Preclinical usability study of multiple augmented reality concepts for K-wire placement

Fischer, Marius; Fuerst, Bernhard; Lee, Sing Chun; Fotouhi, Javad; Habert, Séverine; Weidert, Simon; Euler, Ekkehard; Osgood, Greg; Navab, Nassir

doi:10.1007/s11548-016-1363-x

Cited by 51 publications

(58 citation statements)

References 35 publications

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“…Fischer M. et al [46] compared minimally invasive placement of K-wire into a fractured superior pubic ramus with three different systems: I) conventional Carm, II) C-arm augmented by a video camera, as described by Navab N. et al in [41], and III) a cone-beam CT (CBCT) enabled C-arm augmented by a Red-Green-Blue Depth (RGBD) camera. System III allowed simultaneous visualization from multiple arbitrary views, as opposed to just 2D visualization in the others.…”

Section: Instrument / Implant Placementmentioning

confidence: 99%

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Applicability of augmented reality in orthopedic surgery – A systematic review

Jud

Fotouhi

Andronic

et al. 2020

BMC Musculoskelet Disord

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124

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Background: Computer-assisted solutions are changing surgical practice continuously. One of the most disruptive technologies among the computer-integrated surgical techniques is Augmented Reality (AR). While Augmented Reality is increasingly used in several medical specialties, its potential benefit in orthopedic surgery is not yet clear. The purpose of this article is to provide a systematic review of the current state of knowledge and the applicability of AR in orthopedic surgery. Methods: A systematic review of the current literature was performed to find the state of knowledge and applicability of AR in Orthopedic surgery. A systematic search of the following three databases was performed: "PubMed", "Cochrane Library" and "Web of Science". The systematic review followed the Preferred Reporting Items on Systematic Reviews and Meta-analysis (PRISMA) guidelines and it has been published and registered in the international prospective register of systematic reviews (PROSPERO). Results: 31 studies and reports are included and classified into the following categories: Instrument / Implant Placement, Osteotomies, Tumor Surgery, Trauma, and Surgical Training and Education. Quality assessment could be performed in 18 studies. Among the clinical studies, there were six case series with an average score of 90% and one case report, which scored 81% according to the Joanna Briggs Institute Critical Appraisal Checklist (JBI CAC). The 11 cadaveric studies scored 81% according to the QUACS scale (Quality Appraisal for Cadaveric Studies). Conclusion: This manuscript provides 1) a summary of the current state of knowledge and research of Augmented Reality in orthopedic surgery presented in the literature, and 2) a discussion by the authors presenting the key remarks required for seamless integration of Augmented Reality in the future surgical practice. Trial registration: PROSPERO registration number: CRD42019128569.

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Section: Instrument / Implant Placementmentioning

confidence: 99%

“…Using the RGBD augmented CBCT system [46], Befrui N. et al [48] performed K-wire placement in a long bone phantom and a superior pubic ramus phantom. For control, K-wire placement was also performed using conventional C-arm fluoroscopy alone.…”

Section: Instrument / Implant Placementmentioning

confidence: 99%

Applicability of augmented reality in orthopedic surgery – A systematic review

Jud

Fotouhi

Andronic

et al. 2020

BMC Musculoskelet Disord

Self Cite

124

View full text Add to dashboard Cite

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“…Thus, it could help the surgeon to select the best operative program individually and precisely [21]. Under this technology, the real tissues and preoperative image data can be matched and fused to achieve real-time three-dimensional visual positioning and real-time display of the position of surgical tools, so as to carry out surgical navigation [23,24]. The purpose of the present study was to evaluate PKP assisted with precise navigation by MR technology in the treatment of OVCF with IVC.…”

Section: Introductionmentioning

confidence: 99%

Percutaneous kyphoplasty assisted with/without mixed reality technology in treatment of OVCF with IVC: a prospective study

Wei

Yao

et al. 2019

J Orthop Surg Res

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Background The purpose of this study was to assess the clinical outcome of percutaneous kyphoplasty (PKP) assisted with mixed reality (MR) technology in treatment of osteoporotic vertebral compression fracture (OVCF) with intravertebral vacuum cleft (IVC). Method Forty cases of OVCF with IVC undergoing PKP were randomized into a MR technology-assisted group (group A) and a traditional C-arm fluoroscopy group (group B). Both groups were performed PKP and evaluated by VAS scores, ODI scores, radiological evidence of vertebral body height, and kyphotic angle (KA) at pre-operation and post-operation. The volume of injected cement, fluoroscopy times, and operation time were recorded. And cases of non-PMMA-endplates-contact(NPEC) in radiological evidence was also recorded postoperatively. The clinical outcomes and complications were evaluated afterwards. All patients received 10 to 14 months follow-up, with an average of 12 months. Result This MR-assisted group (group A) acquired more about the amount of the polymethyl methacrylate (PMMA) injection and postoperative vertebral height and less about postoperative KA, fluoroscopy times, and operation time compared with the control group (group B) ( P < 0.05). The VAS scores and ODI scores in both groups have improved, but more significantly in group A ( P < 0.05). Also, more cases achieve both-endplates-touching of cement in group A ( P < 0.05). And there are less of the loss of vertebral height, KA, and occurrence of re-collapse of the vertebra in group A during the follow-up ( P < 0.05). Conclusion PKP assisted with MR technology can accurately orientate the position of IVC area, which can be augmented by the balloon leading to more satisfied vertebral height improvement, cement diffusion, and pain relief. Trial registration ClinicalTrials.gov Identifier: NCT03959059 . Registered 25 September 2016.

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“…The orientation of the cup in the X-ray images could be either automatically preset based on desired angles relative to the APP plane (or other known pelvic coordinate frames), or be adjusted by the surgeon. Once the desired pose of the acetabular cup is estimated relative to the C-arm, we use optical information from the co-calibrated RGBD camera that is mounted on the C-arm to provide an AR overlay [45][46][47] that enables placement of the cup according to the planning. As the cup is not visible in RGBD, we exploit the fact that the acetabular cup is placed using an impactor that is rigidly attached to the cup and is well perceived by the RGBD camera.…”

Section: Proposed Solutionmentioning

confidence: 99%

Plan in 2-D, execute in 3-D: an augmented reality solution for cup placement in total hip arthroplasty

et al. 2018

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Reproducibly achieving proper implant alignment is a critical step in total hip arthroplasty procedures that has been shown to substantially affect patient outcome. In current practice, correct alignment of the acetabular cup is verified in C-arm x-ray images that are acquired in an anterior-posterior (AP) view. Favorable surgical outcome is, therefore, heavily dependent on the surgeon's experience in understanding the 3-D orientation of a hemispheric implant from 2-D AP projection images. This work proposes an easy to use intraoperative component planning system based on two C-arm x-ray images that are combined with 3-D augmented reality (AR) visualization that simplifies impactor and cup placement according to the planning by providing a real-time RGBD data overlay. We evaluate the feasibility of our system in a user study comprising four orthopedic surgeons at the Johns Hopkins Hospital and report errors in translation, anteversion, and abduction as low as 1.98 mm, 1.10 deg, and 0.53 deg, respectively. The promising performance of this AR solution shows that deploying this system could eliminate the need for excessive radiation, simplify the intervention, and enable reproducibly accurate placement of acetabular implants.

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Preclinical usability study of multiple augmented reality concepts for K-wire placement

Abstract: The 3D visualization of patient, tool, and DRR shows clear advantages over the conventional X-ray imaging and provides intuitive feedback to place the medical tools correctly and efficiently.

Cited by 51 publications

References 35 publications

Applicability of augmented reality in orthopedic surgery – A systematic review

Applicability of augmented reality in orthopedic surgery – A systematic review

Percutaneous kyphoplasty assisted with/without mixed reality technology in treatment of OVCF with IVC: a prospective study

Plan in 2-D, execute in 3-D: an augmented reality solution for cup placement in total hip arthroplasty

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