Pioneering surgeon uses AR technology to restore ex-soldier’s mobility

A top surgeon has used augmented reality technology like that used by the US Army’s Apache helicopter gunship pilots to get an ex-soldier back on his feet – and his bike.

Hip and knee specialist Alan Highcock, based at Spire Murrayfield Hospital at Barnston puts on a computerised headset similar to the one worn by Apache pilots when he performs delicate operations to rebuild damaged knee joints.

He is the first surgeon in the North of England and one of the first in the UK to use the pioneering AR (augmented reality) technology developed in France that superimposes a computer-generated image on the view of his real-world surgery.

Ex-Royal Corps of Transport soldier and keen scuba diver Robert Riley, 60, was one of his first patients to benefit from the high-tech method.

The operation, carried out at Spire Murrayfield Hospital, took just over an hour under general anaesthetic and is far less invasive than traditional knee replacement procedures.

Alan Highcock wearing the computerised headset

A few weeks later keen golfer and scuba diving instructor Robert, an HGV delivery driver for aviation fuel from the Stanlow oil refinery, is back on the golf course and planning to start diving again after severe arthritis in both knees forced him to give up his favourite pastimes nearly three years ago.

He explained, “I was really getting depressed. I couldn’t do anything. I have dived all over the world but if we went on holiday I could get into the swimming pool but I couldn’t get out again and there was no way I could get on a golf course or go scuba diving.

“If I put all the diving gear on I couldn’t stand up and I couldn’t even kick a ball around with my seven-year-old grandchild.

“I was 58 and in the space of 12 months I had gone from someone who could yomp up Moel Famau with the grandkids to needing sticks just to walk.”

His weight ballooned to 23 stone as he faced a wait of over two years for operations on the NHS and he said, “I’d have been in a wheelchair by then but my wife, Joy, had gone behind my back, cashed in her pension and got me an appointment with Mr Highcock who is a Wirral lad himself.”

Fourteen months ago, Alan operated on Robert’s left knee successfully and then just 11 weeks ago he used the new technique wearing an innovative Augmented Reality headset which allows him to see superimposed images and data as he operates.

Alan, originally from Bromborough, trained as a doctor at the University of Liverpool and went into orthopaedic surgery, becoming the first winner of the world renowned Biennial International Fellowship Award in 2015 at Mount Sinai Hospital in Toronto, Canada, to work under the supervision of renowned surgeon Dr Allan Gross.

He said, “It’s very important to get the angle of the thigh bone exactly correct and the AR technique makes it much easier to do that.

“The conventional method involves cutting into the thigh and placing a metal rod inside the femur to get the correct angle for the new knee joint, a technique that can cause a lot of bleeding.

“AR superimposes the axis for the cut onto the leg which I can see while I operate. It is more accurate which should give a better outcome and because you don’t have to insert the metal rod there is much less blood loss, less post-operative pain and a quicker recovery.”

The new metal and plastic knee joint comes in different sizes to fit each patient exactly, while the futuristic-looking headset is manufactured in France by Pixee Medical and distributed by MicroPort Orthopedics based in Chester.

The headset precisely calculates the 3D coordinates of the hip, thigh bone and knee for the surgeon to guide the position of the replacement, using QR code markers picked up by the integrated camera and displayed in the surgeon’s field of vision.

Alan is now pioneering this technique with the Evolution® Medial Pivot knee system and is performing this surgery regularly.

He said, “It’s important that the angle of the femur is as accurate as possible to allow the ligament structures of the knee to work in harmony with the implant – the personalised alignment ability of this technology allows angular placement of the knee to within a single degree of accuracy.

“AR is the next big step in orthopaedic surgery. It allows you to see all this additional information while still looking at what you’re doing. You don’t have to look away at a screen but can remain focused on what’s in front of you.

“It offers greater accuracy and a quicker and more complete recovery – that means better outcomes for our patients.”

Robert, who hopes to return to work soon, is certainly happy with his new knee, said, “I could kiss Mr Highcock. He asked me if he could use the AR technique and I said yes.

“The first op has made a real difference to me but the second with the AR has healed better and more quicky, the bruising wasn’t severe and I’m thinking of going back to work just 11 weeks afterwards.

“It’s given me a new lease of life – I never thought I’d be walking along New Brighton front again, eating ice cream with the grandkids. I’ve even bought a pushbike now with an attachment so one of them can ride behind me.

“It was horrendous being housebound, so depressing, but now I’m just so grateful. He’s a lovely fellow and he certainly knows his stuff.

“I also have to say a big thank you to Reynolds Logistics who I work for in Ellesmere Port because Andrew Reynolds, the Transport Manager Darina Corr and all the staff and my fellow drivers have done their utmost to help me over the past two years.”

Image credit: Mandy Jones Photography

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