Fluoroscopy-based 3{D}-navigation of complex correction osteotomies at the proximal femur

Type of publication:  Artikel
Zeitschrift: Der Orthop
Band: 34
Nummer: 11
Jahr: 2005
Monat: November
Seiten: 1137--1143
ISSN: 1433-0431
DOI: 10.1007/s00132-005-0859-9
Abriss: Background: Besides great advances in hip-alloarthroplasty there are still numerous indications for joint saving procedures as correction osteotomies. Often these procedures include complex 3D rearrangements of the proximal femur, which are for the surgeon technically very demanding. The project aim was to develop a precise intraoperative virtual 3D planning tool including a detailed biomechanical analysis and enable the surgeon to realize exactly this plan by using computer assisted techniques. Methods: Using only 2 different angled fluoro frames a simplified femoral model was inversely constructed. For navigation a passive optical system was used with a C-arm calibration kit and PC-based developed software. For in vitro evaluation complex osteotomies were performed on 10 femora under simulated OR conditions. Results: The mean difference between the planning and real surgical outcome for the wedge size was less then 2° and for the femur head center position less then 4 mm. No implant penetrated the femur neck isthmus. Conclusion: Without changing the standard operative procedure the method can be of high clinical importance to improve the accuracy of the planning and the consecutive operative realization for a precise fragment positioning and the plate location without penetrating the isthmus of the femoral neck. And - beside precision - it can potentially help to reduce intraoperative complications as implant penetration and minimize x-ray use.
Nutzerfelder: file={bgrgs_05.pdf:bgrgs_05.pdf:PDF}
Schlagworte: biomechanical planning, computer assisted navigation, Femur, Fluoroscopy, Osteotomy
Autoren: Burgkart, Rainer
Gottschling, Heiko
Roth, Michael
Gradinger, Reiner
Schweikard, Achim