1,112 research outputs found
Recent trends, technical concepts and components of computer-assisted orthopedic surgery systems: A comprehensive review
Computer-assisted orthopedic surgery (CAOS) systems have become one of the most important and challenging types of system in clinical orthopedics, as they enable precise treatment of musculoskeletal diseases, employing modern clinical navigation systems and surgical tools. This paper brings a comprehensive review of recent trends and possibilities of CAOS systems. There are three types of the surgical planning systems, including: systems based on the volumetric images (computer tomography (CT), magnetic resonance imaging (MRI) or ultrasound images), further systems utilize either 2D or 3D fluoroscopic images, and the last one utilizes the kinetic information about the joints and morphological information about the target bones. This complex review is focused on three fundamental aspects of CAOS systems: their essential components, types of CAOS systems, and mechanical tools used in CAOS systems. In this review, we also outline the possibilities for using ultrasound computer-assisted orthopedic surgery (UCAOS) systems as an alternative to conventionally used CAOS systems.Web of Science1923art. no. 519
Technical Approaches toComputer-Assisted Orthopedic Surgery
Abstract : Surgical navigation systems and medical robotic devices are increasingly being used during trauma and orthopedic surgery. This article tries to present the underlying technology of these devices and to describe different approaches to the various aspects of the methods. To structure the variety of available products and presented research modules, a new categorization for these approaches is proposed. Examples of pre- or intraoperative imaging modalities, of trackers for navigation systems, of different surgical robots, and of methods for registration as well as referencing are discussed. Many applications that have been realized for numerous surgical procedures will be presented and their advantages, disadvantages, and possible implications will be elucidate
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Equivalent Mid-Term Results of Open vs Endoscopic Gluteal Tendon Tear Repair Using Suture Anchors in Forty-Five Patients.
BackgroundLittle is known about the relative efficacy of open (OGR) vs endoscopic (EGR) gluteal tendon repair of gluteal tendon tears in minimizing pain and restoring function. Our aim is to compare these 2 surgical techniques and quantify their impact on clinical outcomes.MethodsAll patients undergoing gluteal tendon tear repair at our institution between 2015 and 2018 were retrospectively reviewed. Pain scores, limp, hip abduction strength, and the use of analgesics were recorded preoperatively and at last follow-up. The Hip disability and Osteoarthritis Outcome Score Junior and Harris Hip Score Section1 were obtained at last follow-up. Fatty degeneration was quantified using the Goutallier-Fuchs Classification (GFC). Statistical analysis was conducted using one-way analysis of variance and t-tests.ResultsForty-five patients (mean age 66, 87% females) met inclusion criteria. Average follow-up was 20.3 months. None of the 10 patients (22%) undergoing EGR had prior surgery. Of 35 patients (78%) undergoing OGR, 12 (27%) had prior hip replacement (75% via lateral approach). The OGRs had more patients with GFC ≥2 (50% vs 11%, P = .02) and used more anchors (P = .03). Both groups showed statistical improvement (P ≤ .01) for all outcomes measured. GFC >2 was independently associated with a worst limp and Harris Hip Score Section 1 score (P = .05). EGR had a statistically higher opioid use reduction (P < .05) than OGR. Other comparisons between EGR and OGR did not reach statistical significance.ConclusionIn this series, open vs endoscopic operative approach did not impact clinical outcomes. More complex tears were treated open and with more anchors. Fatty degeneration adversely impacted outcomes. Although further evaluation of the efficacy of EGR in complex tears is indicated, both approaches can be used successfully
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Digital Orthopaedics: A Glimpse Into the Future in the Midst of a Pandemic.
BackgroundThe response to COVID-19 catalyzed the adoption and integration of digital health tools into the health care delivery model for musculoskeletal patients. The change, suspension, or relaxation of Medicare and federal guidelines enabled the rapid implementation of these technologies. The expansion of payment models for virtual care facilitated its rapid adoption. The authors aim to provide several examples of digital health solutions utilized to manage orthopedic patients during the pandemic and discuss what features of these technologies are likely to continue to provide value to patients and clinicians following its resolution.ConclusionThe widespread adoption of new technologies enabling providers to care for patients remotely has the potential to permanently change the expectations of all stakeholders about the way care is provided in orthopedics. The new era of Digital Orthopaedics will see a gradual and nondisruptive integration of technologies that support the patient's journey through the successful management of their musculoskeletal disease
Augmented reality for computer assisted orthopaedic surgery
In recent years, computer-assistance and robotics have established their presence in operating
theatres and found success in orthopaedic procedures. Benefits of computer assisted orthopaedic
surgery (CAOS) have been thoroughly explored in research, finding improvements in clinical outcomes, through increased control and precision over surgical actions. However, human-computer interaction in CAOS remains an evolving field, through emerging display technologies including augmented reality (AR) – a fused view of the real environment with virtual, computer-generated holograms. Interactions between clinicians and patient-specific data generated during CAOS are limited to basic 2D interactions on touchscreen monitors, potentially creating clutter and cognitive challenges in surgery.
Work described in this thesis sought to explore the benefits of AR in CAOS through: an integration between commercially available AR and CAOS systems, creating a novel AR-centric surgical workflow to support various tasks of computer-assisted knee arthroplasty, and three pre–clinical studies exploring the impact of the new AR workflow on both existing and newly proposed quantitative and qualitative performance metrics.
Early research focused on cloning the (2D) user-interface of an existing CAOS system onto a virtual AR screen and investigating any resulting impacts on usability and performance. An infrared-based registration system is also presented, describing a protocol for calibrating commercial AR headsets with optical trackers, calculating a spatial transformation between surgical and holographic coordinate frames. The main contribution of this thesis is a novel AR workflow designed to support computer-assisted patellofemoral arthroplasty. The reported workflow provided 3D in-situ holographic guidance for CAOS tasks including patient registration, pre-operative planning, and assisted-cutting. Pre-clinical experimental validation on a commercial system (NAVIO®, Smith & Nephew) for these contributions demonstrates encouraging early-stage results showing successful deployment of AR to CAOS systems, and promising indications that AR can enhance the clinician’s interactions in the future. The thesis concludes with a summary of achievements, corresponding limitations and future research opportunities.Open Acces
Augmented and virtual reality in spine surgery, current applications and future potentials
BACKGROUND CONTEXT: The field of artificial intelligence (AI) is rapidly advancing, especially with recent improvements in deep learning (DL) techniques. Augmented (AR) and virtual reality (VR) are finding their place in healthcare, and spine surgery is no exception. The unique capabilities and advantages of AR and VR devices include their low cost, flexible integration with other technologies, user-friendly features and their application in navigation systems, which makes them beneficial across different aspects of spine surgery. Despite the use of AR for pedicle screw placement, targeted cervical foraminotomy, bone biopsy, osteotomy planning, and percutaneous intervention, the current applications of AR and VR in spine surgery remain limited. PURPOSE: The primary goal of this study was to provide the spine surgeons and clinical researchers with the general information about the current applications, future potentials, and accessibility of AR and VR systems in spine surgery. STUDY DESIGN/SETTING: We reviewed titles of more than 250 journal papers from google scholar and PubMed with search words: augmented reality, virtual reality, spine surgery, and orthopaedic, out of which 89 related papers were selected for abstract review. Finally, full text of 67 papers were analyzed and reviewed. METHODS: The papers were divided into four groups: technological papers, applications in surgery, applications in spine education and training, and general application in orthopaedic. A team of two reviewers performed paper reviews and a thorough web search to ensure the most updated state of the art in each of four group is captured in the review. RESULTS: In this review we discuss the current state of the art in AR and VR hardware, their preoperative applications and surgical applications in spine surgery. Finally, we discuss the future potentials of AR and VR and their integration with AI, robotic surgery, gaming, and wearables. CONCLUSIONS: AR and VR are promising technologies that will soon become part of standard of care in spine surgery. (C) 2021 Published by Elsevier Inc
Augmented Reality-based Feedback for Technician-in-the-loop C-arm Repositioning
Interventional C-arm imaging is crucial to percutaneous orthopedic procedures
as it enables the surgeon to monitor the progress of surgery on the anatomy
level. Minimally invasive interventions require repeated acquisition of X-ray
images from different anatomical views to verify tool placement. Achieving and
reproducing these views often comes at the cost of increased surgical time and
radiation dose to both patient and staff. This work proposes a marker-free
"technician-in-the-loop" Augmented Reality (AR) solution for C-arm
repositioning. The X-ray technician operating the C-arm interventionally is
equipped with a head-mounted display capable of recording desired C-arm poses
in 3D via an integrated infrared sensor. For C-arm repositioning to a
particular target view, the recorded C-arm pose is restored as a virtual object
and visualized in an AR environment, serving as a perceptual reference for the
technician. We conduct experiments in a setting simulating orthopedic trauma
surgery. Our proof-of-principle findings indicate that the proposed system can
decrease the 2.76 X-ray images required per desired view down to zero,
suggesting substantial reductions of radiation dose during C-arm repositioning.
The proposed AR solution is a first step towards facilitating communication
between the surgeon and the surgical staff, improving the quality of surgical
image acquisition, and enabling context-aware guidance for surgery rooms of the
future. The concept of technician-in-the-loop design will become relevant to
various interventions considering the expected advancements of sensing and
wearable computing in the near future
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