A novel surgical navigation technology for placement of implants in slipped capital femoral epiphysis

© 2019 John Wiley & Sons, Ltd Background: Fixation with a single screw is the recommended treatment for slipped capital femoral epiphysis (SCFE). Achieving optimal implant positioning can be difficult owing to the complex geometry of the proximal femur in SCFE. We assessed a novel navigation technology incorporating an inertial measurement unit to facilitate implant placement in an SCFE model. Methods: Guidewires were placed into 30 SCFE models, using a navigation system that displayed the surgeon\u27s projected implant trajectory simultaneously in multiple planes. The accuracy and the precision of the system were assessed as was the time to perform the procedure. Results: Implants were placed an average of 5.3 mm from the femoral head center, with a system precision of 0.94 mm. The actual trajectory of the implant deviated from the planned trajectory by an average of 4.9° ± 2.2°. The total average procedure time was 97 seconds. Conclusion: The use of computer-based navigation in a SCFE model demonstrated good accuracy and precision in terms of both implant trajectory and placement in the center of the femoral head

A novel surgical navigation technology for placement of implants in slipped capital femoral epiphysis.

© 2019 John Wiley & Sons, Ltd Background: Fixation with a single screw is the recommended treatment for slipped capital femoral epiphysis (SCFE). Achieving optimal implant positioning can be difficult owing to the complex geometry of the proximal femur in SCFE. We assessed a novel navigation technology incorporating an inertial measurement unit to facilitate implant placement in an SCFE model. Methods: Guidewires were placed into 30 SCFE models, using a navigation system that displayed the surgeon\u27s projected implant trajectory simultaneously in multiple planes. The accuracy and the precision of the system were assessed as was the time to perform the procedure. Results: Implants were placed an average of 5.3 mm from the femoral head center, with a system precision of 0.94 mm. The actual trajectory of the implant deviated from the planned trajectory by an average of 4.9° ± 2.2°. The total average procedure time was 97 seconds. Conclusion: The use of computer-based navigation in a SCFE model demonstrated good accuracy and precision in terms of both implant trajectory and placement in the center of the femoral head

Inertial measurement unit for radiation-free navigated screw placement in slipped capital femoral epiphysis surgery

© Springer International Publishing Switzerland 2015. Slipped Capital Femoral Epiphysis (SCFE) is a common pathologic hip condition in adolescents. In the standard treatment, a surgeon relies on multiple intra-operative fluoroscopic X-ray images to plan the screw placement and to guide a drill along the intended trajectory. More complex cases could require more images, and thereby, higher radiation dose to both patient and surgeon. We introduce a novel technique using an Inertial Measurement Unit (IMU) for recovering and visualizing the orthopedic tool trajectory in two orthogonal Xray images in real-time. The proposed technique improves screw placement accuracy and reduces the number of required fluoroscopic X-ray images without changing the current workflow. We present results from a phantom study using 20 bones to perform drilling and screw placement tasks. While dramatically reducing the number of required fluoroscopic images from 20 to 4, the results also show improvement in accuracy compared to the manual SCFE approach

Radiation-free methods for navigated screw placement in slipped capital femoral epiphysis surgery

© 2019, CARS. Purpose: For orthopedic procedures, surgeons utilize intra-operative medical images such as fluoroscopy to plan screw placement and accurately position the guide wire with the intended trajectory. The number of fluoroscopic images needed depends on the complexity of the case and skill of the surgeon. Since more fluoroscopic images lead to more exposure and higher radiation dose for both surgeon and patient, a solution that decreases the number of fluoroscopic images would be an improvement in clinical care. Methods: This article describes and compares three different novel navigation methods and techniques for screw placement using an attachable Inertial Measurement Unit device or a robotic arm. These methods provide projection and visualization of the surgical tool trajectory during the slipped capital femoral epiphysis procedure. Results: These techniques resulted in faster and more efficient preoperative calibration and set up times compared to other intra-operative navigation systems in our phantom study. We conducted an experiment using 120 model bones to measure the accuracy of the methods. Conclusion: As conclusion, these approaches have the potential to improve accuracy of surgical tool navigation and decrease the number of required X-ray images without any change in the clinical workflow. The results also show 65% decrease in total error compared to the conventional manual approach