Computer Aided Orthopaedic Surgery: Incremental shift or paradigm change?

Joskowicz, Leo; Hazan, E

doi:10.1016/j.media.2016.06.036

Cited by 47 publications

(32 citation statements)

References 10 publications

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“…Advanced image guidance based on the computer-aided design and manufacturing (CAD/CAM) paradigm has been successfully utilized in clinical trials. [364] The CAD/CAM paradigm creates surgical plans and executable tasks in advance based on CT or MRI preoperative images resulting in superior precision and lower rates of failure. [365] To achieve a higher level of automation, additional safety mechanisms are required to protect the patient from system failure while improvement in control algorithms can contribute to achieving complete autonomous task execution.…”

Section: Potential Surgeries With Automationmentioning

confidence: 99%

Advanced Intelligent Systems for Surgical Robotics

Thai

Phan

Hoang

et al. 2020

Advanced Intelligent Systems

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Surgical robots have had clinical use since the mid‐1990s. Robot‐assisted surgeries offer many benefits over the conventional approach including lower risk of infection and blood loss, shorter recovery, and an overall safer procedure for patients. The past few decades have shown many emerging surgical robotic platforms that can work in complex and confined channels of the internal human organs and improve the cognitive and physical skills of the surgeons during the operation. Advanced technologies for sensing, actuation, and intelligent control have enabled multiple surgical devices to simultaneously operate within the human body at low cost and with more efficiency. Despite advances, current surgical intervention systems are not able to execute autonomous tasks and make cognitive decisions that are analogous to those of humans. Herein, the historical development of surgery from conventional open to robotic‐assisted approaches with discussion on the capabilities of advanced intelligent systems and devices that are currently implemented in existing surgical robotic systems is reviewed. Also, available autonomous surgical platforms are comprehensively discussed with comments on the essential technologies, existing challenges, and suggestions for the future development of intelligent robotic‐assisted surgical systems toward the achievement of fully autonomous operation.

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Section: Potential Surgeries With Automationmentioning

confidence: 99%

Advanced Intelligent Systems for Surgical Robotics

Thai

Phan

Hoang

et al. 2020

Advanced Intelligent Systems

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“…In 2014, we published a paper examining the reasons why CAOS was not mainstream at the time, as opposed to laparoscopic surgery and neuro-stereotactic guided surgery as both of them are unchallenged methods in their field [59]. Many factors limited the spread of CAOS for wide adoption in total knee replacement (TKA), the object of our study, because of its perceived risks, additional surgical times and additional attendant costs [1]. Nonetheless, we found that two main factors limiting CAOS expansion were ergonomics and economics [59].…”

Section: Impact Of Caos On General "Orthopaedic Forum"mentioning

confidence: 99%

“…[12] Since Hounfield's[27] and Lauterbur's[28] initial works on CT and MRI technology respectively, tremendous progress has been made in not only new diagnostic tools but also in computer-assisted 3D reconstruction[29]. Mathematical algorithms combined with new hardware, facilitated patient-specific planning, matching, modelling, intraoperative registration and intraoperative guidance[1]. Computer-assisted design (CAD) and computer-assisted manufacturing (CAM), in the orthopaedic world, expedited "custom-made implants".…”

mentioning

confidence: 99%

Computer assisted orthopaedic surgery: Past, present and future

Picard

Deakin

Riches

et al. 2019

Medical Engineering & Physics

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Computer technology is ubiquitous and relied upon in virtually all professional activities including neurosurgery which is why it is baffling that it is not the case for orthopaedic surgery with less than 5% of surgeon using available computer 2 technology in their surgeries. In this review, we explore the evolution and background of computer assisted orthopaedic surgery (CAOS) delving into the basic principles behind the technology and the changes in the discussion on the subject throughout the years and the impact these discussions had on the field. We found that industry had an important role in driving the discussion at least in knee arthroplasty a leading field of CAOS with the ratio between patents and publications increased from approximately 1:10 in 2004 to almost 1:3 in 2014. The adoption of CAOS is largely restrained by economics and ergonomics with sceptics challenging the accuracy and precision of navigation during the early years of CAOS moving to patient functional improvements and long term survivorship. Despite this, the future of CAOS remains positive with new technologies such as improvements in imageguided surgery, enhanced navigation systems, robotics and artificial intelligence.

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“…In the field of orthopedic surgery, it is becoming more common to introduce computer-aided technology [11][12][13][14][15][16][17]. Regarding 3D preoperative planning for fracture management, there have been some attempts to prepare a preoperative plan for osteosynthesis by creating 3D models or 3D images of fracture parts [16][17][18][19][20][21].…”

Section: Introductionmentioning

confidence: 99%

Development of three-dimensional preoperative planning system for the osteosynthesis of distal humerus fractures

et al. 2020

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Background: To reproduce anatomical reduction and appropriate implant placement/choices during osteosynthesis for elbow fractures, we developed a 3D preoperative planning system. To assess the utility of 3D digital preoperative planning for the osteosynthesis of distal humerus fractures, we evaluated the reproducibility of implant reduction shapes and placements in patients with distal humerus fractures. Methods: Twelve patients with distal humerus fractures who underwent osteosynthesis using 3D preoperative planning were evaluated. Reduction shapes were evaluated by the angle between the diaphysis axis and a line connecting the vertices of the medial epicondyle and the lateral epicondyle (epicondyle angle), and the angle between the diaphysis axis and the articular surface (joint angle) in the coronal plane, and the distance between the anterior diaphysis and the anterior articular surface in the sagittal plane (anterior distance) based on 3D images of the distal humerus. In addition, the implant positions were evaluated by the positions of the proximal and posterior edge of the plate, and the angle of the plate to the epicondyle line. The reproducibility was evaluated by intra-class correlation coefficients of the parameters between pre-and postoperative images. Results: The intra-class correlation coefficients were 0.545, 0.802, and 0.372 for the epicondyle angle, joint angle, and anterior distance, respectively. The differences in the measurements between the preoperative plan and postoperative reduction were 2.1 ± 2.1 degrees, 2.3 ± 1.8 degrees, and 2.8 ± 2.0 mm, for the epicondyle angle, joint angle, and anterior distance, respectively. The intra-class correlation coefficients were 0.983, 0.661, and 0.653 for the proximal and posterior plate positions, and the angle to the epicondyle, respectively. The differences in the measurements between the preoperative plan and postoperative reduction were 3.3 ± 2.1 mm, 2.7 ± 1.7 mm and 9.7 ± 9.8 degrees, for the plate positions of proximal and posterior edge, and the angle of the plate to the epicondyle line, respectively. There were significant correlations for the epicondyle angle, joint angle, and plate positions. Conclusions: 3D preoperative planning for osteosynthesis of distal humerus fracture was reproducible for the reduction shape of the coronal view and the plate positions.

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Computer Aided Orthopaedic Surgery: Incremental shift or paradigm change?

Cited by 47 publications

References 10 publications

Advanced Intelligent Systems for Surgical Robotics

Advanced Intelligent Systems for Surgical Robotics

Computer assisted orthopaedic surgery: Past, present and future

Development of three-dimensional preoperative planning system for the osteosynthesis of distal humerus fractures

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