Computer Assisted Surgery最新文献

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A review on organ deformation modeling approaches for reliable surgical navigation using augmented reality. 利用增强现实技术进行可靠手术导航的器官变形建模方法综述。
IF 1.5 4区 医学
Computer Assisted Surgery Pub Date : 2024-12-01 Epub Date: 2024-09-10 DOI: 10.1080/24699322.2024.2357164
Zheng Han, Qi Dou
{"title":"A review on organ deformation modeling approaches for reliable surgical navigation using augmented reality.","authors":"Zheng Han, Qi Dou","doi":"10.1080/24699322.2024.2357164","DOIUrl":"https://doi.org/10.1080/24699322.2024.2357164","url":null,"abstract":"<p><p>Augmented Reality (AR) holds the potential to revolutionize surgical procedures by allowing surgeons to visualize critical structures within the patient's body. This is achieved through superimposing preoperative organ models onto the actual anatomy. Challenges arise from dynamic deformations of organs during surgery, making preoperative models inadequate for faithfully representing intraoperative anatomy. To enable reliable navigation in augmented surgery, modeling of intraoperative deformation to obtain an accurate alignment of the preoperative organ model with the intraoperative anatomy is indispensable. Despite the existence of various methods proposed to model intraoperative organ deformation, there are still few literature reviews that systematically categorize and summarize these approaches. This review aims to fill this gap by providing a comprehensive and technical-oriented overview of modeling methods for intraoperative organ deformation in augmented reality in surgery. Through a systematic search and screening process, 112 closely relevant papers were included in this review. By presenting the current status of organ deformation modeling methods and their clinical applications, this review seeks to enhance the understanding of organ deformation modeling in AR-guided surgery, and discuss the potential topics for future advancements.</p>","PeriodicalId":56051,"journal":{"name":"Computer Assisted Surgery","volume":"29 1","pages":"2357164"},"PeriodicalIF":1.5,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142301863","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Flexible endoscope manipulating robot using quad-roller friction mechanism. 使用四辊摩擦机构的柔性内窥镜操纵机器人。
IF 1.5 4区 医学
Computer Assisted Surgery Pub Date : 2024-12-01 Epub Date: 2024-09-21 DOI: 10.1080/24699322.2024.2404695
Subin Lee, Hyeonwook Kim, Jaehyeon Byeon, Seongbo Shim, Hyun-Joo Lee, Jaesung Hong
{"title":"Flexible endoscope manipulating robot using quad-roller friction mechanism.","authors":"Subin Lee, Hyeonwook Kim, Jaehyeon Byeon, Seongbo Shim, Hyun-Joo Lee, Jaesung Hong","doi":"10.1080/24699322.2024.2404695","DOIUrl":"https://doi.org/10.1080/24699322.2024.2404695","url":null,"abstract":"<p><p>A robotic system for manipulating a flexible endoscope in surgery can provide enhanced accuracy and usability compared to manual operation. However, previous studies require large-scale, complex hardware systems to implement the rotational and translational motions of the soft endoscope cable. The conventional control of the endoscope by actuating the endoscope handle also leads to undesired slack between the endoscope tip and the handle, which becomes more problematic with long endoscopes such as a colonoscope. This study proposes a compact quad-roller friction mechanism that enables rotational and translational motions triggered not from the endoscope handle but at the endoscope tip. Controlling two pairs of tilted rollers achieves both types of motion within a small space. The proposed system also introduces an unsynchronized motion strategy between the handle and tip parts to minimize the robot's motion near the patient by employing the slack positively as a control index. Experiments indicate that the proposed system achieves accurate rotational and translational motions, and the unsynchronized control method reduces the total translational motion by up to 88% compared to the previous method.</p>","PeriodicalId":56051,"journal":{"name":"Computer Assisted Surgery","volume":"29 1","pages":"2404695"},"PeriodicalIF":1.5,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142301864","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Monte Carlo-based rendering of 3D echocardiography for mixed reality-guided atrial septal puncture positioning. 基于蒙特卡罗的三维超声心动图渲染,用于混合现实引导的房间隔穿刺定位。
IF 1.5 4区 医学
Computer Assisted Surgery Pub Date : 2024-12-01 Epub Date: 2024-09-20 DOI: 10.1080/24699322.2024.2403444
Dharani Dhar Maddali, Håvard Solvin, Matthias Lippert, Yücel Karabiyik, Gry Dahle, Jon Mikkelsen Hjelmervik, Gabriel Kiss, Ole Jakob Elle, Henrik Brun
{"title":"Monte Carlo-based rendering of 3D echocardiography for mixed reality-guided atrial septal puncture positioning.","authors":"Dharani Dhar Maddali, Håvard Solvin, Matthias Lippert, Yücel Karabiyik, Gry Dahle, Jon Mikkelsen Hjelmervik, Gabriel Kiss, Ole Jakob Elle, Henrik Brun","doi":"10.1080/24699322.2024.2403444","DOIUrl":"https://doi.org/10.1080/24699322.2024.2403444","url":null,"abstract":"<p><p>Catheter-based intervention procedures contain complex maneuvers, and they are often performed using fluoroscopic guidance assisted by 2D and 3D echocardiography viewed on a flat screen that inherently limits depth perception. Emerging mixed reality (MR) technologies, combined with advanced rendering techniques, offer potential enhancement in depth perception and navigational support. The study aims to evaluate a MR-based guidance system for the atrial septal puncture (ASP) procedure utilizing a phantom anatomical model. A novel MR-based guidance system using a modified Monte Carlo-based rendering approach for 3D echocardiographic visualization was introduced and evaluated against standard clinical 3D echocardiographic display on a flat screen. The objective was to guide the ASP procedure by facilitating catheter placement and puncture across four specific atrial septum quadrants. To assess the system's feasibility and performance, a user study involving four experienced interventional cardiologists was conducted using a phantom model. Results show that participants accurately punctured the designated quadrant in 14 out of 16 punctures using MR and 15 out of 16 punctures using the flat screen of the ultrasound machine. The geometric mean puncture time for MR was 31 s and 26 s for flat screen guidance. User experience ratings indicated MR-based guidance to be easier to navigate and locate tents of the atrial septum. The study demonstrates the feasibility of MR-guided atrial septal puncture. User experience data, particularly with respect to navigation, imply potential benefits for more complex procedures and educational purposes. The observed performance difference suggests an associated learning curve for optimal MR utilization.</p>","PeriodicalId":56051,"journal":{"name":"Computer Assisted Surgery","volume":"29 1","pages":"2403444"},"PeriodicalIF":1.5,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142301865","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Early postoperative efficacy of a fully automated orthopedic robotic system-assisted percutaneous pedicle screw fixation for isthmic spondylolisthesis. 全自动骨科机器人系统辅助经皮椎弓根螺钉固定治疗峡部脊柱滑脱症的术后早期疗效。
IF 2.1 4区 医学
Computer Assisted Surgery Pub Date : 2024-09-12 DOI: 10.1080/24699322.2024.2399502
Li Zongze,Cheng Yongquan,Zeng Guanjie,Zhu Yongjian,Cui Yuhui,Jiang Hui,Chen Jianting
{"title":"Early postoperative efficacy of a fully automated orthopedic robotic system-assisted percutaneous pedicle screw fixation for isthmic spondylolisthesis.","authors":"Li Zongze,Cheng Yongquan,Zeng Guanjie,Zhu Yongjian,Cui Yuhui,Jiang Hui,Chen Jianting","doi":"10.1080/24699322.2024.2399502","DOIUrl":"https://doi.org/10.1080/24699322.2024.2399502","url":null,"abstract":"To assess the feasibility of percutaneous pedicle screw fixation assisted by a fully automated orthopedic robotic system for the treatment of isthmic spondylolisthesis and evaluate its early postoperative outcome. Totally 20 patients with isthmic spondylolisthesis who underwent surgical procedure by the same medical group from March 2020 to March 2023 were retrospectively analyzed, including 10 patients in the robot-assisted group (RA group) and the other 10 patients in the conventional free-hand technique group (FH group). Accuracy of screw insertion was determined using the Gertzbein-Robbins Scale. The accuracy of the novel robotic system was evaluated by comparing the screw position in the preoperative planning and measuring the entry point deviation distance and the trajectory rotation. The differences in operative time, intraoperative blood loss, radiographic fluoroscopy time and fluoroscopic dosage, and length of hospital stay were compared between the two groups. The lumbar visual analog scale scores before and 7 days after operation were analyzed to evaluate the improvement of low back pain as the early postoperative outcome. A total of 84 pedicle screws were placed. In the RA group, 97.5% of screws were Grade A, and 2.5% were Grade B. In the FH group, 88.6% of screws were Grade A, 9.1% were Grade B, and 2.3% were Grade C. No statistical difference was found in the operation time between two groups. The RA group showed a significant reduction in intraoperative blood loss, radiographic fluoroscopy time and fluoroscopic dosage, and length of hospital stay compared to the FH group. The low back pain in both groups was significantly improved after the operation. The novel orthopedic robotic system-assisted percutaneous pedicle screw fixation, with accurate intraoperative screw placement, less surgical damage, less fluoroscopy and shorter length of hospital stay, can be safe and effective for the surgical treatment of isthmic spondylolisthesis.","PeriodicalId":56051,"journal":{"name":"Computer Assisted Surgery","volume":"27 1","pages":"2399502"},"PeriodicalIF":2.1,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142193996","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Virtual surgical planning in craniomaxillofacial surgery: a structured review. 颅颌面外科的虚拟手术计划:结构综述。
IF 2.1 4区 医学
Computer Assisted Surgery Pub Date : 2023-12-01 Epub Date: 2023-10-20 DOI: 10.1080/24699322.2023.2271160
Kaye Velarde, Rentor Cafino, Armando Isla, Karen Mae Ty, Xavier-Lewis Palmer, Lucas Potter, Larry Nadorra, Luchin Valrian Pueblos, Lemuel Clark Velasco
{"title":"Virtual surgical planning in craniomaxillofacial surgery: a structured review.","authors":"Kaye Velarde, Rentor Cafino, Armando Isla, Karen Mae Ty, Xavier-Lewis Palmer, Lucas Potter, Larry Nadorra, Luchin Valrian Pueblos, Lemuel Clark Velasco","doi":"10.1080/24699322.2023.2271160","DOIUrl":"10.1080/24699322.2023.2271160","url":null,"abstract":"<p><p>Craniomaxillofacial (CMF) surgery is a challenging and very demanding field that involves the treatment of congenital and acquired conditions of the face and head. Due to the complexity of the head and facial region, various tools and techniques were developed and utilized to aid surgical procedures and optimize results. Virtual Surgical Planning (VSP) has revolutionized the way craniomaxillofacial surgeries are planned and executed. It uses 3D imaging computer software to visualize and simulate a surgical procedure. Numerous studies were published on the usage of VSP in craniomaxillofacial surgery. However, the researchers found inconsistency in the previous literature which prompted the development of this review. This paper aims to provide a comprehensive review of the findings of the studies by conducting an integrated approach to synthesize the literature related to the use of VSP in craniomaxillofacial surgery. Twenty-nine related articles were selected as a sample and synthesized thoroughly. These papers were grouped assigning to the four subdisciplines of craniomaxillofacial surgery: orthognathic surgery, reconstructive surgery, trauma surgery and implant surgery. The following variables - treatment time, the accuracy of VSP, clinical outcome, cost, and cost-effectiveness - were also examined. Results revealed that VSP offers advantages in craniomaxillofacial surgery over the traditional method in terms of duration, predictability and clinical outcomes. However, the cost aspect was not discussed in most papers. This structured literature review will thus provide current findings and trends and recommendations for future research on the usage of VSP in craniomaxillofacial surgery.</p>","PeriodicalId":56051,"journal":{"name":"Computer Assisted Surgery","volume":"28 1","pages":"2271160"},"PeriodicalIF":2.1,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49685405","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Performance assessment of surgical tracking systems based on statistical process control and longitudinal QA. 基于统计过程控制和纵向QA的手术跟踪系统性能评估。
IF 2.1 4区 医学
Computer Assisted Surgery Pub Date : 2023-12-01 Epub Date: 2023-11-09 DOI: 10.1080/24699322.2023.2275522
I Butz, M Fernandez, A Uneri, N Theodore, W S Anderson, J H Siewerdsen
{"title":"Performance assessment of surgical tracking systems based on statistical process control and longitudinal QA.","authors":"I Butz, M Fernandez, A Uneri, N Theodore, W S Anderson, J H Siewerdsen","doi":"10.1080/24699322.2023.2275522","DOIUrl":"10.1080/24699322.2023.2275522","url":null,"abstract":"<p><p>A system for performance assessment and quality assurance (QA) of surgical trackers is reported based on principles of geometric accuracy and statistical process control (SPC) for routine longitudinal testing. A simple QA test phantom was designed, where the number and distribution of registration fiducials was determined drawing from analytical models for target registration error (TRE). A tracker testbed was configured with open-source software for measurement of a TRE-based accuracy metric <math><mi>ε</mi></math> and Jitter (<math><mi>J</mi></math>). Six trackers were tested: 2 electromagnetic (EM - Aurora); and 4 infrared (IR - 1 Spectra, 1 Vega, and 2 Vicra) - all NDI (Waterloo, ON). Phase I SPC analysis of Shewhart mean (<math><mrow><mrow><mrow><mover><mrow><mi>x</mi></mrow><mo>¯</mo></mover></mrow></mrow></mrow></math>) and standard deviation (<math><mi>s</mi></math>) determined system control limits. Phase II involved weekly QA of each system for up to 32 weeks and identified Pass, Note, Alert, and Failure action rules. The process permitted QA in <1 min. Phase I control limits were established for all trackers: EM trackers exhibited higher upper control limits than IR trackers in <math><mi>ε</mi></math> (EM: <math><mrow><msub><mrow><mrow><mrow><mrow><mover><mrow><mi>x</mi></mrow><mo>¯</mo></mover></mrow></mrow></mrow></mrow><mrow><mi>ε</mi></mrow></msub></mrow><mi> </mi><mo>∼</mo></math>2.8-3.3 mm, IR: <math><mrow><msub><mrow><mrow><mrow><mrow><mover><mrow><mi>x</mi></mrow><mo>¯</mo></mover></mrow></mrow></mrow></mrow><mrow><mi>ε</mi></mrow></msub></mrow><mi> </mi><mo>∼</mo></math>1.6-2.0 mm) and Jitter (EM: <math><mrow><msub><mrow><mrow><mrow><mrow><mover><mrow><mi>x</mi></mrow><mo>¯</mo></mover></mrow></mrow></mrow></mrow><mrow><mi>jitter</mi></mrow></msub></mrow><mi> </mi><mo>∼</mo></math>0.30-0.33 mm, IR: <math><mrow><msub><mrow><mrow><mrow><mrow><mover><mrow><mi>x</mi></mrow><mo>¯</mo></mover></mrow></mrow></mrow></mrow><mrow><mi>jitter</mi></mrow></msub></mrow><mi> </mi><mo>∼</mo></math>0.08-0.10 mm), and older trackers showed evidence of degradation - e.g. higher Jitter for the older Vicra (<i>p</i>-value < .05). Phase II longitudinal tests yielded 676 outcomes in which a total of 4 Failures were noted - 3 resolved by intervention (metal interference for EM trackers) - and 1 owing to restrictive control limits for a new system (Vega). Weekly tests also yielded 40 Notes and 16 Alerts - each spontaneously resolved in subsequent monitoring.</p>","PeriodicalId":56051,"journal":{"name":"Computer Assisted Surgery","volume":"28 1","pages":"2275522"},"PeriodicalIF":2.1,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71523503","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Research on augmented reality navigation of in vitro fenestration of stent-graft based on deep learning and virtual-real registration. 基于深度学习和虚拟实配准的支架体外开窗增强现实导航研究。
IF 2.1 4区 医学
Computer Assisted Surgery Pub Date : 2023-12-01 Epub Date: 2023-12-07 DOI: 10.1080/24699322.2023.2289339
Fengfeng He, Xiaoyu Qi, Qingmin Feng, Qiang Zhang, Ning Pan, Chao Yang, Shenglin Liu
{"title":"Research on augmented reality navigation of in vitro fenestration of stent-graft based on deep learning and virtual-real registration.","authors":"Fengfeng He, Xiaoyu Qi, Qingmin Feng, Qiang Zhang, Ning Pan, Chao Yang, Shenglin Liu","doi":"10.1080/24699322.2023.2289339","DOIUrl":"10.1080/24699322.2023.2289339","url":null,"abstract":"<p><strong>Objectives: </strong><i>In vitro</i> fenestration of stent-graft (IVFS) demands high-precision navigation methods to achieve optimal surgical outcomes. This study aims to propose an augmented reality (AR) navigation method for IVFS, which can provide <i>in situ</i> overlay display to locate fenestration positions.</p><p><strong>Methods: </strong>We propose an AR navigation method to assist doctors in performing IVFS. A deep learning-based aorta segmentation algorithm is used to achieve automatic and rapid aorta segmentation. The Vuforia-based virtual-real registration and marker recognition algorithm are integrated to ensure accurate <i>in situ</i> AR image.</p><p><strong>Results: </strong>The proposed method can provide three-dimensional <i>in situ</i> AR image, and the fiducial registration error after virtual-real registration is 2.070 mm. The aorta segmentation experiment obtains dice similarity coefficient of 91.12% and Hausdorff distance of 2.59, better than conventional algorithms before improvement.</p><p><strong>Conclusions: </strong>The proposed method can intuitively and accurately locate fenestration positions, and therefore can assist doctors in performing IVFS.</p>","PeriodicalId":56051,"journal":{"name":"Computer Assisted Surgery","volume":"28 1","pages":"2289339"},"PeriodicalIF":2.1,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138500344","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Biomechanical behavior of the three-dimensionally printed surgical plates for mandibular defect reconstruction: a finite element analysis. 三维打印手术板用于下颌缺损重建的生物力学行为:有限元分析。
IF 2.1 4区 医学
Computer Assisted Surgery Pub Date : 2023-12-01 Epub Date: 2023-11-27 DOI: 10.1080/24699322.2023.2286181
Chao-Fei Wang, Shuo Liu, Lei-Hao Hu, Yao Yu, Xin Peng, Wen-Bo Zhang
{"title":"Biomechanical behavior of the three-dimensionally printed surgical plates for mandibular defect reconstruction: a finite element analysis.","authors":"Chao-Fei Wang, Shuo Liu, Lei-Hao Hu, Yao Yu, Xin Peng, Wen-Bo Zhang","doi":"10.1080/24699322.2023.2286181","DOIUrl":"10.1080/24699322.2023.2286181","url":null,"abstract":"<p><p>The aim of the study was to investigate the biomechanical behavior of three-dimensionally (3D)-printed surgical plates used for mandibular defect reconstruction, compare them with conventional surgical plates, and provide experimental evidence for their clinical application. Three-dimensional models were created for the normal mandible and for mandibular body defects reconstructed using free fibula and deep circumflex iliac artery flaps. Three-dimensional finite element models of reconstructed mandibles fixed using 3D-printed and conventional surgical plates were established. Vertical occlusal forces were applied to the remaining teeth and the displacement and Von Mises stress distributions were studied using finite element analysis. The normal and reconstructed mandibles had similar biomechanical behaviors. The displacement distributions for the surgical plates were similar, and the maximum total deformation occurred at the screw hole of the anterior segment of the surgical plates. However, there were differences in the Von Mises stress distributions for the surgical plates. In reconstructed mandibles fixed using 3D-printed surgical plates, the maximum equivalent Von Mises stress occurred at the screw hole of the posterior segment, while in those fixed using conventional surgical plates, the maximum equivalent Von Mises stress was at the screw hole of the anterior segment. In the mandible models reconstructed with the same free flap but fixed with different surgical plates, the plates had similar biomechanical behaviors. The biomechanical behavior of 3D-printed surgical plates was similar to conventional surgical plates, suggesting that 3D-printed surgical plates used to reconstruct mandibular body defects with vascularized autogenous bone grafts could lead to secure and stable fixation.</p>","PeriodicalId":56051,"journal":{"name":"Computer Assisted Surgery","volume":"28 1","pages":"2286181"},"PeriodicalIF":2.1,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138447210","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Tibial component rotation alters soft tissue balance in a cruciate retaining total knee arthroplasty 保留交叉韧带的全膝关节置换术中胫骨组件旋转改变软组织平衡
IF 2.1 4区 医学
Computer Assisted Surgery Pub Date : 2022-06-01 DOI: 10.1080/24699322.2022.2078738
G. Clark, M. Quinn, J. Murgier, D. Wood
{"title":"Tibial component rotation alters soft tissue balance in a cruciate retaining total knee arthroplasty","authors":"G. Clark, M. Quinn, J. Murgier, D. Wood","doi":"10.1080/24699322.2022.2078738","DOIUrl":"https://doi.org/10.1080/24699322.2022.2078738","url":null,"abstract":"Abstract Our aim was to understand whether using different landmarks for tibial component rotation influenced articular contact pressures in a balanced total knee arthroplasty (TKA). Twelve patients underwent TKA (Triathlon CR, Stryker Inc., Mahwah, NJ) and contact pressures were assessed using a wireless sensor. Robotic arm assisted TKA using a functional alignment technique was performed, with balanced gaps between medial and lateral compartments. Compartment pressures were measured with the trial tibial component rotated to Akagi's line and to Insall's axis respectively. Rotating the tibial component to Akagi's line resulted in a significantly greater proportion of knees being balanced and lower contact pressures than when the tibial component was rotated to Insall's axis at 10°, 45° and 90° of flexion (p < 0.05). Medial compartment pressures were significantly increased in 10° of flexion, as were lateral compartment pressures in all positions when the tibial component was aligned to Insall's axis (p < 0.05). The mean difference in rotation observed with the two landmarks was 6.9° (range 4.1–9.1°). Rotational alignment of the tibial component using Akagi's line reduced contact pressures, improved balance and reduced the need for soft tissue release when compared with Insall's axis in robotic arm assisted TKA.","PeriodicalId":56051,"journal":{"name":"Computer Assisted Surgery","volume":"27 1","pages":"35 - 40"},"PeriodicalIF":2.1,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42933436","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Dimensional accuracy of TKA cut surfaces with an active robotic system 基于主动机器人系统的TKA切削面尺寸精度研究
IF 2.1 4区 医学
Computer Assisted Surgery Pub Date : 2022-05-30 DOI: 10.1080/24699322.2022.2080116
S. Kreuzer, A. Brar, V. Campanelli
{"title":"Dimensional accuracy of TKA cut surfaces with an active robotic system","authors":"S. Kreuzer, A. Brar, V. Campanelli","doi":"10.1080/24699322.2022.2080116","DOIUrl":"https://doi.org/10.1080/24699322.2022.2080116","url":null,"abstract":"Abstract This is a study of the dimensional accuracy of the bone cut surfaces in robotic TKA. One surgeon performed robotic TKA on four cadaveric knees. A novel technique was developed for measuring the dimensional accuracy of both the femoral and tibial cut surfaces. CT scans were used to create a pre-operative plan and generate nominal cut surfaces on the 3D bone model. After TKA, the cut surfaces were then laser scanned. Two femoral components were also scanned and compared to nominal dimensions. Flatness was computed as the standard deviation between each of the cut surfaces and the best-fit plane. The angles between the five femoral best-fit planes were compared to the nominal values. The point-to-point distances between the femoral cut surfaces and the nominal cut planes were computed to estimate the bone-to-implant gap. The cut surfaces had an average flatness of 0.16 ± 0.06 mm with low variability between different cut planes. The femoral cut surfaces had average angular errors of 0.47 ± 0.39°, which are of similar magnitude as the errors found for the implants. The bone-to-implant gap was within ±1 mm for 97.9% of the surface on average. Using a novel methodology, the dimensional accuracy of an active robotic system for TKA was found to be very high for both the femoral and tibial bone cuts. Comparison studies are needed with other robotic systems as well as studies comparing manual and robotic techniques.","PeriodicalId":56051,"journal":{"name":"Computer Assisted Surgery","volume":"27 1","pages":"41 - 49"},"PeriodicalIF":2.1,"publicationDate":"2022-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44754199","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 2
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