Outcomes of computer-assisted peri-acetabular osteotomy compared with conventional osteotomy in hip dysplasia

Imai, Hiroshi; Kamada, Tomomi; Miyawaki, Joji; Maruishi, Akira; Mashima, Naohiko; Miura, Hiromasa

doi:10.1007/s00264-020-04578-x

Cited by 17 publications

(6 citation statements)

References 25 publications

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“…This significantly complicates the process of aligning navigation information with the actual surgical site [39]. Generally, there is consensus that computer assistance is beneficial for PAO in different aspects, also supported by long-term studies involving a high number of patients [40]. However, we believe that usability must be further increased to achieve a broad clinical acceptance [41].…”

Section: Introductionmentioning

confidence: 99%

Augmented Reality Based Surgical Navigation of Complex Pelvic Osteotomies—A Feasibility Study on Cadavers

et al. 2021

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Augmented reality (AR)-based surgical navigation may offer new possibilities for safe and accurate surgical execution of complex osteotomies. In this study we investigated the feasibility of navigating the periacetabular osteotomy of Ganz (PAO), known as one of the most complex orthopedic interventions, on two cadaveric pelves under realistic operating room conditions. Preoperative planning was conducted on computed tomography (CT)-reconstructed 3D models using an in-house developed software, which allowed creating cutting plane objects for planning of the osteotomies and reorientation of the acetabular fragment. An AR application was developed comprising point-based registration, motion compensation and guidance for osteotomies as well as fragment reorientation. Navigation accuracy was evaluated on CT-reconstructed 3D models, resulting in an error of 10.8 mm for osteotomy starting points and 5.4° for osteotomy directions. The reorientation errors were 6.7°, 7.0° and 0.9° for the x-, y- and z-axis, respectively. Average postoperative error of LCE angle was 4.5°. Our study demonstrated that the AR-based execution of complex osteotomies is feasible. Fragment realignment navigation needs further improvement, although it is more accurate than the state of the art in PAO surgery.

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Section: Introductionmentioning

confidence: 99%

Augmented Reality Based Surgical Navigation of Complex Pelvic Osteotomies—A Feasibility Study on Cadavers

et al. 2021

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“…Surgical management, speci cally PAO [8] [9] [10] [11], was performed in 3 patients (3 hips) in whom pain was still present after 6 months of nonsurgical management for DDH (PAO group). The remaining 3 patients (3 hips) reported reduced pain after conservative treatment and did not undergo PAO (non-PAO group).…”

Section: Methodsmentioning

confidence: 99%

Dynamic Instability in Young Adults with Symptomatic Hip Dysplasia: Analysis using a Computer-Assisted Image-Matching Procedure

Imai

Shiraishi

Sakai

et al. 2021

Preprint

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Background: Repeated microtrauma often causes damage to the periarticular soft tissues. This damage, together with the lack of acetabular bony coverage, such as developmental dysplasia of the hip (DDH), can contribute to various degrees of dynamic instability of the hip joint and cause progressive osteoarthritic changesThe purpose of this study was to use an image-matching procedure to compare dynamic instability of the hip joint in patients with DDH who did or did not undergo periacetabular osteotomy (PAO). Methods: Six patients (6 hips) with symptomatic DDH were enrolled. A 6-month trial of nonsurgical management was initiated at the first visit. PAO was performed in 3 patients who experienced persistent pain after conservative treatment. The dynamic instability of all 6 hips was evaluated. Results: Japanese Orthopaedic Association hip scores improved significantly in all hips regardless of PAO. At the first visit, the center-edge angle, Sharp angle, vertical-center-anterior angle, and acetabular head index were not significantly different between the PAO and non-PAO groups. Dynamic instability was defined as the 3D translation of the femoral head center for the acetabular center at hip abduction angles from 0° to 30°. In the non-PAO group, the mean sagittal, axial, and coronal translations were 2.4 mm, 2.2 mm, and 1.1 mm, respectively, and in the PAO group they were 2.4 mm, 7.2 mm, and 2.7 mm, respectively. There was a significant difference in axial translation between the 2 groups. Conclusion:Dynamic instability leads to periarticular soft tissue damage and insufficient bony coverage, and causes progressive osteoarthritic changes. Dynamic instability in the axial plane induces persistent hip pain after nonsurgical management. Affected patients should undergo PAO as soon as possible.

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“…Therefore, navigation systems are invented as a great alternative to improve accuracy. (7,8,9,10) In recent years, scads of studies have reported that electromagnetic (EM) tracking systems can achieve satisfying accuracy. The EM sensors are usually small and delicate, allowing more free movement between the sensors and the generator.…”

Section: Background and Rationale {6a}mentioning

confidence: 99%

A prospective small-sample random controlled trial of navigation system-assisted distraction osteogenesis for hemifacial microsomia based on artificial intelligence

Liu

Zhang

Han

et al. 2023

Preprint

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Background: Mandibular distraction osteogenesis (MDO) is a major part of the treatment for hemifacial microsomia patients. Due to the narrow surgical field of the intraoral approach, osteotomy accuracy is highly dependent on the surgeons’ experience. Electromagnetic (EM) tracking systems can achieve satisfying accuracy to provide helpful real-time surgical navigation. Our research team developed an EM navigation system based on artificial intelligence, which has been justified in improving the accuracy of osteotomy in the MDO in animal experiments. This study aims to clarify the effect of the EM navigation system in improving the MDO accuracy for hemifacial microsomia patients. Methods:This study is designed as a single-centered and randomized controlled trial. Altogether 22 hemifacial microsomia patients are randomly assigned to the experiment group and control groups. All patients receive three-dimensional CT scans and preoperative surgical plans. The EM navigation system will be set up for those in the experiment group, and the control group will undergo traditional surgery. The primary outcome is the surgical precision by comparing the osteotomy position of pre- and postoperative CT scan images through the Geomagic Control software. The secondary outcomes include mandibular symmetry (occlusal plane deviation angle, mandibular ramus height and body length), pain scale and complications. Other indications, such as the adverse events of the system and the satisfactory score from patients and their families, will be recorded. Discussion: This small sample randomized controlled trial intends to explore the application of an EM navigation system in MDO for patients, which has been adopted in other surgeries such as orthognathic procedures. Because of the delicate structures of children and the narrow surgical view, accurate osteotomy and protection of nearby tissue from injury are essential for successful treatment. The EM navigation system based on artificial intelligence adopted in this trial is hypothesized to provide precise real-time navigation for surgeons and optimally improve patients outcomes including function and aesthetic results. The results of this trial will extend the application of new navigation technology in pediatric plastic surgery. Trial registration: Trial registration: Chinese Clinical Trial Registry: No. ChiCTR2200061565. Registered on June29, 2022.

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Outcomes of computer-assisted peri-acetabular osteotomy compared with conventional osteotomy in hip dysplasia

Cited by 17 publications

References 25 publications

Augmented Reality Based Surgical Navigation of Complex Pelvic Osteotomies—A Feasibility Study on Cadavers

Augmented Reality Based Surgical Navigation of Complex Pelvic Osteotomies—A Feasibility Study on Cadavers

Dynamic Instability in Young Adults with Symptomatic Hip Dysplasia: Analysis using a Computer-Assisted Image-Matching Procedure

A prospective small-sample random controlled trial of navigation system-assisted distraction osteogenesis for hemifacial microsomia based on artificial intelligence

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