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Minimizing Electromagnetic Interference from Surgical Instruments on Electromagnetic Surgical Navigation

  • Basic Research
  • Published:
Clinical Orthopaedics and Related Research®

Abstract

Background

Electromagnetic computer-assisted surgery (EM-CAS) can be affected by various metallic or ferromagnetic factors.

Questions/purposes

We determined to what extent metals interfere with accuracy and identified measures to prevent interference from occurring.

Methods

Using an EM-CAS system, we made six standard measurements of tibiofemoral position and alignment on a surrogate knee. A stainless steel mallet was positioned 10 cm from the stylus, and then 10 cm from the localizer to create errors attributable to electromagnetic interference. The experiment was repeated with bars of different metals placed 10 cm from the stylus.

Results

The maximum errors recorded with a mallet were: varus/valgus alignment, −2.7° and 2.4°; flexion/extension, −5.8° and 3.0°; lateral resection level, −3.1 and 7.5 mm; and medial resection level, −4.0 and 2.3 mm, respectively. The smallest errors were recorded with cylinders of titanium, cobalt-chrome alloy, and stainless steels. When moved more than 10 cm away from the stylus, errors became negligible.

Conclusions

The accuracy of EM navigation systems is affected substantially by the size, type, proximity, and shape of metal objects.

Clinical Relevance

Stainless steel objects, such as cutting blocks and trial prostheses, should be kept more than 10 cm from EM-CAS instruments to minimize error.

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Acknowledgments

We thank Dr. L. Fang for editorial assistance and other FSOR staff who helped with this project. We also thank Dr. Rohan R. Wagle for technical assistance in performing the reported experiments.

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Authors and Affiliations

  1. Baylor College of Medicine, Houston, TX, USA

    Faustin Stevens BS, Philip C. Noble PhD & David R. Lionberger MD

  2. Institute of Orthopedic Research and Education, 6550 Fannin St, Suite 2512, Houston, TX, 77030, USA

    Michael A. Conditt PhD, Nikhil Kulkarni MS, Sabir K. Ismaily BS & Philip C. Noble PhD

  3. Southwest Orthopedic Group, LLP, 6560 Fannin, Suite 1016, Houston, TX, 77030, USA

    David R. Lionberger MD

Authors
  1. Faustin Stevens BS
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  2. Michael A. Conditt PhD
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  3. Nikhil Kulkarni MS
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  4. Sabir K. Ismaily BS
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  5. Philip C. Noble PhD
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  6. David R. Lionberger MD
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Corresponding author

Correspondence to David R. Lionberger MD.

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Each author certifies that he or she has no commercial associations (eg, consultancies, stock ownership, equity interest, patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article.

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Stevens, F., Conditt, M.A., Kulkarni, N. et al. Minimizing Electromagnetic Interference from Surgical Instruments on Electromagnetic Surgical Navigation. Clin Orthop Relat Res 468, 2244–2250 (2010). https://doi.org/10.1007/s11999-010-1366-9

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  • DOI: https://doi.org/10.1007/s11999-010-1366-9

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