ObjectiveTo describe clinical applications of computer‐assisted orthopedic surgery (CAOS) in horses with a navigation system coupled with a cone beam computed tomography unit.Study designRetrospective clinical case series.AnimalsThirteen adult horses surgically treated with CAOS.MethodsMedical records were searched for horses that underwent CAOS between 2016 and 2019. Data retrieved included signalment, diagnosis, lameness grade prior to surgery, surgical technique and complications, anesthesia and surgery time, and information pertaining to the perioperative case management and outcome.ResultsIn 10 cases, surgical implants were placed in the proximal phalanx, third metatarsal bone, ulna, or medial femoral condyle. In one case, navigated transarticular drilling was performed to promote ankylosis of the distal tarsal joints. In another case, an articular fragment of the middle phalanx was removed with the help of CAOS guidance. In the final case, a focal osteolytic lesion of the calcaneal tuber was curetted with the aid of CAOS. In seven cases, a purpose‐built frame was used for the surgical procedure. All surgeries were performed successfully and according to the preoperative plan.ConclusionComputer‐assisted orthopedic surgery can be an integral part of the clinical case management in equine surgery. To optimize workflow and time‐efficiency, the authors recommend designating one team for operative planning and another for the execution of the surgical plan. Specialized equipment, such as the purpose‐built frame, will further improve CAOS applications in equine surgery.Clinical significanceAfter they have become familiar with the operational principles, equine surgeons can readily apply CAOS for a broad spectrum of indications.
Objective: To determine the influence of a purpose-built frame on the accuracy of screw placement during computer-assisted orthopedic surgery (CAOS) of the equine extremity. Study design: Experimental cadaveric study. Sample population: Twenty-four paired equine cadaveric limbs obtained from seven horses. Methods: Three 4.5-mm cortex screws were inserted in lag technique in three different planes of orientation in the proximal phalanx (P1) by means of CAOS. In the study group (n = 12 limbs), the tracker was anchored on a purpose-built frame designed to stabilize the extremity. In the control group (n = 12 limbs), a conventional tracker array was used that was anchored directly on P1. The stability of both tracker arrays was assessed during the procedure by using fiducial markers. After screw placement, preoperative and postoperative computed tomographic images were assessed to measure surgical accuracy aberrations (SAA) between the planned and achieved screw position. Descriptive statistics and repeated-measures analysis of variance were performed to compare SAA measurements between the study and control group. Results: Both tracker arrays remained consistently stable in all specimens. Mean overall SAA of screw insertion were lower in the study group (0.7 mm; median, 0.5; range 0-3.4) than in the control group (1.2 mm; median, 0.9; range, 0-4.2 mm). Conclusion: The mean SAA achieved in cortex screw placement using CAOS lies within the range of approximately 1 mm. The use of a purpose-built frame avoided additional drilling of the target bone and improved surgical accuracy compared with the conventional tracker array. Clinical significance: The purpose-built frame described in this report can be used to facilitate CAOS in equine orthopedics without compromising surgical accuracy. 1 | INTRODUCTION Numerous indications in equine orthopedic surgery demand the highest possible precision in cortex screw placement, leaving little room for error. Preoperative and intraoperative three-dimensional (3D) image guidance help increase the accuracy of cortex screw placement and set new standards in precision. 1-6 In addition, aiming
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