Evaluation of a fluoroscopy-based navigation system enabling a virtual radiation-free preview of X-ray images for placement of cannulated hip screws. A cadaver study

Müller, Marcus; Belei, Peter; Fuente, M. de la; Strake, M.; Weber, O.; Burger, C.; Radermacher, Klaus; Wirtz, Dieter Christian

doi:10.3109/10929088.2010.542694

Cited by 13 publications

(12 citation statements)

References 23 publications

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“…In clinical use, this may minimise revision surgery caused by early failure of implant fixation in a weakened femoral neck or early osteoarthritis caused by penetration of the femoral head. In comparison to authors who performed biplanar computer-assisted guide wire placement in the femoral neck, the results are similar [13][14][15][16]. In these studies, one of 15 computer-assisted trials required a second pass because the surgeon did not follow the computer plan [14].…”

Section: Drilling Attemptsmentioning

confidence: 61%

Three-dimensional computer-assisted navigation for the placement of cannulated hip screws. A pilot study

Müller

Belei

Pennekamp

et al. 2012

International Orthopaedics (SICOT)

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Purpose Medial femoral neck fractures are common, and closed reduction and internal fixation by three cannulated screws is an accepted method for the surgical treatment.Computer navigation for screw placement may reduce fluoroscopy time, the number of guidewire passes and optimise screw placement. Methods In the context of a sawbone study, a computerassisted planning and navigation system based on 3D-imaging for guidewire placement in the femoral neck was tested to improve screw placement. Three screws were inserted into 12, intact, femoral sawbones using the conventional technique and into 12, intact, femoral sawbones guided by the computer-based navigation system. Guidewire and subsequent screw placement in the femoral neck were evaluated. Results Use of the navigation system resulted in a significant reduction of the number of drilling attempts (p≤0.05) and achieved optimised accuracy of implant placement by attaining significantly better screw parallelism (p≤0.05) and significantly enlarged neck-width coverage by the three screws (p≤0.0001). Computer assistance significantly increased the number of fluoroscopic images (p≤0.001) and the operation time (p≤0.0001).Conclusions Three-dimensional computer-assisted navigation improves accuracy of cannulated screw placement in femoral neck while increasing the number of fluoroscopic images and operation time. Additional studies including fractured sawbones and cadaver models with the goal of reducing operation time are indispensable before introduction of this navigation system into clinical practice.

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Section: Drilling Attemptsmentioning

confidence: 61%

Three-dimensional computer-assisted navigation for the placement of cannulated hip screws. A pilot study

Müller

Belei

Pennekamp

et al. 2012

International Orthopaedics (SICOT)

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“…Our finding of no significant change in task time with AXIS is somewhat different compared with findings for the virtX system (24% decrease) and the zero-dose navigation system (68% increase) (Bott 2008, Müller 2011. Carm positioning accuracy was not reported for these related systems.…”

Section: Discussioncontrasting

confidence: 55%

“…Several groups have tried to address this problem by overlaying artificial X-ray images on a live video feed (Chen 2013, Reaungamornat 2012, Müller 2011. Others have used artificial X-rays for simulation training (Bott 2008, Gong 2014, Cleary 2004.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of the Use of Artificial X-Rays for Educational and Intraoperative Guidance During C-Arm Positioning

Touchette¹,

Anglin²,

Guy³

et al.

EPiC Series in Health Sciences

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Fluoroscopic C-arms are operated by medical radiography technologists (RTs) in the Canadian operating room (OR). While they do receive formal, accredited training, most of this training is theoretical, rather than hands-on. During their first encounters in the OR, new RTs can experience difficulty achieving the radiographic views required by surgeons, often needing several scout X-rays during C-arm positioning before achieving the correct anatomical view. Furthermore, ambiguous language by surgeons often inadequately conveys their request (Pally 2013). The result is often frustration, unnecessary radiation exposure, and added OR time (Booij 2007).Several groups have tried to address this problem by overlaying artificial X-ray images on a live video feed (Chen 2013, Reaungamornat 2012, Müller 2011). Others have used artificial X-rays for simulation training (Bott 2008, Gong 2014, Cleary 2004). Though the intent is to improve C-arm positioning accuracy and efficiency during orthopaedic procedures, these systems have primarily been evaluated on system accuracy and not on their potential to decrease radiation exposure inside the OR or C-arm positioning time.The purpose of this study was therefore to evaluate the value of artificial X-rays in enhancing C-arm positioning performance using inexperienced users.

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“…Navigation has been successfully used in other models, such as fixation of the femoral neck fractures. Studies have demonstrated improved accuracy, precision, better parallelism, and screw spread in the femoral neck with navigation systems . Compared with femoral neck fractures, the deformity present in SCFE poses an additional three‐dimensional challenge, making it a model where navigation may be more useful.…”

Section: Introductionmentioning

confidence: 99%

A novel surgical navigation technology for placement of implants in slipped capital femoral epiphysis

Oetgen

Litrenta

Koutenaei

et al. 2020

Robotics Computer Surgery

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Background: Fixation with a single screw is the recommended treatment for slipped capital femoral epiphysis (SCFE). Achieving optimal implant positioning can be difficult owing to the complex geometry of the proximal femur in SCFE. We assessed a novel navigation technology incorporating an inertial measurement unit to facilitate implant placement in an SCFE model.Methods: Guidewires were placed into 30 SCFE models, using a navigation system that displayed the surgeon's projected implant trajectory simultaneously in multiple planes. The accuracy and the precision of the system were assessed as was the time to perform the procedure.Results: Implants were placed an average of 5.3 mm from the femoral head center, with a system precision of 0.94 mm. The actual trajectory of the implant deviated from the planned trajectory by an average of 4.9 ± 2.2 . The total average procedure time was 97 seconds. Conclusion:The use of computer-based navigation in a SCFE model demonstrated good accuracy and precision in terms of both implant trajectory and placement in the center of the femoral head.

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Evaluation of a fluoroscopy-based navigation system enabling a virtual radiation-free preview of X-ray images for placement of cannulated hip screws. A cadaver study

Cited by 13 publications

References 23 publications

Three-dimensional computer-assisted navigation for the placement of cannulated hip screws. A pilot study

Three-dimensional computer-assisted navigation for the placement of cannulated hip screws. A pilot study

Evaluation of the Use of Artificial X-Rays for Educational and Intraoperative Guidance During C-Arm Positioning

A novel surgical navigation technology for placement of implants in slipped capital femoral epiphysis

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