Preoperative planning in pelvic and acetabular surgery: The value of advanced computerised planning modules

Cimerman, Matej; Kristan, Anže

doi:10.1016/j.injury.2007.01.033

Cited by 130 publications

(79 citation statements)

References 16 publications

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“…Various indirect signs on plain radiograph should be better recognised and comprehended. Apart from giving the surgeon precise fracture characters prior to surgery, the technique has been modified and used to assist screw placement in various bone procedures [35][36][37][38][39].…”

Section: Discussionmentioning

confidence: 99%

The study of broken quadrilateral surface in fractures of the acetabulum

Prasartritha

Chaivanichsiri

2013

International Orthopaedics (SICOT)

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Purpose Three-dimensional computerised tomography (3DCT) can provide comprehensive patho-anatomy of complex bone on a single image. Though important, the key articular quadrilateral [Q] surface has not been a part of the systems developed for classifying acetabulum fractures. The purpose of the study was to simplify the complexity of classification by the direct sign of the broken Q surface which lies opposite the entire floor of the acetabulum. Methods The study reviewed 84 acetabular fractures using 3DCT images of the interior lateral view (IL) taken between June 2002 to December 2009. Fractures were traditionally classified using the anatomical disruption, plane of the fracture line breaking through or not through the bone column described by Judet and Letournel. Results The 3D images clearly show the primary site of impaction acting on the acetabulum and the whole course of fracture. The image could not illustrate disruption of the lips of acetabulum and congruity of hip joints in 20 cases of wall (W) fracture. There were 30 transverse (T) fractures classified when the acetabulum was divided horizontally from front to back into upper and lower parts and 34 cases of column (C) fracture when the main vertical lines run and collide along the anterior and posterior column. Conclusions This study showed that the well-known complex fractures can be satisfactorily classified with the broad flat inner plane of the Q surface.

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Section: Discussionmentioning

confidence: 99%

The study of broken quadrilateral surface in fractures of the acetabulum

Prasartritha

Chaivanichsiri

2013

International Orthopaedics (SICOT)

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“…In orthopaedic and trauma surgery, the importance of preoperative planning is steadily increasing. This is particularly true for MIO of complex fractures, e.g., acetabular fractures, where access to the fracture site is anatomically demanding [11,27]. Reliable tools already exist for virtual fracture reduction [27,28].…”

Section: Discussionmentioning

confidence: 99%

“…Thus, minimally invasive osteosynthesis (MIO) could significantly reduce operative morbidity and also lower the rate of intra-and postoperative complications. In addition, AIs ideally complement computer-assisted surgical workflows, which may comprise preoperative planning, computer-aided execution, and postoperative evaluation of the osteosynthesis [11][12][13]. AIs are routinely and successfully used at various locations, e.g., the proximal and distal humerus, the femur, the proximal and distal tibia, and the orbital floor, but do not yet exist for AFO [14,15].…”

Section: Introductionmentioning

confidence: 99%

Morphometric analysis of anatomical implant forms for minimally invasive acetabular fracture osteosynthesis

Maier

Kamer

Noser

et al. 2012

Computer Aided Surgery

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Introduction: Anatomical implants enable minimally invasive osteosynthesis (MIO) and represent ideal complements of computer-assisted surgical workflows. This 3D morphometric study analyzes anatomical implant forms (AIF) for acetabular fracture osteosynthesis (AFO). Materials and Methods: Three-dimensional pelvis models were created from clinical CT data of 99 European-Caucasian patients (50 females, 49 males). The mean age of the patients was 60.1 years (range: 20-89; SD 10.8). Definition of a referential region of interest (ROI) corresponding to an AIF for AFO was followed by automated ROI computation for each of the 198 hemipelvises. Three-dimensional statistical modeling and analysis of the resulting 198 homologous ROIs consisted of thin-plate spline transformation, generalized Procrustes fit, and principal component analysis. Results: The mean ROI length was 18.2 cm (range: 16.1-20.1 cm; SD 0.76). The first principal component (PC1) mainly modeled the ROI length, which correlated well with body height (r ¼ 0.325; p < 0.001). PC1 comprised 47.4% of the overall ROI form variation. PC2 primarily influenced the ROI curvature in the anterior-posterior (inlet) view. Curvatures were more pronounced in female patients compared to males (p < 0.001). There was no gender-specific ROI size variation. PC1-4 contained 80.2% of the total ROI form variation. Left and right ROI forms displayed symmetry. Conclusion: This 3D morphometric study demonstrates the feasibility of anatomical implants for minimally invasive acetabular fracture osteosynthesis. Implant size/length is by far the most important variable of form variation. The necessity of gender-specific implant forms requires further investigation. The non-fractured, contralateral hemipelvis can be used for preoperative surgical planning. Ultimately, the plate design will depend on prospective implant fit tests based on the required fit as defined by the clinician.

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“…A computer model for pre-operative planning of pelvic and acetabular surgery was developed by Cimerman & Kristan in 2007 [75]. The program is currently being used for planning actual surgeries at the author's institution, University Medical Centre Ljubljana (Fig.…”

Section: Knee and Other Orthopaedic Procedures Training Simulatorsmentioning

confidence: 99%

A review of virtual reality based training simulators for orthopaedic surgery

Vaughan

Dubey

Wainwright

et al. 2016

Medical Engineering & Physics

166

108

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This review presents current virtual reality based training simulators for hip, knee and other orthopaedic surgery, including elective and trauma surgical procedures. There have not been any reviews focussing on hip and knee orthopaedic simulators. A comparison of existing simulator features is provided to identify what is missing and what is required to improve upon current simulators. In total 11 total hip replacement pre-operative planning tools were analysed, plus 9 hip trauma fracture training simulators. Additionally 9 knee arthroscopy simulators and 8 other orthopaedic simulators were included for comparison. The findings are that for orthopaedic surgery simulators in general, there is increasing use of patient-specific virtual models which reduce the learning curve. Modelling is also being used for patient-specific implant design and manufacture. Simulators are being increasingly validated for assessment as well as training. There are very few training simulators available for hip replacement, yet more advanced virtual reality is being used for other procedures such as hip trauma and drilling. Training simulators for hip replacement and orthopaedic surgery in general lag behind other surgical procedures for which virtual reality has become more common. Further developments are required to bring hip replacement training simulation up to date with other procedures. This suggests there is a gap in the market for a new high fidelity hip replacement and resurfacing training simulator.

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Preoperative planning in pelvic and acetabular surgery: The value of advanced computerised planning modules

Cited by 130 publications

References 16 publications

The study of broken quadrilateral surface in fractures of the acetabulum

The study of broken quadrilateral surface in fractures of the acetabulum

Morphometric analysis of anatomical implant forms for minimally invasive acetabular fracture osteosynthesis

A review of virtual reality based training simulators for orthopaedic surgery

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