Digital support for surgeons during knee operations

Summary

ACL-X

During surgery of the Anterior Cruciate Ligament (ACL) in the knee joint, the surgeon can use an X-ray image intensifier to improve the precision of the drill canals. Today, manual measurement of the intraoperative X-ray image is necessary to determine the optimal drill channel position. However, this procedure is cumbersome, time-consuming and error-prone, which could reduce the required precision and increase the risk of errors.

ACL-X simplifies the intraoperative procedure and makes it more accurate and reliable. The surgeon (or an assistant) can import the radiograph into the ACL-X app and position virtual guidelines that can be used to precisely reference and quantify the actual drill wire position in the femur and tibia to the radiographic anatomy. If the app is used by a trained assistant, sterile packaging of the iPhone is not required.

More information on the official website

Challenge

The idea for ACL-X arose directly from the daily surgical routine of a cruciate ligament surgeon in the Sportsclinic Cologne in Germany. It seemed imprecise, time-consuming and outdated to perform the measurement of an intraoperative X-ray image during cruciate ligament surgery – if at all – with the help of manual ruler measurements on the X-ray image. The question was: would it be imaginable to support the surgeon during cruciate ligament surgery with the help of a smartphone app?

In order to avoid any user hurdles, the app had to be applicable as a separate tool that could be used quickly, – i.e. without a lengthy login and without complex integration into other systems. The approach was to simply “partially digitalize” the known process based on the X-ray image: A photo of the X-ray image had to be sufficient to virtually draw auxiliary lines on it in the app. On this basis, the actual drill channel position could be referenced and quantified according to a recognized, scientific calculation method.

Process

In a prototype, Linova, with the expert support of a cruciate ligament surgeon, first validated the basic feasibility of the core features: the use of a simple photo of an X-ray image as a basis and the overlaying of the image with virtual guidelines in order to calculate the optimal drill channel position according to the quadrant method by Bernard and Hertel.

A professional UI/UX design, security hints, continuous context help, in-app-purchases for calculation contingents, an archive as well as an export function gradually rounded off the app for productive use.

The smooth, agile implementation and integration of these features also highlighted the benefits of our development and collaboration processes and tools in the Sportsclinic Cologne, Linova and QuickBird Medical network.

Result

The ACL-X app has quickly proven its practicality in use in surgical centers such as the Sportsclinic Cologne. The app is quickly at hand and can also be operated by an assistant, for example, without any major interruption in the surgical procedure. With minimal effort, results are achieved in no time at all that clearly surpass previously used methods in terms of accuracy and reliability.

We are positively surprised, but also feel a sense of confirmation that an important work step has been fundamentally digitized with an app that is essentially quite simple, that processes have been simplified and accelerated as a result, and operations have been better secured.

Screenshots

Future

The benefits of the ACL-X app are being brought to the attention of target users – cruciate ligament surgeons – at medical conferences – with consistently positive feedback. Based on input from these real-world users, we plan to further optimize the app into a fast, even more helpful tool for knee and cruciate ligament surgeries.

Thanks to its modular design, the ACL-X app can also be expanded at any time to include further calculation methods and additional features, such as a connection to a patient management system.

It is also well conceivable to apply the basic principles of the app to other surgical procedures and their preparation.

You want to realize an app idea?

Contact us without obligation. Together, we will take a look at how much effort would be required and in what time frame implementation would be possible. We can also provide technical feedback on the sticking points of your project.

QuickBird Medical

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