Abstract
Abstract
Introduction
The periacetabular osteotomy is a technically demanding procedure with the goal to improve the osseous containment of the femoral head. The options for controlled execution of the osteotomies and verification of the acetabular reorientation are limited. With the assistance of augmented reality, new possibilities are emerging to guide this intervention. However, the scientific knowledge regarding AR navigation for PAO is sparse.
Methods
In this cadaveric study, we wanted to find out, if the execution of this complex procedure is feasible with AR guidance, quantify the accuracy of the execution of the three-dimensional plan, and find out what has to be done to proceed to real surgery. Therefore, an AR guidance for the PAO was developed and applied on 14 human hip cadavers. The guidance included performance of the four osteotomies and reorientation of the acetabular fragment. The osteotomy starting points, the orientation of the osteotomy planes, as well as the reorientation of the acetabular fragment were compared to the 3D planning.
Results
The mean 3D distance between planned and performed starting points was between 9 and 17 mm. The mean angle between planned and performed osteotomies was between 6° and 7°. The mean reorientation error between the planned and performed rotation of the acetabular fragment was between 2° and 11°.
Conclusion
The planned correction can be achieved with promising accuracy and without serious errors. Further steps for a translation from the cadaver to the patient have been identified and must be addressed in future work.
Publisher
Springer Science and Business Media LLC
Subject
Orthopedics and Sports Medicine,General Medicine,Surgery,Surgery
Reference21 articles.
1. Ackermann J, Liebmann F, Hoch A, Snedeker JG, Farshad M, Rahm S, Zingg PO, Fürnstahl P (2021) Augmented reality based surgical navigation of complex pelvic osteotomies—a feasibility study on cadavers. Appl Sci 11:1228
2. Ali M, Malviya A (2019) Complications and outcome after periacetabular osteotomy—influence of surgical approach. Hip Int 30:4–15
3. Kosuge D, Cordier T, Solomon LB, Howie DW (2014) Dilemmas in imaging for peri-acetabular osteotomy. Bone Joint J 96-B:1155–1160
4. Fan Chiang CY, Tsai TT, Chen LH, Lai PL, Fu TS, Niu CC, Chen WJ (2012) Computed tomography-based navigation-assisted pedicle screw insertion for thoracic and lumbar spine fractures. Chang Gung Med J 35:332–338
5. Furnstahl P, Vlachopoulos L, Schweizer A, Fucentese SF, Koch PP (2015) Complex osteotomies of tibial plateau malunions using computer-assisted planning and patient-specific surgical guides. J Orthop Trauma 29:e270–e376
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