1. Computer-Assisted Knee Replacement Surgery

2. Knee Replacement Surgery Arthritic surfaces on the tibia and femur are removed. Arthritic surfaces on the tibia and femur are removed. Bones are prepared for new covering. Bones are prepared for new covering. Femoral and tibial components are attached. Femoral and tibial components are attached. Patella is resurfaced. Patella is resurfaced.

3. Addressing Implant Alignment

4. Malpositioning can potentially lead to… Early loosening Early loosening Increased poly wear Increased poly wear Poor function Poor function

5. Computer-assisted surgery can assist the surgeon in providing proper implant alignment, even through small incisions

6. What is computer-assisted surgery? A new approach to knee replacement. A new approach to knee replacement. The patient’s specific anatomy is simulated and displayed on a computer during surgery. The patient’s specific anatomy is simulated and displayed on a computer during surgery. Computer provides information about where to place components for proper alignment. Computer provides information about where to place components for proper alignment.

7. CAS – Common names Computer-assisted Surgery (CAS) Computer-assisted Surgery (CAS) Image Guided Surgery (IGS) Image Guided Surgery (IGS) Computer-assisted Orthopaedic Surgery (CAOS) Computer-assisted Orthopaedic Surgery (CAOS) Computer Navigation Computer Navigation

8. Types of CAS Passive vs. Active Systems Passive vs. Active Systems Use of wires or infrared to communicate to the computer Use of wires or infrared to communicate to the computer Open vs. Closed Systems Open vs. Closed Systems Whether a system’s software can be used with multiple manufacturers’ implants (open) or those of one manufacturer (closed) Whether a system’s software can be used with multiple manufacturers’ implants (open) or those of one manufacturer (closed) Image vs. Imageless Systems Image vs. Imageless Systems Use or non-use of CT scans or fluoroscopy to register patient anatomy Use or non-use of CT scans or fluoroscopy to register patient anatomy

9. Ci ™ System DePuy Orthopaedics’ computer-assisted surgery system, powered by a leading computer- assisted surgery company. DePuy Orthopaedics’ computer-assisted surgery system, powered by a leading computer- assisted surgery company. Passive and image-free. Passive and image-free. Hardware and software are unique to DePuy for use with clinically proven implants. Hardware and software are unique to DePuy for use with clinically proven implants. Optional instrumentation, designed specifically for use with the Ci ™ System, gives surgeons fine-tune precision and reduces the traditional number of surgical steps required. Optional instrumentation, designed specifically for use with the Ci ™ System, gives surgeons fine-tune precision and reduces the traditional number of surgical steps required.

10. How does the Ci ™ System work? Camera searches for arrays placed on the patient via infrared signals. Computer calculates the best position to place the components for accurate alignment Patient’s anatomical information is entered into the computer through a process called registration. Information is fed back to the camera and communicated to the computer

11. Why are surgeons using the Ci System? Assists with new techniques, such as smaller incisions, that reduce visualization. Assists with new techniques, such as smaller incisions, that reduce visualization. Assists with intraoperative decision making during technically demanding procedures. Assists with intraoperative decision making during technically demanding procedures. Enables better precision and accuracy. Enables better precision and accuracy. Addresses patient demand for the latest technology. Addresses patient demand for the latest technology.

12. Benefits Guides surgeon in areas that are difficult to visualize. Relays specific measurements not previously available to surgeons. Gives precise, accurate data on the patient’s specific anatomy – not a “standard” patient anatomy. Fine-tuning instruments allow surgeons to make adjustments within 1 mm and 1 degree of accuracy, guided by on-screen imaging.

13. Thank You