Computer assisted orthopaedic surgery: Past, present and future

Abstract

Computer technology is ubiquitous and relied upon in virtually all professional activities including neurosurgery which is why it is baffling that it is not the case for orthopaedic surgery with less than 5% of surgeon using available computer 2 technology in their surgeries. In this review, we explore the evolution and background of computer assisted orthopaedic surgery (CAOS) delving into the basic principles behind the technology and the changes in the discussion on the subject throughout the years and the impact these discussions had on the field. We found that industry had an important role in driving the discussion at least in knee arthroplasty a leading field of CAOS with the ratio between patents and publications increased from approximately 1:10 in 2004 to almost 1:3 in 2014. The adoption of CAOS is largely restrained by economics and ergonomics with sceptics challenging the accuracy and precision of navigation during the early years of CAOS moving to patient functional improvements and long term survivorship. Despite this, the future of CAOS remains positive with new technologies such as improvements in imageguided surgery, enhanced navigation systems, robotics and artificial intelligence.

Recent Trends, Technical Concepts and Components of Computer-Assisted Orthopedic Surgery Systems: A Comprehensive Review

“…The CAOS systems also have an ambition to be used as a system with a minimal invasiveness in the tissue engineering on the artificial cartilage replacement. In this operation, the CAOS systems can control the tissue shape [263,264,265,266,267,268].…”

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

“…Computer-navigated surgery has been used in neurosurgery since the 1980s, where improved accuracy in resections for cancer was achieved by mapping brain tumours preoperatively and using this to plan surgical resection. It is only at the turn of the 21st century that it has been adopted within the orthopaedic community [16,17], principally in the field of spinal surgery. A technology that provides real-time feedback within a field that has a small margin for error has an obvious home in the specialty of orthopaedic oncology.…”

Robot-assisted vs freehand cannulated screw placement in femoral neck fractures surgery

“…These developments aim to improve visibility to the surgical field, offers hitherto unavailable quantitative data, and increases geometrical accuracy when carrying out surgical procedures. [ 9 , 10 ] For more than 2 decades, the continuous development and functional improvement of robot-assisted method (RA) orthopedic surgery has been more accurate, minimally invasive and safe, and accepted by an increasing number of orthopedic doctors and promoted in clinical practice. [ 11 ] Yet conversely, they were still not commonplace compared to un-assisted, conventional freehand method surgery (FH) [ 2 , 9 – 11 ] as previous studies failed to prove that RA provided better clinical outcome than FH.…”