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Innovative bildbasierte Operationsplanung in der muskuloskelettalen Chirurgie

Innovative image-based planning in musculoskeletal surgery

  • Leitthema
  • Published:
Die Orthopädie Aims and scope Submit manuscript

Zusammenfassung

Hintergrund

Zur Vorbereitung operativer Eingriffe in der Orthopädie und Unfallchirurgie sind die genaue Kenntnis der Bildgebung und die dreidimensionale Vorstellungskraft des Operateurs von herausragender Bedeutung. Eine bildgestützte, präoperative, zweidimensionale Planung ist heutzutage der Goldstandard in der Endoprothetik. Bei besonders komplexen Eingriffen wird darüber hinaus weitere Bildgebung im Sinne einer Computertomographie oder einer Magnetresonanztomographie durchgeführt, wodurch ein dreidimensionales Modell der untersuchten Körperregion generiert wird und dem Operateur bei der Planung der operativen Versorgung helfen kann. Auch erste vierdimensionale, dynamische, computertomographische Untersuchungen sind bereits publiziert worden und stehen ergänzend zur Verfügung.

Digitale Hilfsmittel

Durch digitale Hilfsmittel soll eine verbesserte Darstellung der zu behandelnden Pathologie erreicht und die Vorstellungskraft des Operateurs optimiert werden. Zur Berücksichtigung patientenspezifischer und implantatspezifischer Parameter steht die Finite-Elemente-Methode präoperativ zur Simulation zur Verfügung und kann bei der Operationsplanung berücksichtigt werden. Bei der Operationsdurchführung können relevante Informationen durch Augmented Reality intraoperativ zur Verfügung gestellt werden, ohne den Operationsablauf wesentlich zu beeinflussen.

Abstract

Background

For the preparation of surgical procedures in orthopedics and trauma surgery, precise knowledge of imaging and the three-dimensional imagination of the surgeon are of outstanding importance. Image-based, preoperative two-dimensional planning is the gold standard in arthroplasty today. In complex cases, further imaging such as computed tomography (CT) or magnetic resonance imaging is also performed, generating a three-dimensional model of the body region and helping the surgeon in the planning of the surgical treatment. Four-dimensional, dynamic CT studies have also been reported and are available as a complementary tool.

Digital aids

Furthermore, digital aids should generate an improved representation of the pathology to be treated and optimize the surgeon’s imagination. The finite element method allows patient-specific and implant-specific parameters to be taken into account in preoperative surgical planning. Intraoperatively, relevant information can be provided by augmented reality without significantly influencing the surgical workflow.

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Abbreviations

AR:

Augmented Reality

BMI :

Body-Mass-Index

CAD:

Computer Aided Design

FE:

Finite-Elemente

FEM:

Finite-Elemente-Methode

SC :

Sternoclaviculargelenk

VR :

Virtual Reality

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  1. Klinik für Orthopädie und Orthopädische Chirurgie, Universität des Saarlandes, Kirrberger Str. 100, 66421, Homburg, Deutschland

    Philipp Winter, Stephan Rother, Patrick Orth & Ekkehard Fritsch

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Correspondence to Philipp Winter.

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P. Winter, S. Rother, P. Orth und E. Fritsch geben an, dass kein Interessenkonflikt besteht.

Für diesen Beitrag wurden von den Autor/-innen keine Studien an Menschen oder Tieren durchgeführt. Für die aufgeführten Studien gelten die jeweils dort angegebenen ethischen Richtlinien.

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Winter, P., Rother, S., Orth, P. et al. Innovative bildbasierte Operationsplanung in der muskuloskelettalen Chirurgie. Orthopädie 52, 532–538 (2023). https://doi.org/10.1007/s00132-023-04393-3

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