A cost-effective surgical navigation solution for periacetabular osteotomy (PAO) surgery

  • Silvio PflugiEmail author
  • Li Liu
  • Timo M. Ecker
  • Steffen Schumann
  • Jennifer Larissa Cullmann
  • Klaus Siebenrock
  • Guoyan Zheng
Original Article



To evaluate a low-cost, inertial sensor-based surgical navigation solution for periacetabular osteotomy (PAO) surgery without the line-of-sight impediment.


Two commercial inertial measurement units (IMU, Xsens Technologies, The Netherlands), are attached to a patient’s pelvis and to the acetabular fragment, respectively. Registration of the patient with a pre-operatively acquired computer model is done by recording the orientation of the patient’s anterior pelvic plane (APP) using one IMU. A custom-designed device is used to record the orientation of the APP in the reference coordinate system of the IMU. After registration, the two sensors are mounted to the patient’s pelvis and acetabular fragment, respectively. Once the initial position is recorded, the orientation is measured and displayed on a computer screen. A patient-specific computer model generated from a pre-operatively acquired computed tomography scan is used to visualize the updated orientation of the acetabular fragment.


Experiments with plastic bones (eight hip joints) performed in an operating room comparing a previously developed optical navigation system with our inertial-based navigation system showed no statistically significant difference on the measurement of acetabular component reorientation. In all eight hip joints the mean absolute difference was below four degrees.


Using two commercially available inertial measurement units we show that it is possible to accurately measure the orientation (inclination and anteversion) of the acetabular fragment during PAO surgery and therefore to successfully eliminate the line-of-sight impediment that optical navigation systems have.


Computer-assisted surgery Inertial measurement unit  Navigation system PAO surgery 


Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Supplementary material

Supplementary material 1 (mp4 95141 KB)


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Copyright information

© CARS 2015

Authors and Affiliations

  • Silvio Pflugi
    • 1
    Email author
  • Li Liu
    • 1
  • Timo M. Ecker
    • 2
  • Steffen Schumann
    • 1
  • Jennifer Larissa Cullmann
    • 3
  • Klaus Siebenrock
    • 2
  • Guoyan Zheng
    • 1
  1. 1.Institute for Surgical Technology and BiomechanicsUniversity of BernBernSwitzerland
  2. 2.Department of Orthopedic Surgery, InselspitalUniversity of BernBernSwitzerland
  3. 3.Department of Radiology, InselspitalUniversity of BernBernSwitzerland

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