Medstrat - Zgreatlakes.com

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1.800.882.4224
Joints
 A templating software designed by Medstrat that is web
based but requires a core download to run on your
computer
 Requires a user name and password that can be assigned by
Tom Tjalsma or Bill Sherman
 This includes sales force, hospital, offices or physicians
 Can be added to a hospital, surgeons office or home for no
cost or fee.
 All xrays in Joints can be imported directly into Zimmer
SMS, printed or exported to a DICOM or JPEG file
 If you want a Joints account, please email Bill Sherman
with your: First and Last Name and your email address
Why use Joints
 Only takes about 3 minutes of your time to template and
import into SMS
 If you import into SMS, all of your team can see your sizes
and templated xrays
 If “Relay” is set up it let’s you obtain xrays in a matter of
minutes with little effort
 Gives you an accurate measurement of implants
 + or – 1 implant size 95% of the time (Odell Woods/ Daniel)
 Let’s you tailor your implant request
 If using DICOM you do not need magnification markers
 Surgeons can have templating software on their home,
office or hospital computers for no cost or fee
Definitions/Modality
 PACS: Picture archiving and communications system
 DICOM: Digital Imaging and Communications in
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Medicine
CR: Computed Radiography; uses an xray plate that is
reusable
DR: Digital Radiography; uses a plate that is directly
connected to a server (either wired or wireless)
Most images are taken either CR/DR but they are all
DICOM. All DICOM images can be printed to look like
regular film xrays
Some offices still use the old xray hard xrays
Software Download
Go to www.Medstrat.com
Click on Downloads tab and log in with your user name and password
Software Download
Username: first name initial then last name @zimmergl: example: [email protected]
Password: Zimmer1 (you can change it if you want to)
Software Download
If downloading Joints select either MAC or Windows Browser
If downloading Joints Relay select either Mac or Windows
The viewer is for viewing only and not templating
Software Download
 Follow Software Download Wizard
 You will need your username and password to log on to
Joints
 Product Key (Joints Relay does not need a product key)
 3T-4U-AC-ZS-SV-99-9D
 Download and Install Templates
 See next slide
Download and Install Templates
Click on the Manage tab, then Manage Templates
Download and Install Templates
Click on Show all Available then Install; to install all templates at once, highlight all
templates Then Click Install (it takes about 20 minutes depending on internet speed)
Upload an Image or Series
 Three ways
 1. Push directly from PACS or imaging system (via Joints
Relay): DICOM only
 2. Drag and Drop (via Joints Relay): DICOM Only
 3. Import to Joints: DICOM or JPEG
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If DICOM you do not need mag marker but you can if you
want to
If JPEG you will need a mag marker
“Push” Image upload
 How to: is specific to PACS software
 Must always have Joints Relay running when doing a “push” or
“Drag and Drop” upload
 DICOM images load directly to specified user’s
“To-Do” tab in Joints.
 Must set up Joints Relay at office or hospital
 Need administrative privileges to download and run software.
 May need to speak directly to imaging software help desk to
learn how to add a “push” upload
 Need IP Address, AE Title, AE port

When relay is configured it will display all three items above
Drag and Drop Upload
 When images are dragged and dropped into Relay
Folder they will be added to your “To Do” tab in Joints
 Relay Folder will automatically appear on desktop once
Joints Relay is opened and running
 DICOM images only
 Joints Relay must be up and running
Import an Image
Click on Study, Import, then either DICOM or Plain Images (for JPEG Images), find
Folder assigned to images (either a CD/DVD/USB or on the hard drive and click on
Import.
Import an Image
 DICOM images will automatically import the patient
information but JPEG image information will have to
be manually inputted.
 DICOM images do not need a magnification marker
But you can use one if you want to.
For DICOM find folder and upload images.
 JPEG images need a magnification marker
Import a JPEG Image
 Click “Ok” when: Import to… Zimmer-Great Lakes
window comes up
 Click on Manual Entry
Add Patient Name and ID then click Accept
Patient ID can be whatever you want but
I always make it the name
Import a JPEG Image
 Type in Study Description and Body Part Examined
then click accept. Image will begin to upload
Tabs
 Everything: Everything you have in your “personal”
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Joints server
To Do: All images waiting to be templated
Templated: All images templated but not “Planned”
Planned: All images templated and linked to a case in
SMS
Training: All images added to your “personal” Joints
server to practice with
Zimmer -Great Lakes: All images you have in your
“personal” Joints server
Tabs
How to Template
 Click on “To Do” tab
 Double click on patient to be templated
 If you want to have the
AP and Lateral in the same window
click on box cut into 4 quadrants on
top left of the Joints Viewer page
And select 1x2.
Templating
 Click on the crossed wrench and screwdriver
 DICOM: you do not need to calibrate
 Make sure Magnification is 115% for knees and 120% for hips
 JPEG: Click calibrate and manipulate red calibration marker to appropriate
magnification marker
 If you want a full circle make: Arc Length 180 deg
 Type diameter or length of marker in the Diameter box in mm
 Click submit
Templating
 Ensure correct planning items are checked
 Body Part, Zimmer, Plane, Side, Orientation
 Select Implants you wish to template
Templating
 From this point you can do multiple things. Click on file and one
of the tasks below
 Save: Saves templated Films but they can still be adjusted (all
templated xrays must be saved in order to print or send to SMS)
 Print: Allows you to print the xrays with templates on them
 Duplicate: Allows you to copy the image with the templates burned
into them. This allows you to export images with templates on
them.
 Export: Export allows you to export one image or the entire series in
either a DICOM or JPEG format
 Manage: Allows you to send the templated images to SMS.
 Other administrative functions.
Save
Print
Duplicate
Export
Manage
Sending Images to SMS
 You must first ensure you preferences are set.
 When you have the image opened: Click on Edit,
preferences
 Case with patient info must be in SMS before sending
images to SMS
Sending Images to SMS
 Add your SMS user name and password under the
“CASE” tab.
Sending Images to SMS
 Before sending to SMS ensure you have saved your images.
They do not need to be labeled anything specific. Click file,
then save
 Select file, manage plan, type in surgeons name, click add
Sending Images to SMS
 Highlight the images to be sent to SMS and click accept
 Joints will automatically send images to SMS but not in the
case yet. Click save once all images have been sent.
Adding Images to SMS Case
 Open SMS and find the case in which images are to be added.
 On the bottom, select plans and link plan
Adding Images to SMS Case
 Find patient to be added to SMS and click on the plan
number. The plan will be added to your SMS case.
Viewing Images in SMS
 Find case to be viewed. Go to bottom of screen and select the plan
 select the plan number
 Select Files and open up the images
Setting up a Relay
 Download relay from Mestrat website just like you did
with Joints
Setting up a Relay
 Open up Relay via the link created on your desktop
 Label the organization whatever you want
 Select Configure
Setting up a Relay
 Under physician; select add
 Add physicians information and click ok
 You can add as many surgeons as you like to send images from that
relay
Setting up a Relay
 Under Joint Reps select “Username” and in “contains” type the username you want
images sent to.
 Select “search” and it will ask for your Joints username and password, enter it and click ok
 Highlight the name and select add
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Setting up a Relay
Change AE name to Zimmer_Surgeon
Click Accept
You can add as many reps as you like
You can close this screen
Setting up a Relay
 Notice each surgeon has there own AE Title and AE
Port regardless of how many Reps.
The IP Address, AE Title and AE
Port are what is needed when
setting up a “Push” from an office
or hospital PACS. This is why it is
important to change the AE title
to the surgeon name
Drag and Drop
 Notice the folders that are created for each surgeon when they are
added to Relay. This is where you drag and drop your DICOM images to
be sent to Joints.
 The folders will go away when Relay is closed. All files that are dragged
into these folders will disappear once they are sent to Joints.
Tips
 Preferences: Set knee magnification to 115% and hips
to 120%
 Select “compressed” on Joints main screen. This lets
the images download faster.
 If you are going to export a DICOM image, ensure you
create a duplicate study so the images are burned on
the xray

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