A novel method of light projection and modular jigs to improve accuracy in bone sarcoma resection

He, Guangyu; Dai, Amos Z.; Mustahsan, Vamiq M.; Shah, Aadit; Li, Liming; Khan, Jafar A.; Bielski, Michael R.; Komatsu, David E.; Kao, Imin; Khan, Farhat Ullah

doi:10.1002/jor.25300

Cited by 6 publications

(2 citation statements)

References 29 publications

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“…The extracted bone surface in Figure 4A was then registered to the preoperative CT-scan model by a surface matching algorithm, with the surface match shown in Figure 4B . (Refer to our previous article 9 , 12 , 13 for a detailed explanation of the revised Drost’s algorithm. 14 ) Next, the preoperative plan was superimposed onto the extracted bone surface and shown to the surgeon on a computer as a visual aid to accurately reproduce the preoperative plan by drawing the planned osteotomy lines, as illustrated in Figure 4C .…”

Section: Methodsmentioning

confidence: 99%

A Novel 3D Light Assisted Drawing (3D-LAD) Method to Aid Intraoperative Reproduction of Osteotomy Lines Surrounding a Bone Tumor During Wide Resection: An Experimental Study

He¹,

Dai²,

Mustahsan³

et al. 2022

ORR

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Introduction Computer navigation and customized 3D-printed jigs improve accuracy during bone tumor resection, but such technologies can be bulky, costly, and require intraoperative radiation, or long lead time to be ready in OR. Methods We developed a method utilizing a compact, inexpensive, non-X-ray based 3D surface light scanner to provide a visual aid that helps surgeons accurately draw osteotomy lines on the surface of exposed bone to reproduce a well-defined preoperative bone resection plan. We tested the accuracy of the method on 18 sawbones using a distal femur hemimetaphyseal resection model and compared it with a traditional, freehand method. Results The method significantly reduces the positional error from 2.53 (±1.13) mm to 1.04 (±0.43) mm (p<0.001), and angular error of the front angle from 2.10° (±0.83°) to 0.80° (±0.66°) (p=0.001). The method also reduces the mean maximum deviation of the bone resection, with respect to the preoperative path, from 3.75mm to 2.69mm (p=0.003). However, no increased accuracy was observed at the back side of the bone surface where this method would not be expected to provide information. Discussion In summary, we developed a novel 3D-LAD navigation technology. From the experimental study, we demonstrated that the method can improve the ability of surgeons to accurately draw the preoperative osteotomy lines and perform resection of a primary bone sarcoma, with comparison to traditional methods, using 18 sawbones.

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Section: Methodsmentioning

confidence: 99%

A Novel 3D Light Assisted Drawing (3D-LAD) Method to Aid Intraoperative Reproduction of Osteotomy Lines Surrounding a Bone Tumor During Wide Resection: An Experimental Study

He¹,

Dai²,

Mustahsan³

et al. 2022

ORR

Self Cite

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“…However, the current PSI still has some limitations. Inadequate surface matching, variation in the guide design, and soft tissue on the skeletal surface may make it difficult to accurately place the PSI exactly to the designated site, leading to decreased accuracy, or even errors [ 8 , 13 , 14 ].…”

Section: Introductionmentioning

confidence: 99%

Fluoroscopically calibrated 3D-printed patient-specific instruments improve the accuracy of osteotomy during bone tumor resection adjacent to joints

Wang,

Huang,

et al. 2024

3D Print Med

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Background Inadequate surface matching, variation in the guide design, and soft tissue on the skeletal surface may make it difficult to accurately place the 3D-printed patient-specific instrument (PSI) exactly to the designated site, leading to decreased accuracy, or even errors. Consequently, we developed a novel 3D-printed PSI with fluoroscopy-guided positioning markers to enhance the accuracy of osteotomies in joint-preserving surgery. The current study was to compare whether the fluoroscopically calibrated PSI (FCPSI) can achieve better accuracy compared with freehand resection and conventional PSI (CPSI) resection. Methods Simulated joint-preserving surgery was conducted using nine synthetic left knee bone models. Osteotomies adjacent to the knee joint were designed to evaluate the accuracy at the epiphysis side. The experiment was divided into three groups: free-hand, conventional PSI (CPSI), and fluoroscopically Calibrated PSI (FCPSI). Post-resection CT scans were quantitatively analyzed. Analysis of variance (ANOVA) was used. Result FCPSI improved the resection accuracy significantly. The mean location accuracy is 2.66 mm for FCPSI compared to 6.36 mm (P < 0.001) for freehand resection and 4.58 mm (P = 0.012) for CPSI. The mean average distance is 1.27 mm compared to 2.99 mm (p < 0.001) and 2.11 mm (p = 0.049). The mean absolute angle is 2.16° compared to 8.50° (p < 0.001) and 5.54° (p = 0.021). The mean depth angle is 1.41° compared to 8.10° (p < 0.001) and 5.32° (p = 0.012). However, there were no significant differences in the front angle compared to the freehand resection group (P = 0.055) and CPSI (P = 0.599) group. The location accuracy observed with FCPSI was maintained at 4 mm, while CPSI and freehand resection exhibited a maximum deviation of 8 mm. Conclusion The fluoroscopically calibrated 3D-printed patient-specific instruments improve the accuracy of osteotomy during bone tumor resection adjacent to joint joints compared to conventional PSI and freehand resection. In conclusion, this novel 3D-printed PSI offers significant accuracy improvement in joint preserving surgery with a minimal increase in time and design costs.

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A novel intraoperative method to project osteotomy lines for accurate resection of primary bone sarcomas

He¹,

Dai²,

Mustahsan³

et al. 2022

Journal of Orthopaedics

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A novel method of light projection and modular jigs to improve accuracy in bone sarcoma resection

Cited by 6 publications

References 29 publications

A Novel 3D Light Assisted Drawing (3D-LAD) Method to Aid Intraoperative Reproduction of Osteotomy Lines Surrounding a Bone Tumor During Wide Resection: An Experimental Study

A Novel 3D Light Assisted Drawing (3D-LAD) Method to Aid Intraoperative Reproduction of Osteotomy Lines Surrounding a Bone Tumor During Wide Resection: An Experimental Study

Fluoroscopically calibrated 3D-printed patient-specific instruments improve the accuracy of osteotomy during bone tumor resection adjacent to joints

A novel intraoperative method to project osteotomy lines for accurate resection of primary bone sarcomas

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