Category: Preoperative Planning

Computer-assisted surgery prevents complications during peri-acetabular osteotomy

periacetabular-osteotomy-preoperative

Computer-assisted surgery prevents complications during peri-acetabular osteotomy, Hayashi, S., Hashimoto, S., Matsumoto, T. et al. International Orthopaedics (SICOT) (2018).

Abstract:

Purpose
The aim of study is to evaluate the accuracy of a navigation system during curved peri-acetabular osteotomy (CPO).

Methods
Forty-seven patients (53 hips) with hip dysplasia were enrolled and underwent CPO with or without navigation during surgery. Clinical and radiographical evaluations were performed and compared between the navigation group and non-navigation group, post-operatively.

Results
The clinical outcomes were not significantly different between the navigation and non-navigation groups. Furthermore, post-operative reorientation of the acetabular fragment was similar between the navigation and non-navigation groups. However, the discrepancy between the pre-operative planning line and post-operative osteotomy line was significantly improved in the navigation group compared with that in the non-navigation group (p < 0.05). Further, the complication rate was significantly improved in the navigation group (p < 0.001). Conclusion The accuracy of the osteotomy’s position was significantly improved by using the navigation. Therefore, the use of navigation during peri-acetabular osteotomy can avoid complications.

periacetabular-osteotomy-preoperative-planning
The measurement of the distance between the 100-mm radius sphere line that was determined during pre-operative planning and the post-operative iliac bone surface (the error distance) on the a coronal and b axial planes. a The error distance outside the pelvis on the coronal plane (50–45.5 mm= 4.5 mm). b The error of the distance inside the pelvis on the axial plane (57.8–50 mm= 7.8 mm)

Treatment of sagittal fracture of the zygomatic arch root assisted by surgical navigation technology

Published ahead of print: Treatment of Sagittal Fracture of the Zygomatic Arch Root Assisted by Surgical Navigation Technology, by Dai et al. Journal of Craniofacial Surgery (2018).

Abstract:

Sagittal fracture at the temporal root of the zygomatic arch often occurs as a part of zygomaticomaxillary fractures. The authors described the application of computer-assisted navigation in the lag screw insertion for the fixation of sagittal fracture at the temporal root of zygomatic arch. Using the presurgical planning of the computer-assisted navigation system, the trajectory of lag screw insertion was designed, and the insertion depth was calculated. In the presurgical planning, the trajectory of screw insertion was placed with an anterior inclination of 10° to 15° (mean: 12.24°), and the screw insertion depth was 9.0 to 12.0 mm (mean: 10.65 mm). In the operation, the screw insertion in the fixation of the sagittal fracture was performed under the guidance of navigation system according to the presurgical planning. The postoperative CT scan showed exact reduction and fixation of the sagittal fracture in all cases. Computer-assisted navigation is a useful tool for the lag screw insertion in the precise fixation of sagittal fracture at the temporal root of the zygomatic arch in complex zygomaticomaxillary fractures.

zygomatic_navigation
(A) In the presurgical planning, the entry point (red point) and trajectory of screw insertion (red line) were designed in the mirrored zygomatic arch root, and the calculated screw insertion depth (yellow line) was 10.1mm in this case. (B) Registered surgical motor used for screw hole drilling. (C) The sagittal fractures at the zygomatic arch root. (D) Screw hole drilling according to presurgical planning under computer-assisted navigation, and the long axis of drill (yellow line) coincided with the designed trajectory (red line) in the axial, sagittal, and coronal planes. (E) Screw hole drilling performed with guidance of the computer-assisted navigation system.