The effect of anatomic landmark selection of the distal humerus on registration accuracy in computer-assisted elbow surgery

Computer assisted surgery of the distal humerus can employ contralateral images for pre-operative planning, registration, and surgical intervention

“…1,22,29,34 Registration of the distal humerus to a medical CT image has been investigated in a simulated in vitro environment, with errors close to 1.0 mm. 23,24 However, it is not known how registration error and, consequently, navigational error would be affected following registration of the contralateral anatomy. Referencing the contralateral anatomy for the purpose of surgical planning has been investigated at other joints.…”

Image-based navigation improves the positioning of the humeral component in total elbow arthroplasty

“…This is in agreement with a previous study investigating the effect of anatomic landmark selection on registration accuracy. 38 These results indicate that the TRE will remain close to 1.0 mm and 1.0 regardless of landmark selection, leading to the accurate placement of an implant. Exposure of the posterior aspect of the distal humerus is simpler with current surgical exposures than visualization of the anterior humerus, which is required for the stage I registration.…”

Implant alignment in total elbow arthroplasty: conventional vs. navigated techniques

“…These landmarks were selected to simulate a scenario where adequate bone stock was not available. While they were proximal to the distal articulation, they remained readily available for typical surgical exposures and are unlikely compromised due to humeral bone loss 20 . A surface-based registration of the digitized landmarks to each CT surface model was performed using the iterative closest point (ICP) least-squares algorithm 21 .…”