scholarly journals The Dimensionless Squared Jerk: An Objective Parameter That Improves Assessment of Hand Motion Analysis during Simulated Shoulder Arthroscopy

2018 ◽  
Vol 2018 ◽  
pp. 1-8 ◽  
Author(s):  
Erica Kholinne ◽  
Maulik J. Gandhi ◽  
Arnold Adikrishna ◽  
Hanpyo Hong ◽  
Haewon Kim ◽  
...  
Keyword(s):  
Motion Analysis ◽  
Path Length ◽  
Shoulder Arthroscopy ◽  
Tracking System ◽  
Arthroscopic Surgery ◽  
Optical Tracking ◽  
Hand Movements ◽  
Total Path Length ◽  
Acceleration Threshold ◽  
Objective Parameter

Purpose. Attempts to quantify hand movements of surgeons during arthroscopic surgery faced limited progress beyond motion analysis of hands and/or instruments. Surrogate markers such as procedure time have been used. The dimensionless squared jerk (DSJ) is a measure of deliberate hand movements. This study tests the ability of DSJ to differentiate novice and expert surgeons (construct validity) whilst performing simulated arthroscopic shoulder surgical tasks. Methods. Six residents (novice group) and six consultants (expert group) participated in this study. Participants performed three validated tasks sequentially under the same experimental setup (one performance). Each participant had ten performances assessed. Hand movements were recorded with optical tracking system. The DSJ, time taken, total path length, multiple measures of acceleration, and number of movements were recorded. Results. There were significant differences between novices and experts when assessed using time, number of movements with average and minimal acceleration threshold, and DSJ. No significant differences were observed in maximum acceleration, total path length, and number of movements with 10m/s2 acceleration threshold. Conclusion. DSJ is an objective parameter that can differentiate novice and expert surgeons’ simulated arthroscopic performances. We propose DSJ as an adjunct to more conventional parameters for arthroscopic surgery skills assessment.

scholarly journals Navigation-assisted anchor insertion in shoulder arthroscopy: a validity study

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Kyunghwa Jung ◽  
Hyojune Kim ◽  
Erica Kholinne ◽  
Dongjun Park ◽  
Hyunseok Choi ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Path Length ◽  
Shoulder Arthroscopy ◽  
Level Of Evidence ◽  
Surgical Performance ◽  
Screw Insertion ◽  
Insertion Angle ◽  
Phantom Model ◽  
Total Path Length ◽  
Repeatability And Reproducibility

Abstract Background This study aimed to compare conventional and navigation-assisted arthroscopic rotator cuff repair in terms of anchor screw insertion. Methods The surgical performance of five operators while using the conventional and proposed navigation-assisted systems in a phantom surgical model and cadaveric shoulders were compared. The participating operators were divided into two groups, the expert group (n = 3) and the novice group (n = 2). In the phantom model, the experimental tasks included anchor insertion in the rotator cuff footprint and sutures retrieval. A motion analysis camera system was used to track the surgeons’ hand movements. The surgical performance metric included the total path length, number of movements, and surgical duration. In cadaveric experiments, the repeatability and reproducibility of the anchor insertion angle were compared among the three experts, and the feasibility of the navigation-assisted anchor insertion was validated. Results No significant differences in the total path length, number of movements, and time taken were found between the conventional and proposed systems in the phantom model. In cadaveric experiments, however, the clustering of the anchor insertion angle indicated that the proposed system enabled both novice and expert operators to reproducibly insert the anchor with an angle close to the predetermined target angle, resulting in an angle error of < 2° (P = 0.0002). Conclusion The proposed navigation-assisted system improved the surgical performance from a novice level to an expert level. All the experts achieved high repeatability and reproducibility for anchor insertion. The navigation-assisted system may help surgeons, including those who are inexperienced, easily familiarize themselves to of suture anchors insertion in the right direction by providing better guidance for anchor orientation. Level of evidence A retrospective study (level 2).

scholarly journals Navigation-assisted anchor insertion in shoulder arthroscopy: a validity study

2020 ◽  
Author(s):  
Kyunghwa Jung ◽  
Hyojune Kim ◽  
Erica Kholinne ◽  
Dongjun Park ◽  
Hyunseok Choi ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Path Length ◽  
Shoulder Arthroscopy ◽  
Level Of Evidence ◽  
Surgical Performance ◽  
Screw Insertion ◽  
Insertion Angle ◽  
Phantom Model ◽  
Total Path Length ◽  
Repeatability And Reproducibility

Abstract Background This study aimed to compare conventional and navigation-assisted arthroscopic rotator cuff repair in terms of anchor screw insertion.Methods The surgical performance of five operators while using the conventional and proposed navigation-assisted systems in a phantom surgical model and cadaveric shoulders were compared. The participating operators were divided into two groups, the expert group (n = 3) and the novice group (n = 2). In the phantom model, the experimental tasks included anchor insertion in the rotator cuff footprint and sutures retrieval. A motion analysis camera system was used to track the surgeons’ hand movements. The surgical performance metric included the total path length, number of movements, and surgical duration. In cadaveric experiments, the repeatability and reproducibility of the anchor insertion angle were compared among the three experts, and the feasibility of the navigation-assisted anchor insertion was validated.Results No significant differences in the total path length, number of movements, and time taken were found between the conventional and proposed systems in the phantom model. In cadaveric experiments, however, the clustering of the anchor insertion angle indicated that the proposed system enabled both novice and expert operators to reproducibly insert the anchor with an angle close to the predetermined target angle, resulting in an angle error of <2° (P = 0.0002).Conclusion The proposed navigation-assisted system improved the surgical performance from a novice level to an expert level. All the experts achieved high repeatability and reproducibility for anchor insertion. The navigation-assisted system may help surgeons, including those who are inexperienced, easily familiarize themselves to of suture anchors insertion in the right direction by providing better guidance for anchor orientation.Level of Evidence A retrospective study (level 2)

scholarly journals Improvement of arthroscopic surgical performance using a new wide-angle arthroscope

2018 ◽  
Author(s):  
Jae-Man Kwak ◽  
Erica Kholinne ◽  
Kyoung Hwan Koh ◽  
In-Ho Jeon
Keyword(s):  
Tracking System ◽  
Optical Tracking ◽  
Wide Angle ◽  
Surgical Performance ◽  
Optical Tracking System ◽  
Total Path Length ◽  
Average Acceleration ◽  
Hand Eye Coordination ◽  
Arthroscopic Rotator Cuff ◽  
Cuff Repair

AbstractBackgroundWe have developed a new arthroscope with a field of view of 150°. This requires less motion to maneuver, and the optical error is decreased. It also improves how novices learn arthroscopy. We hypothesized that surgical performance using this arthroscope is superior to a conventional arthroscope. This study tested the hypothesis using motion analysis and a new validated parameter, “dimensionless squared jolt” (DSJ).MethodsWe compared the surgical performance using between the wide-angle and the conventional arthroscope among 14 novice orthopedic residents who performed three standardized tasks three times with each arthroscope. The tasks simulated arthroscopic rotator cuff repair surgical skills. Their motion was analyzed using an optical tracking system. The differences in performance parameters, such as time taken, average acceleration of the hands (m/s2), the number of movements, and the total path length (m) including DSJ between the two arthroscopes, were investigated using paired t-tests.ResultsAll the estimated values for the tasks using the 150° arthroscope were lower than those for the 105° arthroscope. There were statistically significant differences in performance between the two arthroscopes only for DSJ (p = 0.014) and average acceleration (p = 0.039).ConclusionsDSJ and average acceleration are reliable parameters for representing hand-eye coordination. The surgical performance of novice arthroscopists was better with the new wide-angle arthroscope than with the conventional arthroscope.

scholarly journals Protocol for a multicenter randomized controlled trial comparing a non-opioid prescription to the standard of care for pain control following arthroscopic knee and shoulder surgery

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Aaron Gazendam ◽  
◽  
Seper Ekhtiari ◽  
Nolan S. Horner ◽  
Nicole Simunovic ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Pain Control ◽  
Shoulder Arthroscopy ◽  
Controlled Trial ◽  
Arthroscopic Surgery ◽  
Standard Of Care ◽  
Opioid Prescription ◽  
Randomized Controlled ◽  
Secondary Outcomes ◽  
Arthroscopic Knee

Abstract Background Opioids continue to be the analgesic of choice for postoperative pain control following arthroscopic knee and shoulder surgery. Despite their widespread use, there are limited evidence-based clinical practice guidelines for postoperative opioid prescribing. The Non-Opioid Prescriptions after Arthroscopic Surgery in Canada (NO PAin) Trial is a randomized controlled trial (RCT) designed to determine whether a non-opioid analgesia approach to postoperative pain, compared to usual care, reduces oral morphine equivalents (OME) consumed in patients undergoing outpatient knee and shoulder arthroscopy. Methods This is a multi-centre, RCT with a target sample size of 200 patients. Adult (18+ years of age) patients undergoing outpatient knee and shoulder arthroscopy will be randomized to a non-opioid postoperative protocol (intervention) or the current standard of care (control). The intervention will consist of a standardized non-opioid analgesic prescription, a limited rescue opioid prescription, and a patient education infographic. The control is defined as the treating surgeons’ pre-trial postoperative analgesic regimen. Exclusion criteria include chronic opioid use, concomitant open surgery, contraindications to the prescribed analgesics or ongoing workers compensation/litigation. The primary outcome is OMEs consumed at 6 weeks postoperatively. Secondary outcomes will include patient-reported pain and satisfaction, quantity of OMEs prescribed, number of opioid refills, and any adverse events up to 6 weeks postoperatively. Utilizing the intention to treat principle for all analyses, independent samples t-test and presented with a p-value as well as a mean difference (MD) with 95% confidence intervals (CIs) will be performed for primary and secondary outcomes. Discussion The ongoing opioid epidemic and overprescribing of opioids in orthopaedics serve as the rationale for this trial. There is a lack of evidence upon which to develop post-operative pain management guidelines for patients undergoing arthroscopic surgery. A prospective evaluation of this relatively inexpensive intervention will demonstrate whether an explicit effort to reduce the number of opioids prescribed results in a reduction in the amount of opioids consumed and help to inform future studies and guidelines. Trial registration The NO PAin trial has been prospectively registered with clinicaltrials.gov (NCT04566250).

scholarly journals The Impact of Smoking on Clinical Results Following the Rotator Cuff and Biceps Tendon Complex Arthroscopic Surgery

2021 ◽  
Vol 10 (4) ◽  
pp. 599
Author(s):  
Jan Zabrzyński ◽  
Gazi Huri ◽  
Maciej Gagat ◽  
Łukasz Łapaj ◽  
Alper Yataganbaba ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Functional Outcomes ◽  
Shoulder Arthroscopy ◽  
Smoking Status ◽  
Biceps Tendon ◽  
Arthroscopic Surgery ◽  
Rotator Cuff Tears ◽  
Shoulder Injuries ◽  
The Impact

The purpose of this study was to investigate the association of smoking and functional outcomes after arthroscopic treatment of complex shoulder injuries: rotator cuff tears (RCTs) with biceps tendon (LHBT) tears. This retrospective case-control study has been conducted on a cohort of patients who underwent shoulder arthroscopy between 2015 and 2017 due to complex injury treatment. The outcomes were assessed using the American Shoulder and Elbow Surgeons Score (ASES), the University of California at Los Angeles (UCLA) Shoulder Score, need for non-steroid anti-inflammatory drugs (NSAIDs) consumption and the visual analog scale (VAS). Complications and changes in smoking status were also noted. A cohort of 59 patients underwent shoulder arthroscopy, due to complex LHBT pathology and RCTs, and were enrolled in the final follow-up examination; with mean duration of 26.03 months. According to smoking status, 27 of patients were classified as smokers, and the remaining 32 were non-smokers. In the examined cohort, 36 patients underwent the LHBT tenotomy and 23 tenodesis. We observed a relationship between smoking status and distribution of various RCTs (p < 0.0001). The mean postoperative ASES and UCLA scores were 80.81 and 30.18 in the smoker’s group and 84.06 and 30.93 in the non-smoker’s group, respectively. There were no statistically significant differences in pre/postoperative ASES and postoperative UCLA scores between smokers and non-smokers (p > 0.05). The VAS was significantly lower in the non-smokers’ group (p = 0.0021). Multi-tendon injuries of the shoulder are a serious challenge for surgeons, and to obtain an excellent functional outcome, we need to limit the negative risk factors, including smoking. Furthermore, there is a significant association between smoking and the occurrence of massive rotator cuff tears, and the pain level measured by the VAS. Simultaneous surgical treatment of RC and LHBT lesions in the smoker population allowed us to obtain the functional outcomes approximated to non-smokers in the long-term follow-up. Of course, we cannot assert that smoking is the real cause of all complications, however, we may assume that this is a very important, negative factor in shoulder arthroscopy.

scholarly journals In Vitro and In Vivo Assessment of a New Workflow for the Acquisition of Mandibular Kinematics Based on Portable Tracking System with Passive Optical Reflective Markers

2021 ◽  
Vol 11 (9) ◽  
pp. 3947
Author(s):  
Marco Farronato ◽  
Gianluca M. Tartaglia ◽  
Cinzia Maspero ◽  
Luigi M. Gallo ◽  
Vera Colombo
Keyword(s):  
Measurement Error ◽  
Tracking System ◽  
Intraclass Correlation ◽  
Optical Tracking ◽  
Optical Tracking System ◽  
Rater Reliability ◽  
Tracking Device ◽  
Mandibular Kinematics

Clinical use of portable optical tracking system in dentistry could improve the analysis of mandibular movements for diagnostic and therapeutic purposes. A new workflow for the acquisition of mandibular kinematics was developed. Reproducibility of measurements was tested in vitro and intra- and inter-rater repeatability were assessed in vivo in healthy volunteers. Prescribed repeated movements (n = 10) in three perpendicular directions of the tracking-device coordinate system were performed. Measurement error and coefficient of variation (CV) among repetitions were determined. Mandibular kinematics of maximum opening, left and right laterality, protrusion and retrusion of five healthy subjects were recorded in separate sessions by three different operators. Obtained records were blindly examined by three observers. Intraclass correlation coefficient (ICC) was calculated to estimate inter-rater and intra-rater reliability. Maximum in vitro measurement error was 0.54 mm and CV = 0.02. Overall, excellent intra-rater reliability (ICC > 0.90) for each variable, general excellent intra-rater reliability (ICC = 1.00) for all variables, and good reliability (ICC > 0.75) for inter-rater tests were obtained. A lower score was obtained for retrusion with “moderate reliability” (ICC = 0.557) in the inter-rater tests. Excellent repeatability and reliability in optical tracking of primary movements were observed using the tested portable tracking device and the developed workflow.

scholarly journals High Precision Optical Tracking System Based on near Infrared Trinocular Stereo Vision

Sensors ◽  
2021 ◽  
Vol 21 (7) ◽  
pp. 2528
Author(s):  
Songlin Bi ◽  
Yonggang Gu ◽  
Jiaqi Zou ◽  
Lianpo Wang ◽  
Chao Zhai ◽  
...  
Keyword(s):  
High Precision ◽  
Stereo Vision ◽  
Near Infrared ◽  
Nearest Neighbor ◽  
Tracking System ◽  
Optical Tracking ◽  
Tracking Accuracy ◽  
Optical Tracking System ◽  
Dynamic Tracking ◽  
Trinocular Stereo

A high precision optical tracking system (OTS) based on near infrared (NIR) trinocular stereo vision (TSV) is presented in this paper. Compared with the traditional OTS on the basis of binocular stereo vision (BSV), hardware and software are improved. In the hardware aspect, a NIR TSV platform is built, and a new active tool is designed. Imaging markers of the tool are uniform and complete with large measurement angle (>60°). In the software aspect, the deployment of extra camera brings high computational complexity. To reduce the computational burden, a fast nearest neighbor feature point extraction algorithm (FNNF) is proposed. The proposed method increases the speed of feature points extraction by hundreds of times over the traditional pixel-by-pixel searching method. The modified NIR multi-camera calibration method and 3D reconstruction algorithm further improve the tracking accuracy. Experimental results show that the calibration accuracy of the NIR camera can reach 0.02%, positioning accuracy of markers can reach 0.0240 mm, and dynamic tracking accuracy can reach 0.0938 mm. OTS can be adopted in high-precision dynamic tracking.

scholarly journals Skill Transference of a Probe-Tube Placement Training Simulator

2020 ◽  
Vol 31 (01) ◽  
pp. 040-049 ◽  
Author(s):  
Robert W. Koch ◽  
Hasan Saleh ◽  
Paula Folkeard ◽  
Sheila Moodie ◽  
Conner Janeteas ◽  
...  
Keyword(s):  
Mixed Model ◽  
Tracking System ◽  
Optical Tracking ◽  
Tube Placement ◽  
Control Group ◽  
Educational Settings ◽  
Training Simulator ◽  
Nonlinear Mixed Model ◽  
Optical Tracking System ◽  
Clinical Scenarios

AbstractProbe-tube placement is a necessary step in hearing aid verification which needs ample hands-on experience and confidence before performing in clinic. To improve the methods of training in probe-tube placement, a manikin-based training simulator was developed consisting of a 3D-printed head, a flexible silicone ear, and a mounted optical tracking system. The system is designed to provide feedback to the user on the depth and orientation of the probe tube, and the time required to finish the task. Although a previous validation study was performed to determine its realism and teachability with experts, further validation is required before implementation into educational settings.This study aimed to examine the skill transference of a newly updated probe-tube placement training simulator to determine if skills learned on this simulator successfully translate to clinical scenarios.All participants underwent a pretest in which they were evaluated while performing a probe-tube placement and real-ear-to-coupler difference (RECD) measurement on a volunteer. Participants were randomized into one of two groups: the simulator group or the control group. During a two-week training period, all participants practiced their probe-tube placement according to their randomly assigned group. After two weeks, each participant completed a probe-tube placement on the same volunteer as a posttest scenario.Twenty-five novice graduate-level student clinicians.Participants completed a self-efficacy questionnaire and an expert observer completed a questionnaire evaluating each participant’s performance during the pre- and posttest sessions. RECD measurements were taken after placing the probe tube and foam tip in the volunteer’s ear. Questionnaire results were analyzed through nonparametric t-tests and analysis of variance, whereas RECD results were analyzed using a nonlinear mixed model method.Results suggested students in the simulator group were less likely to contact the tympanic membrane when placing a probe tube, appeared more confident, and had better use of the occluding foam tip, resulting in more improved RECD measurements.The improved outcomes for trainees in the simulator group suggest that supplementing traditional training with the simulator provides useful benefits for the trainees, thereby encouraging its usage and implementation in educational settings.

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