Comparison of Surface Area across the Allograft-Host Junction Site Using Conventional and Navigated Osteotomy Technique

Lall, Ajay C.; Hohn, Eric; Kim, Mimi Y.; Görlick, Richard; Abraham, John A.; Geller, David S.

doi:10.1155/2012/197540

Cited by 8 publications

(5 citation statements)

References 15 publications

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“…They describe a non-union rate of 6%, which compares well to the literature published on non-CATS allograft surgery [72]. This may well be related to an improvement in the contact area between the native bone and allograft using navigated pre-planned cuts versus freehand osteotomies, which has been suggested previously [73].…”

Section: Appendicular Skeletonsupporting

confidence: 75%

Computer Navigation and 3D Printing in the Surgical Management of Bone Sarcoma

McCulloch

Frisoni

Kurunskal

et al. 2021

Cells

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The long-term outcomes of osteosarcoma have improved; however, patients with metastases, recurrence or axial disease continue to have a poor prognosis. Computer navigation in surgery is becoming ever more commonplace, and the proposed advantages, including precision during surgery, is particularly applicable to the field of orthopaedic oncology and challenging areas such as the axial skeleton. Within this article, we provide an overview of the field of computer navigation and computer-assisted tumour surgery (CATS), in particular its relevance to the surgical management of osteosarcoma.

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Section: Appendicular Skeletonsupporting

confidence: 75%

Computer Navigation and 3D Printing in the Surgical Management of Bone Sarcoma

McCulloch

Frisoni

Kurunskal

et al. 2021

Cells

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“…First, virtually selecting the appropriate donor bone with the use of a virtual bone bank will provide the surgeon with the most suitable graft to obtain the best anatomical fitting [13]. Second, the allograft can be precisely cut using intraoperative navigation techniques to perform osteotomies with extreme accuracy with what was previously virtually planned [9].…”

Section: Discussionmentioning

confidence: 99%

“…Virtual planning of the cuts and intraoperative navigation during the procedure may increase accuracy of the fitting of the host-donor junctions and application of the preplanned fixation. Lall et al [9] analyzed 32 samples to quantify average surface contact areas across simulated intraoperative osteotomies using both freehand and computer-assisted navigation techniques. Mean contact area using the freehand osteotomy technique was equal to 0.21 square inches.…”

Section: Discussionmentioning

confidence: 99%

Does Intraoperative Navigation Assistance Improve Bone Tumor Resection and Allograft Reconstruction Results?

Aponte-Tinao

Ritacco

Ayerza

et al. 2015

Clinical Orthopaedics &Amp; Related Research

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Background Bone tumor resections for limb salvage have become standard treatment. Recently, computer-assisted navigation has been introduced to improve the accuracy of joint arthroplasty and possible tumor resection surgery; however, like with any new technology, its benefits and limitations need to be characterized for surgeons to make informed decisions about whether to use it. Questions/purposes We wanted to (1) assess the technical problems associated with computer-assisted navigation; (2) assess the accuracy of the registration technique; (3) define the time required to perform a navigated resection in orthopedic oncology; and (4) the frequency of complications such as local recurrence, infection, nonunion, fracture, and articular collapse after tumor resection and bone reconstruction with allografts using intraoperative navigation assistance. Methods We analyzed 69 consecutive patients with bone tumors of the extremities that were reconstructed with massive bone allografts using intraoperative navigation assistance with a minimum followup of 12 months (mean, 29 months; range, 12-43 months). All patients had their tumors reconstructed in three-dimensional format in a virtual platform and planning was performed to determine the osteotomy position according to oncology margins in a CT-MRI image fusion. Tumor resections and allograft reconstructions were performed using a computer navigation system according to the previously planned cuts. We analyzed intraoperative data such as technical problems related to the navigation procedure, registration technique error, length of time for the navigation procedure, and postoperative complications such as local recurrence, infection, nonunion, fracture, and articular collapse. Results In three patients (4%), the navigation was not carried out as a result of technical problems. Of the 66 cases in which navigation was performed, the mean registration error was 0.65 mm (range, 0.3-1.2 mm). The mean required time for navigation procedures, including bone resection and allograft reconstruction during surgery, was 35 minutes (range, 18-65 minutes). Complications that required a second surgical procedure were recorded for nine patients including one local recurrence, one infection, two fractures, one articular collapse, and four nonunions. In two of these nine patients, the allograft needed to be removed. At latest followup, three patients died of their original disease. Conclusions The navigation procedure could not be performed for technical reasons in 4% of the series. The mean registration error was 0.65 mm in this series and the navigation procedure itself adds a mean of 35 minutes during

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“…47,48 A study by Lall and colleagues demonstrated better fit and increased contact between allograft implant and resection planes during reconstructive surgery with the use of navigation technology. 49 This could potentially result in improved bone healing and decreased non-union rates, which are reported to be as high as 27% in bulk allograft reconstruction.…”

Section: Navigation Technology and Musculoskeletal Oncologymentioning

confidence: 99%

The evolution of three-dimensional technology in musculoskeletal oncology

Thadani

Riaz

Singh

2018

Journal of Clinical Orthopaedics and Trauma

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Musculoskeletal tumours pose considerable challenges for the orthopaedic surgeon during pre-operative planning, resection and reconstruction. Improvements in imaging technology have improved the diagnostic process of these tumours. Despite this, studies have highlighted the difficulties in achieving consistent resection free margins especially in tumours of the pelvis and spine when using conventional methods. Three-dimensional technology - three-dimensional printing and navigation technology - while relatively new, may have the potential to prove useful in the musculoskeletal tumour surgeon's arsenal. Three-dimensional printing (3DP) allows the production of objects by adding material layer by layer rather than subtraction from raw materials as performed conventionally. High resolution imaging, computer tomography (CT) and magnetic resonance imaging (MRI), are used to print highly complex and accurate items. Powder-based printing, vat polymerization-based printing and droplet-based printing are the common 3DP technologies applied. 3DP has been utilized pre-operatively in surgical planning and intra-operatively for patient specific instruments and custom made prosthesis. Pre-operative 3DP models transfer information to the surgeon in a concise yet exhaustive manner. Patient specific instruments are customized 3DP instruments utilized with the intention to easily replicate surgical plans. Complex musculoskeletal tumours pose reconstructive challenges and standard implants are often unable to reconstruct defects satisfactorily. The ability to use custom materials and tailor the pore size, elastic modulus and porosity of the 3DP prosthesis to be comparable to the patient's bone allows for a potential patient-specific prosthesis with unique incorporation and longevity properties. Similarly, navigation technology utilizes CT or MRI images to provides surgeons with real time intraoperative three-dimensional calibration of instruments. It has been shown to potentially allow surgeons to perform more accurate resections. These technological advancements have the potential to greatly impact the management of musculoskeletal tumours. 3D planning models, patient-specific instruments and customized 3DP implants and navigation should not be thought of as separate, but rather, patient-specific adaptation of relevant modes of application should be selected on a case-by-case basis when taking all unique factors of each case into consideration.

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Comparison of Surface Area across the Allograft-Host Junction Site Using Conventional and Navigated Osteotomy Technique

Cited by 8 publications

References 15 publications

Computer Navigation and 3D Printing in the Surgical Management of Bone Sarcoma

Computer Navigation and 3D Printing in the Surgical Management of Bone Sarcoma

Does Intraoperative Navigation Assistance Improve Bone Tumor Resection and Allograft Reconstruction Results?

The evolution of three-dimensional technology in musculoskeletal oncology

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