Comparison of organic electroluminescence and liquid crystal displays for clinical utility in orthopedic endoscopic surgery

Abstract

Introduction: Organic electroluminescence displays (OELD) use organic materials that self-emit light with the passage of an electric current. OELD provide high contrast, excellent color reproducibility at low brightness, excellent video images, and less restricted viewing angles. OELD are thus promising for medical use. This study compared the utility of an OELD with conventional liquid crystal displays (LCD) for imaging in orthopedic endoscopic surgery.

Methods: One OELD and two conventional LCD that were indistinguishable in external appearance were used in this study. Images from 18 patients were displayed simultaneously on three monitors and evaluated by six orthopedic surgeons with extensive surgical experience. Images were shown for 2 min, repeated twice, and viewed from the front and side (diagonally). Surgeon rated both clinical utility (12 parameters) and image quality (11 parameters) for each image on a 5-point scale: 1, very good; 2, good; 3, average; 4, poor; and 5, very poor.

Results: For clinical utility in 16 percutaneous endoscopic discectomy cases, mean scores for all 12 parameters were significantly better on the OELD than on the LCD, including organ distinguishability (2.1 vs 3.2, respectively), lesion identification (2.2 vs 3.1), and overall viewing impression (2.1 vs 3.1). For image quality, all 11 parameters were better on the OELD than on LCD. Significant differences were identified in six parameters, including contrast (1.8 vs 2.9), color reproducibility in dark areas (1.8 vs 2.9), and viewing angle (2.2 vs 2.9).

Conclusion: The high contrast and excellent color reproducibility of the OELD reduced the constraints of imaging under endoscopy, in which securing a field of view may be difficult. Distinguishability of organs was good, including ligaments, dura mater, nerves, and adipose tissue, contributing to good stereoscopic images of the surgical field. These findings suggest the utility of OELD for excellent display of surgical images and for enabling safe and highly accurate endoscopic surgery.

Keywords: Electroluminescence monitor; endoscopic surgery; orthopedics.