by John Carroll

Dr. Kenneth Bramlett has had years of experience trying to gauge the severity of a child's knee injury or an adult's arthritis through an MRI or by using his fingers in a probing clinical examination. But in many cases Dr. Bramlett never got all the information he really wanted for his diagnosis.

Now, though, he can look right at the damage.

About six months ago, Dr. Bramlett - an orthopaedic surgeon and clinical director of a Southeast orthopedics clinic - began to use Arthrotek's InnerVue Diagnostic Scope System. A 1.9 mm fiberoptic tube - about the size of a surgical needle - can be inserted directly into a knee or shoulder. A tiny camera gives the doctor a crystal clear, digital image of the tissue or bone injury, making it possible to make a visual examination of the damaged area inside the body.

"We can stick this in there and three minutes later make a diagnosis," says Dr. Bramlett. Patients only require a quick shot of Lidocaine to dull any pain in the region of the examination and they're able to leave the physician's office after the examination under their own speed. "It's a very efficient, very quick and easy device to use."

And it's designed to give patients the information in a way that they can understand exactly what needs to be repaired - and share that information with their family and friends, if they like. "You can make a CD, so when the patient gets through he has a CD of his condition," says Dr. Bramlett, which includes the voice-over of his examination as he is looking at the image.

The use of the system - a device that is about five feet tall and mounted on wheels - costs $500 for each examination, says Dr. Bramlett, but that is typically covered by insurance and is far less than what most other advanced diagnostic devices can cost. Jeremiah Hirsch of Arthrotek adds that there is a disposable scope that costs $700 that has to be replaced after each use. The device itself, he adds, costs $35,000.

For Dr. Bramlett, it's another long stride down the path to a fully digitized practice. And the technology has been turning heads around the country. Last year it was inducted into the Space Technology Hall of Fame in Colorado Springs, one of the premier annual gatherings of the space industry.

Dr. Bramlett's group was used as a testing site to demonstrate how the device could be used in a clinical setting. And the manufacturer cites a variety of advantages in a clinical setting. According to Arthrotek, the InnerVue System is:

o More accurate than MRI, particularly with diagnosis of cartilage damage, articular surface damage and assessing arthritis severity.

o Offers the ability to view the injection location for cortisone or hyaluronic acid injections.

o Quick, giving doctors the ability to acquire an immediate diagnosis.

o Simple, consisting of one needle poke (excluding local anesthetic) and the patient may walk out of the office immediately after the procedure.

o Exact, with the ability to determine the type of implant to provide the best treatment for a patient (e.g. a unicompartmental or total knee).

o Able to keep the patient in the doctor's office, eliminating the need of an offsite MRI.

o A less invasive alternative to exploratory surgery for patients that have had metal implanted.

For now, says Hirsch, the company is focusing on marketing the device to orthopaedic specialists. But the InnerVue system is FDA-approved for all body cavities other than the spine and some ear, nose and throat specialists have been indicating that they may start to utilize it as well.