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CT-based Navigation System Using a Patient-Specific Instrument for Femoral Component Positioning: An Experimental in vitro Study with a Sawbone Model

Title
CT-based Navigation System Using a Patient-Specific Instrument for Femoral Component Positioning: An Experimental in vitro Study with a Sawbone Model
Authors
Lee, SeongpungKim, Jun YoungHong, JaesungBaek, Seung HoonKim, Shin Yoon
DGIST Authors
Hong, Jaesung
Issue Date
2018-08
Citation
Yonsei Medical Journal, 59(6), 769-780
Type
Article
Article Type
Article
Author Keywords
Total hip replacementcomputer-assisted surgery3D printing
Keywords
TOTAL HIP-ARTHROPLASTYCOMPUTED-TOMOGRAPHY MEASUREMENTSTEM ANTEVERSIONINTRAOPERATIVE ESTIMATIONORIENTATIONSURGERYVALIDATIONPLACEMENTTEMPLATEACCURACY
ISSN
0513-5796
Abstract
Purpose: The intraoperative version of the femoral component is usually determined by visual appraisal of the stem position relative to the distal femoral condylar axis. However, several studies have suggested that a surgeon’s visual assessment of the stem position has a high probability of misinterpretation. We developed a computed tomography (CT)-based navigation system with a patient-specific instrument (PSI) capable of three-dimensional (3D) printing and investigated its accuracy and consistency in comparison to the conventional technique of visual assessment of the stem position. Materials and Methods: A CT scan of a femur sawbone model was performed, and pre-experimental planning was completed. We conducted 30 femoral neck osteotomies using the conventional technique and another 30 femoral neck osteotomies using the proposed technique. The femoral medullary canals were identified in both groups using a box chisel. Results: For the absolute deviation between the measured and planned values, the mean two-dimensional anteversions of the proposed and conventional techniques were 1.41° and 4.78°, while their mean 3D anteversions were 1.15° and 3.31°. The mean θ1, θ2, θ3, and d, all of which are parameters for evaluating femoral neck osteotomy, were 2.93°, 1.96°, 5.29°, and 0.48 mm for the proposed technique and 4.26°, 3.17°, 4.43°, and 3.15 mm for the conventional technique, respectively. Conclusion: The CT-based navigation system with PSI was more accurate and consistent than the conventional technique for assessment of stem position. Therefore, it can be used to reduce the frequency of incorrect assessments of the stem position among surgeons and to help with accurate determination of stem anteversion. © Yonsei University College of Medicine 2018.
URI
http://hdl.handle.net/20.500.11750/9042
DOI
10.3349/ymj.2018.59.6.769
Publisher
Yonsei University College of Medicine
Related Researcher
  • Author Hong, Jaesung Surgical Robotics & Augmented Reality Lab
  • Research Interests Surgical Navigation; Surgical Robot; Medical Imaging; 영상 유도 수술 로봇; 수술 내비게이션
Files:
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Collection:
Department of Robotics EngineeringSurgical Robotics & Augmented Reality Lab1. Journal Articles


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