Three‐dimensional corrective osteotomy using a patient‐specific osteotomy guide and bone plate based on a computer simulation system: accuracy analysis in a cadaver study

Omori, Shinsuke; Murase, Tsuyoshi; Kataoka, Takao; Kawanishi, Yasuo; Oura, Keiichiro; Miyake, Junichi; Tanaka, Hiroyuki; Yoshikawa, Hideki

doi:10.1002/rcs.1530

Cited by 48 publications

(40 citation statements)

References 27 publications

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“…Recently, we have developed a custom-made bone plate in combination with a custom-made osteotomy guide that exactly fits the bone surface after correction and enables simultaneous accurate reduction and fixation. 29 This could be a future solution to improve rotational and translational correction in adult cases.…”

Section: Discussionmentioning

confidence: 98%

“…5, C). 29,40 The difference between the preoperative computer simulation and the postoperative result was calculated with 6 of freedom based on the local coordinate system by the Euler angle method. 20,21,33 The intraobserver and interobserver reliabilities of this evaluation technique were demonstrated to be very high, at 0.90 to 0.98 and 0.92 to 0.96, respectively, in the previous study.…”

Section: Accuracy Evaluationmentioning

confidence: 99%

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Postoperative accuracy analysis of three-dimensional corrective osteotomy for cubitus varus deformity with a custom-made surgical guide based on computer simulation

Omori

Murase

Oka

et al. 2015

Journal of Shoulder and Elbow Surgery

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Section: Discussionmentioning

confidence: 98%

Section: Accuracy Evaluationmentioning

confidence: 99%

Postoperative accuracy analysis of three-dimensional corrective osteotomy for cubitus varus deformity with a custom-made surgical guide based on computer simulation

Omori

Murase

Oka

et al. 2015

Journal of Shoulder and Elbow Surgery

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“…Moreover, the possibility of using patient-specific osteosynthesis implants, integrated into the preoperative plan and fitted to the patient anatomy, would also improve the evident problem of the poor fitting of anatomical standard-plates. Recently, the application of a first patient-specific implant prototype has been demonstrated in-vitro [55]. However, its high manufacturing costs over 1000 USD limit its wide-spread clinical application.…”

Section: Resultsmentioning

confidence: 99%

Surgical Treatment of Long-Bone Deformities: 3D Preoperative Planning and Patient-Specific Instrumentation

Fürnstahl

Schweizer

Graf

et al. 2015

Lecture Notes in Computational Vision and Biomechanics

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Congenital or posttraumatic bone deformity may lead to reduced range of motion, joint instability, pain, and osteoarthritis. The conventional joint-preserving therapy for such deformities is corrective osteotomy-the anatomical reduction or realignment of bones with fixation. In this procedure, the bone is cut and its fragments are correctly realigned and stabilized with an implant to secure their position during bone healing. Corrective osteotomy is an elective procedure scheduled in advance, providing sufficient time for careful diagnosis and operation planning. Accordingly, computer-based methods have become very popular for its preoperative planning. These methods can improve precision not only by enabling the surgeon to quantify deformities and to simulate the intervention preoperatively in three dimensions, but also by generating a surgical plan of the required correction. However, generation of complex surgical plans is still a major challenge, requiring sophisticated techniques and profound clinical expertise. In addition to preoperative planning, computer-based approaches can also be used to support surgeons during the course of interventions. In particular, since recent advances in additive manufacturing technology have enabled cost-effective production of patient-and intervention-specific osteotomy instruments, customized interventions can thus be planned for and performed using such instruments. In this chapter, state of the art and future perspectives of computer-assisted deformity-correction surgery of the upper and lower extremities are presented. We elaborate on the benefits and pitfalls of different approaches based on our own experience in treating over 150 patients with three-dimensional preoperative planning and patient-specific instrumentation.

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“…Example of that can be seen for cases 7, 17, and 20, where the GS solution was preferred by 83% of the readers. In the future, patient-specific osteosynthesis and osteotomy implants such as the one described by Caiti et al (2018) and Omori et al (2014) could be integrated into the optimization framework.…”

Section: Discussionmentioning

confidence: 99%

An automatic genetic algorithm framework for the optimization of three-dimensional surgical plans of forearm corrective osteotomies

Carrillo

Roner

Atzigen

et al. 2020

Medical Image Analysis

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Three-dimensional (3D) computer-assisted corrective osteotomy has become the state-of-the-art for surgical treatment of complex bone deformities. Despite available technologies, the automatic generation of clinically acceptable, ready-to-use preoperative planning solutions is currently not possible for such pathologies. Multiple contradicting and mutually dependent objectives have to be considered, as well as clinical and technical constraints, which generally require iterative manual adjustments. This leads to unnecessary surgeon efforts and unbearable clinical costs, hindering also the quality of patient treatment due to the reduced number of solutions that can be investigated in a clinically acceptable timeframe. In this paper, we propose an optimization framework for the generation of ready-to-use preoperative planning solutions in a fully automatic fashion. An automatic diagnostic assessment using patient-specific 3D models is performed for 3D malunion quantification and definition of the optimization parameters' range. Afterward, clinical objectives are translated into the optimization module, and controlled through tailored fitness functions based on a weighted and multi-staged optimization approach. The optimization is based on a genetic algorithm capable of solving multi-objective optimization problems with non-linear constraints. The framework outputs a complete preoperative planning solution including position and orientation of the osteotomy plane, transformation to achieve the bone reduction, and position and orientation of the fixation plate and screws. A qualitative validation was performed on 36 consecutive cases of radius osteotomy where solutions generated by the optimization algorithm (OA) were compared against the gold standard solutions generated by experienced surgeons (Gold Standard; GS). Solutions were blinded and presented to 6 readers (4 surgeons, 2 planning engineers), who voted OA solutions to be better in 55% of the time. The quantitative evaluation was based on different error measurements, showing average improvements with respect to the GS from 20% for the reduction alignment and up to 106% for the position of the fixation screws. Notably, our algorithm was able to generate feasible clinical solutions which were not possible to obtain with the current state-of-the-art method. Keywords3D Surgical Planning · Automatic · Forearm · Corrective Osteotomy · Multi-objective Optimization Research Highlights• Automatic diagnosis strategy based on bony landmarks.• Automatic placement of the fixation plate.• Two-stage weighted multi-objective optimization based on a genetic algorithm • Novel bone protrusion evaluation considering bone contact and surfaces gaps.• Patient-specific screw optimization based on bone density information.• Capability of considering all types of common osteotomies: single-cut, opening wedge, closing wedge.

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Three‐dimensional corrective osteotomy using a patient‐specific osteotomy guide and bone plate based on a computer simulation system: accuracy analysis in a cadaver study

Abstract: The system is sufficiently feasible to realize precise 3-D deformity correction of a limb.

Cited by 48 publications

References 27 publications

Postoperative accuracy analysis of three-dimensional corrective osteotomy for cubitus varus deformity with a custom-made surgical guide based on computer simulation

Postoperative accuracy analysis of three-dimensional corrective osteotomy for cubitus varus deformity with a custom-made surgical guide based on computer simulation

Surgical Treatment of Long-Bone Deformities: 3D Preoperative Planning and Patient-Specific Instrumentation

An automatic genetic algorithm framework for the optimization of three-dimensional surgical plans of forearm corrective osteotomies

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