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Advances in Primary and Revision Hip Arthroplasty
Published in K. Mohan Iyer, Hip Joint in Adults: Advances and Developments, 2018
Shibu P. Krishnan, G. Gopinath
Computer-assisted orthopaedic surgery (CAOS) in THA is aimed at improving the accuracy of component positioning along with restoration of offset and limb lengths, thereby improving outcomes and minimising complications. The different techniques of CAOS THA include passive, active and semiactive systems [5]. Passive systems include the use of navigation aids that assist the surgeon in preoperative planning and informs on implant positioning during surgery. Active systems include the use of surgical robots that autonomously perform the surgery as planned by the surgeon. A semiactive system provides guidance to the operator with a haptic robot arm for positioning of the implant that was planned preoperatively. A detailed description of CAOS THA has been dealt with in a separate chapter.
A computer and image-assisted guidance system for radial head arthroplasty
Published in Computer Methods in Biomechanics and Biomedical Engineering: Imaging & Visualization, 2018
Simon R. Deluce, Hannah Shannon, Emily A. Lalone, George S. Athwal, Louis M. Ferreira, Graham J. W. King, James A. Johnson
Anatomically shaped implants rely on precise positioning and either a press-fit or cemented stems to ensure the implant is fixed in the correct position. Accurately positioning anatomically shaped radial head implants during radial head arthroplasty is difficult due to the complex shape of the radial head (van Riet et al. 2004). Anatomic landmarks, such as the biceps tuberosity and radial styloid, can be used to guide implantation but have been shown to be highly variable between patients which can introduce navigational errors (Katchky et al. 2013). These difficulties are further exacerbated when the native radial head is severely fractured or has previously been excised; making it difficult to use these anatomical landmarks. Computer-assisted orthopaedic surgery has been previously applied at the hip and knee in order to guide implant alignment and reduce surgeon errors. Significant improvements in implant positioning have been demonstrated at both joints (Sugano et al. 2001; Jenny et al. 2005; Barrett et al. 2011). However, only one system for computer-assisted placement of the radial head has been described which quantified the effect of axisymmetric implant mal-alignment on elbow joint kinematics (Stacpoole et al. 2003). However, the accuracy of implant placement, which was based on digitised bony landmarks, was not quantified. Therefore, the objective of this study as to develop a navigation system to accurately navigate components of radial head implants using surface-based registration techniques and then to quantify the placement errors associated with navigated radial head arthroplasty.