Computer-Assisted Orthopaedic Surgery: Do We Need Caos?

Sikorski, J; Chauhan, Sandeep

doi:10.1302/0301-620x.85b3.14212

Cited by 67 publications

(47 citation statements)

References 4 publications

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“…In view of these problems, the application of CAS navigation technology in RHA appears reasonable. Computer navigation improves implant positioning and may prolong survivorship in total hip and knee replacement arthroplasty [3,15]. However, there is a paucity of experimental and clinical data relative to CAS applications in RHA.…”

Section: Discussionmentioning

confidence: 99%

“…Recent advances in computer-assisted navigation technology (CAS) address the several fundamental limitations inherent in conventional alignment and implant positioning tools for total hip and knee arthroplasty [4,6,11,13,15,16]. More recently, CAS tools have been used in clinical settings for RHA navigation; however, clinical experience and radiological outcomes of CAS applications in RHA are still limited [1,7], and little is known about their accuracy [5].…”

Section: Introductionmentioning

confidence: 99%

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Accuracy of a computer-assisted navigation system in resurfacing hip arthroplasty

Pitto

Malak

Anderson

2008

International Orthopaedics (SICOT)

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We developed a method to assess the accuracy of an image-free resurfacing hip arthroplasty navigation system in a proximal femur with normal and abnormal anatomy. A phantom lower limb allowed deformation in varus/valgus and ante-retroversion. At specific points during the simulated surgical procedure, information was compared between a digital caliper and the computer navigation system angular measurements. Repeated serial tests were undertaken. In the setting of normal anatomical alignment of the proximal femur, the mean error of the system characterised as the difference between the measured computer navigation and caliper angles was 0.6°in the frontal plane and 3.4°in the lateral plane. In the setting of abnormal anatomical alignment, the mean error was 0.4°i n the frontal plane and 2.1°in the lateral plane. This is the first study designed to assess the accuracy of a femoral navigation system for resurfacing hip arthroplasty in normal settings and in the presence of angular deformity. The study demonstrates satisfactory in-vitro accuracy.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Accuracy of a computer-assisted navigation system in resurfacing hip arthroplasty

Pitto

Malak

Anderson

2008

International Orthopaedics (SICOT)

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“…The majority of cadaver and clinical studies have validated the precision of these systems in specimens or patients with normal or near normal preoperative lower limb mechanical alignment, in terms of postoperative component alignment [6,16]. This reduction in risk for component mal-alignment is well demonstrated by a recent meta-analysis of the published literature in navigated TKA, demonstrating a normal or Gaussian distribution to the summated results with reduced standard deviation from the mean when postoperative alignment is measured [15,17]. Whilst this demonstrates the high degree of precision achievable with navigation systems, it does not identify the factor responsible for outlying results.…”

Section: Discussionmentioning

confidence: 94%

“…There are now numerous published precision studies in the literature which report on the clinical outcomes of procedures performed using a navigation system [2,15,18,20], including a recent study evaluating initial experience with EM technology [1]. The majority of cadaver and clinical studies have validated the precision of these systems in specimens or patients with normal or near normal preoperative lower limb mechanical alignment, in terms of postoperative component alignment [6,16].…”

Section: Discussionmentioning

confidence: 99%

Evaluation of accuracy of an electromagnetic computer-assisted navigation system in total knee arthroplasty

Graydon

Malak

Anderson

et al. 2008

International Orthopaedics (SICOT)

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The objective of this study was to develop a method to assess the accuracy of an electromagnetic technology image-free navigation system for total knee arthroplasty in a leg with normal or abnormal mechanical alignment. An acrylic phantom leg was constructed to simulate tibia and femur deformation. Determination of actual leg alignment was achieved using a digital caliper unit. In the setting of normal alignment, the mean error of the system characterised as the difference between the measured computer navigation and digital caliper angles ranged between 0.8°(frontal plane) and 1.5°(lateral plane). In the setting of abnormal alignment, the mean error ranged between 0.4°(frontal plane) and 1.6°(lateral plane). Deformity had no demonstrable effect on accuracy. The study demonstrates satisfactory in vitro system accuracy in both normal and abnormal leg mechanical alignment settings.Résumé Le but de cette étude était d'évaluer les techniques de navigation sans image par technologie électro-magnét-ique au cours des prothèses totales du genou. Un fantôme acrylique de membre inférieur a été construit de façon à simuler la déformation du tibia et du fémur. La différence moyenne entre la mesure par computer et la mesure instrumentale est de 0,8°dans le plan frontal et de 1,5°d ans le plan latéral. Dans les cas de mauvais alignements la moyenne a été de 0,4°dans le plan frontal et de 1,6°sur le profil. Cette étude in-vitro montre que ce système est fiable aussi bien pour un membre inférieur normalement axé que désaxé.

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“…Once an anatomical registration process has been completed the positioning and angles of the bone cuts can be controlled and monitored. 3 The system has been validated in cadavers and in clinical use 4,5 and the author has experience of its use in over 150 TKRs.…”

Section: Methodsmentioning

confidence: 99%

Computer-assisted revision total knee replacement

Sikorski¹

2004

The Journal of Bone and Joint Surgery. British volume

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A technique for performing allograft-augmented revision total knee replacement (TKR) using computer assistance is described, on the basis of the results in 14 patients. Bone deficits were made up with impaction grafting. Femoral grafting was made possible by the construction of a retaining wall or dam which allowed pressurisation and retention of the graft. Tibial grafting used a mixture of corticocancellous and morsellised allograft. The position of the implants was monitored by the computer system and adjusted while the cement was setting. The outcome was determined using a six-parameter, quantitative technique (the Perth CT protocol) which measured the alignment of the prosthesis and provided an objective score.The final outcomes were not perfect with errors being made in femoral rotation and in producing a mismatch between the femoral and tibial components. In spite of the shortcomings the alignments were comparable in accuracy with those after primary TKR. Computer assistance shows considerable promise in producing accurate alignment in revision TKR with bone deficits.

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Computer-Assisted Orthopaedic Surgery: Do We Need Caos?

Cited by 67 publications

References 4 publications

Accuracy of a computer-assisted navigation system in resurfacing hip arthroplasty

Accuracy of a computer-assisted navigation system in resurfacing hip arthroplasty

Evaluation of accuracy of an electromagnetic computer-assisted navigation system in total knee arthroplasty

Computer-assisted revision total knee replacement

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