Health & Wellness


By Meg Waters     8/8/2017

Mission Hospital is the first hospital west of the Mississippi to offer an innovative new technology to improve the success of shoulder and other joint replacement surgeries. According to orthopaedic surgeon Dr. Ari Youderian, the new Exactech GPS system is a game changer for delicate shoulder replacement surgery. “Shoulder replacement surgery is complicated because the physiology of the shoulder makes it difficult for the surgeon to see what is behind the bone and adjust for variances that may not have been visible in pre-operative CT scans or X-Rays. The result is that sometimes replacement parts wear out or get loose.”  

Dr. Youderian was part of the research and design effort that developed the Exactech GPS system to give the surgical team a three-dimensional view of the shoulder and the progress of the surgery in real time. Because of his involvement, Dr. Youderian was able to bring this technology to Mission Hospital as an early adaptor. “The hospital was very excited and supportive and everyone has worked extremely hard to bring this equipment and procedure to Mission’s patients.” 

The FDA approved the technology within the last few months, and already Dr. Youderian has completed more than a dozen procedures. “It is still early so we do not have long-term studies, but already I see that the patients can leave the hospital within a day and their recovery post-op is pretty amazing.”  

The Exactech GPS stands for Guided Personalized Surgery according to the manufacturer: “Exachtech GPS is a compact, standalone large touch screen tablet and proprietary camera that integrates into the sterile field for easy access and improved line of sight.”  

The shoulder is unique because of the way it works, very little of the joint is exposed. By contrast, the knee is much more exposed during surgery. The replacement shoulder must be seated precisely or parts will wear out faster and need to be replaced. Before this technology, surgeons reviewed CT scans and X-rays to develop a surgical plan based on the patient’s condition. However, during surgery, things can look different, and it is difficult to assess.  

“All we see in surgery is the surface, not what is in or behind the bone”, says Dr. Youderian. “This technology allows us to see things that we were never able to see before, such as the drill as it enters the bone. This means that we can be far more accurate.” 

In addition to offering local patients the new technology, Mission Hospital has been designated as a visitation site for surgeons from all over the world to come and learn how to use the technology. “My colleagues tell me this is truly the ‘latest and greatest’ especially for shoulder replacement. Every surgeon who sees this is amazed.”  

The typical candidate for shoulder replacement is usually age 45 or older and has severe arthritis or an inoperable torn rotator cuff and is not helped by non-surgical remedies. The process can also be applied to hip and knee replacement surgeries.