The field of orthopedic surgery is becoming more reliant on the use of high-end imaging systems that aid surgeons in assessing complicated anatomy, implant position, and making decisions about the procedure being performed. In foot and ankle surgeries where joint alignment, correction of deformities, and accurate placement of implants are crucial factors, 3D imaging can give more anatomical detail than the regular 2D X-rays.
Pulmera, an intraoperative imaging technology company, is broadening the applications of its CBeam™ 3D Imaging Platform in foot and ankle surgery. Launched on August 19, 2026, the product is an addition to the applications of the platform after its first implementation in four surgical procedures at OrthoCarolina in Charlotte, North Carolina. These included two primary total ankle replacement surgeries, one revision total ankle replacement, and one cavus foot reconstruction.
This expansion constitutes yet another attempt by Pulmera to widen access to intra-operative 3-D imaging by integrating the technology in existing C-Arm devices rather than asking hospitals to invest in a new imaging equipment system.
Pulmera Extends CBeam 3D Imaging into Complex Foot and Ankle Procedures
There exist multiple conditions for which there is a need for joint replacement, reconstruction or correction of bone deformity within the foot and ankle surgery. The surgeons need to understand the bone regeneration and anatomical relationship for proper positioning of the implants.
The Pulmera’s CBeam platform was used in four surgeries at the OrthoCarolina, including both primary and revision ankle replacement and foot reconstruction. As it was stated by the company, the platform allowed for visualization in three dimensions of deformity correction and implant positioning intraoperatively, as well as in the postoperative period.
These particular cases are important, since they indicate the first application of the platform to various types of foot and ankle surgery. Primary joint replacement, revision surgeries and foot reconstruction require different considerations regarding anatomy and technique, and thus intraoperative visualization is an important development in the field of clinical technology.
At the same time, the described cases represent the first use of the technology and not necessarily evidence of improved surgical outcomes. Broader evaluation will be necessary to determine how the technology affects surgical workflows and clinical results across larger patient populations.
Pulmera Uses Existing Surgical C-Arms to Enable Intraoperative 3D Visualization
One of the key features of CBeam is the ability of this technology to upgrade regular two-dimensional surgical C-arm systems into an intraoperative three-dimensional imaging solution. The surgical C-arms are commonly used in surgery operating rooms for conducting X-ray imaging. The Pulmera technology applies a position-sensor-based solution that works with compatible surgical C-arms. During the process of rotation, the system generates a sequence of X-ray images that are then combined with positioning data to produce three-dimensional imaging datasets. This solution enables healthcare providers to get additional visual information related to contrast anatomical structures, including bones and joints.
The solution is supposed to help healthcare organizations implement three-dimensional imaging without making them purchase an entirely new imaging solution right away. Working with their current equipment might help healthcare providers test out this technology. CBeam is supposed to be used in order to improve visualization and conduct a clinical evaluation and a decision-making process. However, CBeam is not meant to be an alternative to regular medical imaging practices and solutions.
Pulmera Addresses the Need for Better Implant Positioning and Deformity Assessment
Proper evaluation of anatomical alignment is one factor that should be considered during total ankle replacement and reconstructive foot surgery. It allows doctors to assess the anatomy, perform corrections and verify implant placement.
The use of traditional two-dimensional imaging helps to obtain valuable information, but sometimes it may be insufficient for proper analysis of complex structures. The use of three-dimensional visualization enables a more complete evaluation of anatomy and helps assess the results of surgery before its completion.
Pulmera Builds on CBeam's Broader Orthopedic Surgery Applications
The expansion into foot and ankle surgery follows CBeam's earlier clinical use in spine procedures. According to Becker's Spine Review, the platform was previously used in three spine fusion procedures at Atrium Health's Mercy Hospital in Charlotte, including multilevel lumbar and cervical fusion operations. These applications illustrate Pulmera's strategy of extending a single intraoperative imaging platform across different areas of orthopedic surgery.
Spine surgery, joint replacement, and complex reconstruction all involve anatomical structures that can benefit from detailed intraoperative visualization. Expanding across specialties could provide Pulmera with opportunities to work with more surgeons and healthcare institutions. It may also help the company assess how the platform performs in different clinical environments and identify additional procedures where intraoperative 3D imaging could be useful.
Pulmera's CBeam Platform Could Help Hospitals Extend Existing Imaging Infrastructure
Hospitals face ongoing pressure to balance clinical technology investment with operational efficiency. Advanced imaging systems can require significant capital expenditure, equipment integration, staff training, and maintenance. Pulmera's infrastructure-compatible approach is intended to address part of this challenge by adding three-dimensional imaging capabilities to existing surgical C-arms. Instead of requiring facilities to replace all their conventional imaging equipment, the platform is designed to build on installed systems.
Pulmera Advances the Commercial Development of Intraoperative Imaging
According to Pulmera, the use of CBeam on foot and ankle patients is yet another development in the evolution of the technology from a clinical and business perspective. Collaborating with clinical partners would give the technology firm the opportunity to test its products in actual conditions while helping the surgeons identify whether the new imaging technique can be of any use to them.
Pulmera's Expansion Reflects the Growing Role of 3D Imaging in Orthopedic Surgery
The adoption of CBeam for foot and ankle surgeries reflects the emerging trend of medical devices that give surgeons enhanced intraoperative information regarding anatomy. With the increase in specialization of orthopedic surgery, imaging devices that would allow the assessment of alignment, deformity correction, and implant placement could provide valuable tools for orthopedic surgery.
The key feature of Pulmera's technology is adaptation of traditional C-arm devices to allow three-dimensional visualization. This could contribute to addressing some of the challenges in access to intraoperative imaging solutions for those who want to use existing infrastructure.
The inclusion of the four procedures at OrthoCarolina is an example of the first use of CBeam in primary and revision ankle replacements, as well as complex foot reconstructions. While more clinical data is required to assess the effects on surgery results and efficiency, this is a sign of the company's willingness to apply the solution for other orthopedic surgeries.
Source: Pulmera
