The accuracy and precision of computer assisted surgery in the assessment of frontal plane deviations of the lower extremity: a femoral fracture model

2009 ◽  
Vol 129 (9) ◽  
pp. 1183-1187 ◽  
Author(s):  
Afshin Khalafi ◽  
Musa Citak ◽  
Daniel Kendoff ◽  
Tobias Huefner ◽  
Christian Krettek
2019 ◽  
Vol 32 (03) ◽  
pp. 241-249 ◽  
Author(s):  
Andrew Worth ◽  
Katherine Crosse ◽  
Andrew Kersley

Objective The aim of this study was to report the use of custom saw guides produced using computed tomographic imaging (CT), computer simulation and three-dimensional (3D) printing to aid surgical correction of antebrachial deformities in six dogs. Materials and Methods Antebrachial limb deformities in four small, and two large, breed dogs (seven limbs) were surgically corrected by a radial closing wedge ostectomy and ulnar osteotomy. The location and orientation of the wedge ostectomy were determined using CT data, computer-assisted planning and production of a saw guide in plastic using a 3D printer. At surgery, the guide was clamped to the surface of the radius and used to direct the oscillating saw blade. The resultant ostectomy was closed and stabilized with a bone plate. Results Five limbs healed without complications. One limb was re-operated due to a poorly resolved rotational component of the deformity. One limb required additional stabilisation with external fixation due to screw loosening. The owners of five dogs completed a Canine Orthopedic Index survey at a follow-up period of 37 to 81 months. The median preoperative score was 3.5 and the median postoperative score was 1, representing an overall positive effect of surgery. Radiographically, 5/7 limbs were corrected in the frontal plane (2/7 were under-corrected). Similarly, 5/7 limbs were corrected in the sagittal plane, and 2/7 were over-corrected in the sagittal place. Conclusions Computer-aided design and rapid prototyping technologies can be used to create saw guides to simplify one-stage corrective osteotomies of the antebrachium using internal fixation in dogs. Despite the encouraging results, accurate correction of rotational deformity was problematic and this aspect requires further development.


2019 ◽  
Vol 31 (1) ◽  
Author(s):  
Hyun Woo Lee ◽  
Sang Jun Song ◽  
Dae Kyung Bae ◽  
Cheol Hee Park

Abstract Background There is debate regarding the influence of a surgeon’s experience with computer-assisted surgery (CAS) on the postoperative mechanical axis (MA) in CAS-high tibial osteotomy. The purpose of the present study was to compare radiographic results between early and late cohorts of a consecutive series of patients to assess the influence of CAS experience on accuracy and precision of the postoperative MA during CAS lateral closing-wedge high tibial osteotomy (LCWHTO). Materials and methods Results from 140 CAS-LCWHTO operations were retrospectively reviewed. The first 70 cases, performed during the learning curve period for CAS between 2005 and 2009, were considered to be the “early cohort.” The subsequent 70 cases, performed with greater CAS experience after the completion of the learning curve between 2009 and 2014, were considered to be the “late cohort.” The target postoperative MA angle was valgus 3°. Pre- and postoperative MA angles were evaluated by navigation and radiographs. The proportion of postoperative MA inliers (≤ target angle ±3°) was investigated radiographically. The correlation between the navigation and radiographic measurements was analyzed. Results The average postosteotomy MA angle on navigation was 3.4° in both cohorts. The average postoperative MA angle on radiographs was 1.0° in the early cohort and 2.2° in the late cohort (P = 0.003). Radiographically, the proportion of postoperative MA inliers was greater in the late cohort than in the early cohort (early versus late, 71.4% versus 90%; P = 0.011). The pre- and postoperative correlation between navigation and radiographic measurements was also stronger in the late cohort (early versus late; preoperative r = 0.558 versus 0.663; postoperative r = 0.310 versus 0.376). Conclusions Greater experience with CAS increased the accuracy and precision of postoperative MA alignment as well as the correlation between navigation and radiographic measurements. Caution should be taken during registration procedures to achieve accurate alignment correction in CAS-LCWHTO.


1995 ◽  
Vol 1 (2) ◽  
pp. 103-108 ◽  
Author(s):  
Hong Lin ◽  
John G. Birch ◽  
Mikhail L. Samchukov ◽  
Richard B. Ashman

Skull Base ◽  
2005 ◽  
Vol 15 (S 2) ◽  
Author(s):  
Ralf Gutwald ◽  
R. Schön ◽  
M. Metzger ◽  
C. Zizelmann ◽  
N.-C. Gellrich ◽  
...  

Skull Base ◽  
2007 ◽  
Vol 16 (04) ◽  
Author(s):  
Klaus Stelter ◽  
Christoph Matthias ◽  
Kathrin Spiegl ◽  
Christian Lübbers ◽  
Andreas Leunig ◽  
...  

Skull Base ◽  
2007 ◽  
Vol 16 (04) ◽  
Author(s):  
Wolfgang Maier ◽  
Petra Lohnstein ◽  
Joerg Schipper

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