Youngjun Kim1, Byung Hoon Lee2, Kinde Mekuria1, Hyunchul Cho3, Sehyung Park1, Joon Ho Wang4, Deukhee Lee5. 1. Center for Bionics, Korea Institute of Science and Technology, 5, Hwarangno 14-gil, Seongbuk-gu, Seoul 02792, Republic of Korea; Department of Biomedical Engineering, Korea University of Science and Technology, 217 Gajungro, Yuseong-gu, Daejeon 305-350, Republic of Korea. 2. Department of Orthopaedic Surgery, Kang-Dong Sacred Heart Hospital, Hallym University Medical School Center, Gil-dong, Seoul 134-701, Republic of Korea. 3. Center for Bionics, Korea Institute of Science and Technology, 5, Hwarangno 14-gil, Seongbuk-gu, Seoul 02792, Republic of Korea. 4. Department of Orthopaedic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul 135-710, Republic of Korea. 5. Center for Bionics, Korea Institute of Science and Technology, 5, Hwarangno 14-gil, Seongbuk-gu, Seoul 02792, Republic of Korea; Department of Biomedical Engineering, Korea University of Science and Technology, 217 Gajungro, Yuseong-gu, Daejeon 305-350, Republic of Korea. Electronic address: dkylee@kist.re.kr.
Abstract
BACKGROUND: Recently, surgical navigation systems have been widely used to improve the results of various orthopaedic surgeries. However, surgical navigation has not been successful in anterior cruciate ligament reconstruction, owing to its inaccuracy and inconvenience. This study investigated the registration of preoperative and intraoperative data, which are the key components in improving accuracy of the navigation system. METHODS: An accurate registration method was proposed using new optical tracking markers and landmark retake. A surgical planning and navigation system for anterior cruciate ligament reconstruction was developed and implemented. The accuracy of the proposed system has been evaluated using phantoms and eight cadaveric knees. The present study investigated only the registration accuracy excluding the errors of optical tracking hardware and surgeon. RESULTS: The target registration errors of femoral tunnelling for anterior cruciate ligament reconstruction in phantoms were found to be 0.24±0.03mm and 0.19±0.10° for the tunnel entry position and tunnel direction, respectively. The target registration errors measured using cadavers were 0.9mm and 1.94°, respectively. CONCLUSIONS: The preclinical experimental results showed that the proposed methods enhanced the registration accuracy of the developed system. As the system becomes more accurate, surgeons could more precisely position and orient the femoral and tibial tunnels to their original anatomical locations.
BACKGROUND: Recently, surgical navigation systems have been widely used to improve the results of various orthopaedic surgeries. However, surgical navigation has not been successful in anterior cruciate ligament reconstruction, owing to its inaccuracy and inconvenience. This study investigated the registration of preoperative and intraoperative data, which are the key components in improving accuracy of the navigation system. METHODS: An accurate registration method was proposed using new optical tracking markers and landmark retake. A surgical planning and navigation system for anterior cruciate ligament reconstruction was developed and implemented. The accuracy of the proposed system has been evaluated using phantoms and eight cadaveric knees. The present study investigated only the registration accuracy excluding the errors of optical tracking hardware and surgeon. RESULTS: The target registration errors of femoral tunnelling for anterior cruciate ligament reconstruction in phantoms were found to be 0.24±0.03mm and 0.19±0.10° for the tunnel entry position and tunnel direction, respectively. The target registration errors measured using cadavers were 0.9mm and 1.94°, respectively. CONCLUSIONS: The preclinical experimental results showed that the proposed methods enhanced the registration accuracy of the developed system. As the system becomes more accurate, surgeons could more precisely position and orient the femoral and tibial tunnels to their original anatomical locations.
Authors: Janosch Häberli; Benjamin Voumard; Clemens Kösters; Daniel Delfosse; Philipp Henle; Stefan Eggli; Philippe Zysset Journal: Knee Surg Sports Traumatol Arthrosc Date: 2018-06-01 Impact factor: 4.342