Abstract
Background
Computer-assisted navigation system is well-known orthopaedic advancement which allow surgeon to obtain a real-time feedback during surgeries, thus helps to reduce intraoperative errors. Currently used navigation systems are tracker based, invasive and non-universal. Therefore this study was conducted to test novel tracker-less, image-based, non-invasive, universal, real-time navigation system to predict future position of the guide wire, K wire, screws and plates in orthopaedic trauma surgeries.
Methods
Firstly, the software was tested and validated on bone model. Then utilized for non-randomised comparative study conducted on 81 adult patients with stable intertrochanteric fracture treated by dynamic hip screw and barrel plate fixation. In one group, C-arm was used and in other, software navigation was used in addition to C-arm. Parameters such as time to insertion, number of C-arm shoots and number of attempts for guide wire insertion were documented and compared.
Results
Use of the navigation software for guide wire positioning in bone models and in the DHS barrel plate surgery proved to be significantly beneficial as compared to not using navigation.
Conclusion
Intraoperative use of this new navigation system eliminates trial and error improving accuracy and reducing the operative time and radiation exposure. Thus this novel trackerless, C-arm image-based navigation system have potential to replace existing tracker-based navigation systems because of its universal nature, noninvasive and more effective properties.
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Abbreviations
- AP:
-
Anterioposterior
- CAOS:
-
Computer-Assisted Orthopaedic Surgery
- IT:
-
Inter-trochanteric
- DHS:
-
Dynamic Hip Screw
- 3D:
-
3 Dimension
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Acknowledgements
Author has received grant from Government of India for development of the navigation software. The validity of software has been confirmed first in laboratory setting on bone models before testing it on patients.
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Contributions
Conception of work, NG and VP, acquisition of data NG and VP, data analysis and interpretation NG. Drafting of manuscript NG and VP. Critical revision of articles NG and VP, final approval of the versions to be published NG and VP.
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Author has received grant from Government of India for development of the navigation software.
Ethical approval
Studies have been approved by the appropriate ethical committee and have been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki. Patient consent was waived by the Ethics Committee as the study was considered to carry minimal or no risk there being no intervention, but only image manipulation and visual feedback. Manuscript has been read and approved by all the authors and represent our original work which has not been published anywhere or under consideration.
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Goyal, N.D., Panchnadikar, V.M. A Novel Tracker-Less, Universal, Image-Based, Computer-Assisted Navigation in Orthopaedic Trauma- A pilot Study. JOIO 55 (Suppl 2), 466–472 (2021). https://doi.org/10.1007/s43465-021-00422-5
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DOI: https://doi.org/10.1007/s43465-021-00422-5