The New Standard in Town: An Updated Look at Computer-Aided Surgery Metrology

Computer-aided surgery capabilities for arthroplasty interventions emerged in the late 1990s with limited capabilities and use in the field. The goal of computer-aided surgery in the field of arthroplasty remains to reduce the need for excessive drilling tissue damage to the surgical site by reducing the need for cutting guides and related jigs. In order to assess the capabilities of computer-aided surgery systems in terms of both their accuracy and precision, the development and adherence to an industry standard for testing is necessary. A phantom device with divots of a known coordinate location was used in conjunction with proprietary software to assess the accuracy and precision of the complete surgical system. Measured coordinate data of a single point using the proprietary software was transformed according to the balloted ASTM standard for the generation of an accuracy and precision report. Results indicate 0.255 mm accuracy and sub-millimeter precision under conditions most similar to an operating room. Functional extreme tests indicate a loss of performance, leading to maximum decreased accuracy of 1.71 mm during standard orientation and 4.32 mm during extreme orientation of the phantom. The results suggest the tracking and software system meet manufacturer data under standard orientation and location conditions yet experience an expected significant loss of ability in extreme conditions. These loses in capability may lead to inaccurate alignment of tools and implants when using the proprietary computer-aided surgery software. Additional research is needed to determine the effect of larger reference frames with additional tracking points. Additionally, development of software to limit data return when near functional extremes will improve ease of use of the system.https://digitalcommons.unmc.edu/surp2022/1015/thumbnail.jp