Int J Comput Assist Radiol Surg - Development of a biomechanical guidance system for periacetabular osteotomy.

Tópicos

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Resumo

RPOSE: This paper presents and validates a computer-navigated system for performing periacetabular osteotomy (PAO) to treat developmental dysplasia of the hip. The main motivation of the biomechanical guidance system (BGS) is to plan and track the osteotomy fragment in real time during PAO while simplifying the procedure for less-experienced surgeons. The BGS aims at developing a platform for comparing biomechanical states of the joint with the current gold standard geometric assessment of anatomical angles. The purpose of this study was to (1) determine the accuracy with which the BGS tracks the hip joint through repositioning and (2) identify improvements to the workflow.METHODS: Nineteen cadaveric validation studies quantified system accuracy, verified system application, and helped to refine surgical protocol. In two surgeries, navigation and registration accuracy were computed by affixing fiducials to two cadavers prior to surgery. All scenarios compared anatomical angle measurements and joint positioning as measured intraoperatively to postoperatively.RESULTS: In the two cases with fiducials, computed fragment transformations deviated from measured fiducial transformations by 1.4 and 1.8 mm in translation and 1.0? and 2.2? in rotation, respectively. The additional seventeen surgeries showed strong agreement between intraoperative and postoperative anatomical angles, helped to refine the surgical protocol, and demonstrated system robustness.CONCLUSION: Estimated accuracy with BGS appeared acceptable for future surgical applications. Several major system requirements were identified and addressed, improving the BGS and making it feasible for clinical studies.

Resumo Limpo

rpose paper present valid computernavig system perform periacetabular osteotomi pao treat development dysplasia hip main motiv biomechan guidanc system bgs plan track osteotomi fragment real time pao simplifi procedur lessexperienc surgeon bgs aim develop platform compar biomechan state joint current gold standard geometr assess anatom angl purpos studi determin accuraci bgs track hip joint reposit identifi improv workflowmethod nineteen cadaver valid studi quantifi system accuraci verifi system applic help refin surgic protocol two surgeri navig registr accuraci comput affix fiduci two cadav prior surgeri scenario compar anatom angl measur joint posit measur intraop postoperativelyresult two case fiduci comput fragment transform deviat measur fiduci transform mm translat rotat respect addit seventeen surgeri show strong agreement intraop postop anatom angl help refin surgic protocol demonstr system robustnessconclus estim accuraci bgs appear accept futur surgic applic sever major system requir identifi address improv bgs make feasibl clinic studi

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