scholarly journals Augmented-Reality within Computer Assisted Orthopaedic Surgery Workflows: A Proof of Concept Study

10.29007/dswz ◽  
2019 ◽  
Author(s):  
Hisham Iqbal ◽  
Fabio Tatti ◽  
Ferdinando Rodriguez Y Baena
Keyword(s):  
Augmented Reality ◽  
Qualitative Evaluation ◽  
Computer Assisted Surgery ◽  
Medical Robotics ◽  
Patient Specific ◽  
Computer Assisted ◽  
Specific Data ◽  
Cluttered Environment ◽  
Computer Assisted Orthopaedic Surgery ◽  
Completion Times

The integration of augmented-reality (AR) in medical robotics has been shown to reduce cognitive burden and improve information management in the typically cluttered environment of computer-assisted surgery. A key benefit of such systems is the ability to generate a composite view of medical-informatics and the real environment, streamlining the pathway for delivering patient-specific data. Consequently, AR was integrated within an orthopaedic setting by designing a system that captured and replicated the user- interface of a commercially available surgical robot onto a commercial head mounted see through display. Thus, a clinician could simultaneously view the operating-site and real- time informatics when carrying out an assisted patellofemoral-arthroplasty (PFA). The system was tested with 10 surgeons to examine its usability and impact on procedure- completion times when conducting simulated PFA on sawbone models. A statistically insignificant mean increase in procedure completion-time (+23.7s, p=0.240) was found, and the results of a post-operative qualitative-evaluation indicated a strongly positive consensus on the system, with a large majority of subjects agreeing the system provided value to the procedure without incurring noticeable physical discomfort. Overall, this study provides an encouraging insight into the high levels of engagement AR has with a clinical audience as well as its ability to enhance future generations of medical robotics.

scholarly journals A review of Surface Matching models: perspectives and challenges for Automatic Soft-Tissue Registration in Computer-assisted Interventions

2015 ◽  
Vol 8 (2) ◽  
pp. 143-184
Author(s):  
Thiago Ramos
Keyword(s):  
Shape Matching ◽  
State Of The Art ◽  
Computer Assisted Surgery ◽  
Patient Specific ◽  
Surface Matching ◽  
Computer Assisted ◽  
Imaging Device ◽  
Specific Data ◽  
Tissue Surface ◽  
Matching Models

One of the main challenges related to Computer-Assisted Surgery (CAS) is the registration of multi-modal patient specific data to enhance the surgeon’s navigation capabilities by observing beyond the exposed tissue surface. One increasingly popular approach involves capturing the organ surface with a range imaging device and performing a shape-based registration. This paper (1) discusses the major challenges related to surface matching in the operating theater and (2) provides a general review of state-of-the-art methods in shape matching.

scholarly journals An Exploration of Augmented Reality in Computer Assisted Orthopaedic Surgery

10.29007/72d4 ◽  
2018 ◽  
Author(s):  
He Liu ◽  
Edouard Auvinet ◽  
Joshua Giles ◽  
Ferdinando Rodriguez Y Baena
Keyword(s):  
Augmented Reality ◽  
Three Dimensional ◽  
Hole Drilling ◽  
Depth Information ◽  
Computer Assisted ◽  
Pilot Hole ◽  
Surgical Workflow ◽  
Processing Depth ◽  
Computer Assisted Orthopaedic Surgery ◽  
Preoperative Plan

Computer Aided Surgery (CAS) is helpful, but it clutters an already overcrowded operating theatre, and tends to disrupt the workflow of conventional surgery. In order to provide seamless computer assistance with improved immersion and a more natural surgical workflow, we propose an augmented-reality based navigation system for CAS. Here, we choose to focus on the proximal femoral anatomy, which we register to a plan by processing depth information of the surgical site captured by a commercial depth camera. Intra-operative three-dimensional surgical guidance is then provided to the surgeon through a commercial augmented reality headset, to drill a pilot hole in the femoral head, so that the user can perform the operation without additional physical guides. The user can interact intuitively with the system by simple gestures and voice commands, resulting in a more natural workflow. To assess the surgical accuracy of the proposed setup, 30 experiments of pilot hole drilling were performed on femur phantoms. The position and the orientation of the drilled guide holes were measured and compared with the preoperative plan, and the mean errors were within 2mm and 2°, results which are in line with commercial computer assisted orthopedic systems today.

scholarly journals Comparison of the Accuracy and Clinical Parameters of Patient-Specific and Conventionally Bended Plates for Mandibular Reconstruction

2021 ◽  
Vol 11 ◽  
Author(s):  
Henriette L. Möllmann ◽  
Laura Apeltrath ◽  
Nadia Karnatz ◽  
Max Wilkat ◽  
Erik Riedel ◽  
...  
Keyword(s):  
Computer Assisted Surgery ◽  
Reference Points ◽  
Mandibular Reconstruction ◽  
Patient Specific ◽  
Computer Assisted ◽  
Advantages And Disadvantages ◽  
Patient Specific Implants ◽  
Operative Complications ◽  
The Difference ◽  
And Training

ObjectivesThis retrospective study compared two mandibular reconstruction procedures—conventional reconstruction plates (CR) and patient-specific implants (PSI)—and evaluated their accuracy of reconstruction and clinical outcome.MethodsOverall, 94 patients had undergone mandibular reconstruction with CR (n = 48) and PSI (n = 46). Six detectable and replicable anatomical reference points, identified via computer tomography, were used for defining the mandibular dimensions. The accuracy of reconstruction was assessed using pre- and postoperative differences.ResultsIn the CR group, the largest difference was at the lateral point of the condyle mandibulae (D2) -1.56 mm (SD = 3.8). In the PSI group, the largest difference between preoperative and postoperative measurement was shown at the processus coronoid (D5) with +1.86 mm (SD = 6.0). Significant differences within the groups in pre- and postoperative measurements were identified at the gonion (D6) [t(56) = -2.217; p = .031 <.05]. In the CR group, the difference was 1.5 (SD = 3.9) and in the PSI group -1.04 (SD = 4.9). CR did not demonstrate a higher risk of plate fractures and post-operative complications compared to PSI.ConclusionFor reconstructing mandibular defects, CR and PSI are eligible. In each case, the advantages and disadvantages of these approaches must be assessed. The functional and esthetic outcome of mandibular reconstruction significantly improves with the experience of the surgeon in conducting microvascular grafts and familiarity with computer-assisted surgery. Interoperator variability can be reduced, and training of younger surgeons involved in planning can be reaching better outcomes in the future.

scholarly journals Accuracy of Patient Specific Cutting Blocks in Total Knee Arthroplasty

2014 ◽  
Vol 2014 ◽  
pp. 1-10 ◽  
Author(s):  
Naeder Helmy ◽  
Mai Lan Dao Trong ◽  
Stefanie P. Kühnel
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Computer Assisted Surgery ◽  
Tibial Slope ◽  
Patient Specific ◽  
Computer Assisted ◽  
Success Rates ◽  
Term Survival ◽  
Margin Of Error ◽  
Total Knee

Background.Long-term survival of total knee arthroplasty (TKA) is mainly determined by optimal positioning of the components and prosthesis alignment. Implant positioning can be optimized by computer assisted surgery (CAS). Patient specific cutting blocks (PSCB) seem to have the potential to improve component alignment compared to the conventional technique and to be comparable to CAS.Methods.113 knees were selected for PSI and included in this study. Pre- and postoperative mechanical axis, represented by the hip-knee-angle (HKA), the proximal tibial angle (PTA), the distal femoral angle (DFA), and the tibial slope (TS) were measured and the deviation from expected ideal values was calculated.Results.With a margin of error of ±3°, success rates were 81.4% for HKA, 92.0% for TPA, and 94.7% for DFA. With the margin of error for alignments extended to ±4°, we obtained a success rate of 92.9% for the HKA, 98.2% for the PTA, and 99.1% for the DFA. The TS showed postoperative results of 2.86 ± 2.02° (mean change 1.76 ± 2.85°).Conclusion.PSCBs for TKA seem to restore the overall leg alignment. Our data suggest that each individual component can be implanted accurately and the results are comparable to the ones in CAS.

scholarly journals Accuracy of Coronal Plane Mechanical Alignment in a Customized, Individually Made Total Knee Replacement with Patient-Specific Instrumentation

2017 ◽  
Vol 31 (08) ◽  
pp. 792-796 ◽  
Author(s):  
Gary Levengood ◽  
Jack Dupee
Keyword(s):  
Mechanical Axis ◽  
Computer Assisted Surgery ◽  
Coronal Plane ◽  
Patient Specific ◽  
Computer Assisted ◽  
Consecutive Series ◽  
Mechanical Alignment ◽  
Patient Specific Instrumentation ◽  
Patient Specific Instruments ◽  
Total Knee

AbstractThe objective of this study was to evaluate the accuracy of a customized individually made total knee implant used in conjunction with patient-specific cutting guides in restoring coronal plane mechanical axis alignment using computer-assisted surgery (CAS). A consecutive series of 63 total knee arthroplasty (TKA) patients were prospectively measured with intraoperative CAS. The patient-specific instruments and implants were created utilizing a preoperative CT scan. CAS system was used for all patients, to determine mechanical alignment. Bone cuts were made using the patient-specific instruments. Both bone cuts and final coronal mechanical alignment were recorded utilizing the navigation system for the assessment.The patient-specific instruments and implants provided perfect neutral coronal mechanical alignment (0°) in 53 patients. The remaining 10 patients had a postoperative alignment within ± 2° of neutral. The average preoperative deformity was 5.57° versus 0.18° postoperatively (p < 0.0001). The mean correction angle was 5.68°. No patients had postoperative extension deficits as measured with CAS (7.50° pre-op for 40/63 patients). Customized, individually made total knee implant with patient-specific cutting jigs showed results that are comparable to those of CAS systems in this study. This technology restores the neutral coronal mechanical axis very accurately, while offering unique benefits such as improved implant fit and restoration of the patient's J-curves, which require further investigation.

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