at Yavapai Regional Medical Center (YRMC) – uses the same principles to guide orthopedic surgeons performing reconstructive shoulder surgery. In the world of orthopedics, GPS is the new acronym for Guided Personalized Surgery.
“This is truly amazing technology,” said Bradley Williams, MD, PhD, a YRMC orthopedic surgeon who specializes in sports medicine, arthroscopic surgery, and reconstructive surgery of the knees and shoulders. “I spend lots of time researching technology that’s under development in the orthopedic world. Sometimes, I’ll decide to watch how a technology develops before pursuing it for my patients, but with ExactechGPS, I jumped on it right away.”
The first computer navigation system for shoulder surgery, ExactechGPS is breakthrough technology. Dr. Williams was confident it would benefit many people he treats. In fact, Dr. Williams was the first orthopedic surgeon in northern Arizona to use ExactechGPS, which became part of YRMC’s Orthopedic Surgical program in the spring of 2019.
Total Shoulder Replacement Surgery and ExactechGPS Shoulder Application
To understand ExactechGPS, it’s helpful to know that total shoulder replacement and reverse total shoulder replacement surgery – a common shoulder replacement at YRMC – are complex procedures that have improved immensely over the years.
“Orthopedic surgeons performing reverse shoulder replacement 20 years ago had to learn the optimal placement of the surgical screws in the shoulder,” Dr. Williams said. “Now, you gather information and put into the ExactechGPS, and you’re assured that the placement is precise.”
Achieving that precision with the Exactechgps surgical technique takes planning that begins before Dr. Williams steps into an operating suite at YRMC. Each patient undergoes a CT scan that provides information on their anatomy and the condition of the shoulder. Using the ExactechGPS pre-operative planning function, Dr. Williams virtually performs the patient’s surgery on a computer. He determines if the patient needs to have bone removed during the surgery and selects the best baseplate for the patient.
“The ExactechGPS actually allows you to trial different baseplates and see how they’ll work for that individual patient,” he explained. “You see where the baseplate should be implanted and how deep it should be placed. All that is accurately figured before surgery.”
From Virtual to Reality
In the operating suite, Dr. Williams consults the virtual surgery plan before beginning the actual procedure. He carefully checks the images of the patient’s shoulder displayed on the ExactechGPS screen. A tracker – placed on the patient’s bone – provides information on the patient’s individual anatomy and joint movement. This helps Dr. Williams verify if bone needs to be removed as well as to correctly place the implant.
“Before ExactechGPS, total shoulder replacement or reverse total shoulder replacement would be difficult for older people with fragile bones or people with extensive trauma,” Dr. Williams said. “This technology has changed that. You can walk out of the operating room and know the implant placement is exact.”
A Shoulder-to-Shoulder Comparison
Dr. Williams’ first ExactechGPS patient was in her late 80s. A few years earlier, she had undergone conventional surgery for relentless shoulder pain that didn’t respond to injections, physical therapy or other treatment. While the patient’s conventional surgery went well, both the operation and recovery were difficult.
“There was a big difference between the first surgery on her right shoulder and the ExactechGPS procedure on her left shoulder,” recalled Dr. Williams. “The ExactechGPS went faster and her recovery was immediate. When I saw her for a follow-up visit, she told me there was no pain following the procedure.”
That first surgery, and others that followed, have reinforced with Dr. Williams the value of ExactechGPS.
“I continue to be impressed by the results,” he said. “It’s great that people don’t have to live with shoulder pain.”
Visit Orthopedic Surgical Services for information about other YRMC orthopedic services.