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TRANSCRIPT
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New Developments at Wrightington: 3D printing and movement analysis
Puneet MongaConsultant Orthopaedic Surgeon,
Wrightington Wigan and Leigh NHS Trust
This Talk
• Evolution of Surgery / Orthopaedics
• New Developments at Wrightington
• Looking ahead
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The Past and the Present
The Evolution
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The Evolution
PolioRickets
TBOsteomyelitis
Internal fixationJoint replacement
ArthroscopyMicrosurgery
19142015
Orthopaedics
Orthopaedics= Straight Child
Orthopaedia= Word invented by 83 year old Parisian paediatrician Nicholas André in 1741who wrote a self-help book for parents. “The Art of Correcting and Preventing deformities
in Children”
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Family tree of Orthopaedic surgery
Bracemakers: Care of deformities
General surgeons: Pus, open fractures, amputations
Bone setters: Treated Fractures
Orthopaedics
Family tree of Orthopaedic surgery
Orthopaedics
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How did we get here?
The Three Amigos
Anaesthesia: 1846Asepsis: 1867Xrays: 1895
Advent of Anaesthesia
1559
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2011
Advent of sterile surgery, antibiotics
Lister, Glasgow,1867Use of carbolic acid in surgery
Alexander Fleming, St Mary’s,1928
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Use of Xrays
Roentgen, 1895, Wüzberg,Nobel Prize 1901
World WarsProvided critical mass of trauma
WWI and II Orthopaedic knowledge was tried on a mass scale
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Sir John Charnley
1911-1982
Recreation- “Other than surgery, nothing”
•Manchester Medical school•WWII•Closed treatment of common fractures•Compression arthrodesis•Total hip arthroplasty: HMWPE•Greenhouse•Followed every patient to death
BiomaterialsSiliconeHMWPE
Bone cement
Stainess SteelTitamium
Co-Cr
Ceramic
Orthopaedic surgeons
working with Engineers, Dentists,
Industry and Scientists
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The IT revolution
Digital recordsDigital films
Surgical simulationTelemedicine
Robot assisted surgery
3D printing
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3D printing
Current Imaging
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3 D Print
“3D Printing represents a quantum jump in defining and assessing Orthopaedic osteology”
- Al Najjer, Monga; June2014
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Potential applications for WWL
• Research
• Teaching
• Custom cutting jigs for joint replacements
• Custom implants for joint replacement
• 3 D printing service
Movement assessment
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Basic Science research
Movement Analysis
Kinematic Assessment
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Circumduction
Control Pre-op Post op
Trunk Co ordinates; referenced to the local coordinates
Circumduction
Control vs Pre Op 0.002
Control vs Post Op 0.110
Preop vs Post op 0.214
“Surgical stabilization does not completely restore ROM-Monga, Selfe, Browne, Richards. 2012
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Movement Lab @ Wrightington
Supported by WWL Charitable fund.3D high speed HD synchronized camera system
WWL IT support Key
Applications• Upper Limb Movement Laboratory
• Capture and recording of objective movement data
• Aid to decision making in complex cases
• Biofeedback as treatment mode
• Research and Audit
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Looking ahead.
The MSK disease burden
• 15-30% of GP consultations
• Orthopaedic surgeons largest subgroup At the Royal College of Surgeons
• Key in any healthcare economy
• Everyone will see an Orthopaedic surgeon at some point of time!
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Spectrum of Orthopaedic surgery
• Fix fractures
• Sports Injuries
• Hand surgery
• Spinal surgery
• Microsurgery
• Paediatric surgery
• Joint replacements
Maintaining Our Lead Position
• Research
• Development
• Innovation
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Why am I here?
• Showcase what’s new....
• Facilitate and streamline available support
• Personnel
• IT
• Monetary
Go into Orthopaedics? “Don’t. You will be wasting your surgical talent. Flat feet, crooked backs, and a
few cases of joint tuberculosis” -Advice given in 1910
Join the revolution-2015
Thanks