The accuracy and precision of computer assisted surgery in the assessment of frontal plane deviations of the lower extremity: a femoral fracture model

Khalafi, Afshin; Citak, Musa; Kendoff, Daniel; Huefner, Tobias; Krettek, Christian

doi:10.1007/s00402-009-0818-8

Cited by 7 publications

(7 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Radiological measurements are a well‐known source of error 12. In other studies, custom‐made aluminum wedges of varying angles were used as a gold standard 13. This experimental set‐up, however, does not control the accuracy of navigation systems in all three dimensions.…”

Section: Discussionmentioning

confidence: 99%

Assessment of the accuracy of infrared and electromagnetic navigation using an industrial robot: Which factors are influencing the accuracy of navigation?

Liodakis

Chu

Westphal

et al. 2011

Journal Orthopaedic Research

Self Cite

View full text Add to dashboard Cite

Our objectives were to detect factors that influence the accuracy of surgical navigation (magnitude of deformity, plane of deformity, position of the navigation bases) and compare the accuracy of infrared with electromagnetic navigation. Human cadaveric femora were used. A robot connected with a computer moved one of the bony fragments in a desired direction. The bases of the infrared navigation (BrainLab) and the receivers of the electromagnetic device (Fastrak-Pohlemus) were attached to the proximal and distal parts of the bone. For the first part of the study, deformities were classified in eight groups (e.g., 0 to 5 8 ). For the second part, the bases were initially placed near the osteotomy and then far away. The mean absolute differences between both navigation system measurements and the robotic angles were significantly affected by the magnitude of angulation with better accuracy for smaller angulations (p < 0.001). The accuracy of infrared navigation was significantly better in the frontal and sagittal plane. Changing the position of the navigation bases near and far away from the deformity apex had no significant effect on the accuracy of infrared navigation; however, it influenced the accuracy of electromagnetic navigation in the frontal plane (p < 0.001). In conclusion, the use of infrared navigation systems for corrections of small angulation-deformities in the frontal or sagittal plane provides the most accurate results, irrespectively from the positioning of the navigation bases. Keywords: robot-assisted surgery; electromagnetic navigation; infrared navigation; accuracy; deformityThe main goal of computer assisted orthopaedic techniques is to improve the precision and accuracy by which procedures can be executed. This in turn might lead to improved outcomes and patient satisfaction, decreased complication rates, decreased long-term costs and adoption of less invasive approaches. [1][2][3] Computer navigation is used to track the position and orientation of objects, 4 such as the tip of a pointer or a surgical tool on a preoperative or intraoperative image after registration of landmarks or surfaces on anatomical structures. [4][5][6][7] Instant tracking of objects can be achieved with infrared cameras, electromagnetic navigation, or acoustic technology. 5,8 The most popular technology used in orthopaedic practice is infrared tracking of light emitting diodes (LEDs) attached to rigid bodies. The measurement of position changes is performed by computing the intersection of the three planes corresponding to each camera. 4 The main disadvantages are cost and the need for a line of sight between the object and the camera. Therefore, availability is limited. 4,5 Another interesting modality recently introduced into total knee arthroplasty, but not yet a standard procedure, is electromagnetic navigation. 9 It depends on the generation of an electromagnetic field to attain positional awareness. The main disadvantage of this technology is the interference of magnetic metals with the measurements;...

show abstract

Section: Discussionmentioning

confidence: 99%

Assessment of the accuracy of infrared and electromagnetic navigation using an industrial robot: Which factors are influencing the accuracy of navigation?

Liodakis

Chu

Westphal

et al. 2011

Journal Orthopaedic Research

Self Cite

View full text Add to dashboard Cite

show abstract

“…However, navigated systems (Table 1) provide intraoperative real time control not only for the frontal, but also for the sagittal and trasverse planes, with significantly lower radiation time. Navigation is also more accurate compared to the conventional cable technique with an error margin of 1 mm or 1 • [6,8]. However, the accuracy of navigated analysis depends on the stability of the dynamic reference bases during surgery.…”

Section: Discussionmentioning

confidence: 99%

“…Many techniques were proposed such as visual inspection, cable method, grid with lead impregnated reference lines or more recently navigation systems [5][6][7][8][9][10].…”

Section: Introductionmentioning

confidence: 99%

The axis-board: An alternative to the cable technique for intraoperative assessment of lower limb alignment

Liodakis

Kenawey

Liodaki

et al. 2010

THC

View full text Add to dashboard Cite

Introduction: Accurate intraoperative assessment of lower limb alignment is crucial for the treatment of long bone fractures, implantation of knee arthroplasties and correction of deformities.Purpose: The aim of this study is to present a new technique for the intraoperative analysis of the mechanical axis. Methods:The axis board is placed under the patient's lower limb. With the centre of the ankle and hip lying on the reference line we can assess the mechanical axis of the lower limb. This technique was used in 38 cases (19 high tibial osteotomies, 13 femoral fractures and 6 tibial fractures).Results: Comparing the intraoperative tibiofemoral angles and Mechanical Axis Deviations (MAD) with the results of the postoperative long standing radiographs we showed an accuracy of 1 ± 0.9 • and 2.9 ± 2.6 mm respectively.Conclusion: The method is a simple and convenient option for intraoperative evaluation of the mechanical axis. However, for complex corrections we still recommend the use of navigation systems.

show abstract

“…Over the years, many scholars have tried numerous methods of preoperative planning based on radiology and computer technology. They have reported favorable results in limb, pelvic, and acetabular fracture reduction and osteosynthesis . However, these techniques applied to orthopedic trauma had poor repeatability and took more time because the process was complex, requiring several sets of software and too much manual manipulation.…”

Section: Introductionmentioning

confidence: 99%

Novel computer-assisted preoperative planning system for humeral shaft fractures: report of 43 cases

Chen

Qiang

Kun

et al. 2014

Int J Med Robotics Comput Assist Surg

View full text Add to dashboard Cite

show abstract

The accuracy and precision of computer assisted surgery in the assessment of frontal plane deviations of the lower extremity: a femoral fracture model

Abstract: The high accuracy and precision of navigation systems in determining frontal plane deformities of long bones can make them an invaluable tool for the exact reduction and realignment of lower extremity fractures.

Cited by 7 publications

References 23 publications

Assessment of the accuracy of infrared and electromagnetic navigation using an industrial robot: Which factors are influencing the accuracy of navigation?

Assessment of the accuracy of infrared and electromagnetic navigation using an industrial robot: Which factors are influencing the accuracy of navigation?

The axis-board: An alternative to the cable technique for intraoperative assessment of lower limb alignment

Novel computer-assisted preoperative planning system for humeral shaft fractures: report of 43 cases

Contact Info

Product

Resources

About