Augmented reality-guided periacetabular osteotomy—proof of concept
Abstract Background The Ganz’ periacetabular osteotomy (PAO) consists of four technically challenging osteotomies (OT), namely, supraacetabular (saOT), pubic (pOT), ischial (iOT), and retroacetabular OT (raOT). Purpose We performed a proof of concept study to test (1) the feasibility of augmented re...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2020-11-01
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| Series: | Journal of Orthopaedic Surgery and Research |
| Online Access: | http://link.springer.com/article/10.1186/s13018-020-02066-x |
| _version_ | 1818040478273110016 |
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| author | Pascal Kiarostami Cyrill Dennler Simon Roner Reto Sutter Philipp Fürnstahl Mazda Farshad Stefan Rahm Patrick O. Zingg |
| author_facet | Pascal Kiarostami Cyrill Dennler Simon Roner Reto Sutter Philipp Fürnstahl Mazda Farshad Stefan Rahm Patrick O. Zingg |
| author_sort | Pascal Kiarostami |
| collection | DOAJ |
| description | Abstract Background The Ganz’ periacetabular osteotomy (PAO) consists of four technically challenging osteotomies (OT), namely, supraacetabular (saOT), pubic (pOT), ischial (iOT), and retroacetabular OT (raOT). Purpose We performed a proof of concept study to test (1) the feasibility of augmented reality (AR) guidance for PAO, (2) precision of the OTs guided by AR compared to the freehand technique performed by an experienced PAO surgeon, and (3) the effect of AR on performance depending on experience. Methods A 3D preoperative plan of a PAO was created from segmented computed tomography (CT) data of an anatomic plastic pelvis model (PPM). The plan was then embedded in a software application for an AR head-mounted device. Soft tissue coverage was imitated using foam rubber. The 3D plan was then registered onto the PPM using an anatomical landmark registration. Two surgeons (one experienced and one novice PAO surgeon) each performed 15 freehand (FH) and 15 AR-guided PAOs. The starting point distances and angulation between the planned and executed OT planes for the FH and the AR-guided PAOs were compared in post-intervention CTs. Results AR guidance did not affect the performance of the expert surgeon in terms of the mean differences between the planned and executed starting points, but the raOT angle was more accurate as compared to FH PAO (p = 0.0027). AR guidance increased the accuracy of the performance of the novice surgeon for iOT (p = 0.03). An intraarticular osteotomy performed by the novice surgeon with the FH technique could be observed only once. Conclusion AR guidance of osteotomies for PAOs is feasible and seems to increase accuracy. The effect is more accentuated for less-experienced surgeons. Clinical relevance This is the first proof of concept study documenting the feasibility of AR guidance for PAO. Based on these findings, further studies are essential for elaborating on the potential merits of AR guidance to increase the accuracy of complex surgical procedures. |
| first_indexed | 2024-12-10T08:15:10Z |
| format | Article |
| id | doaj.art-b628424e7c59493d9ec2359fa3532f23 |
| institution | Directory Open Access Journal |
| issn | 1749-799X |
| language | English |
| last_indexed | 2024-12-10T08:15:10Z |
| publishDate | 2020-11-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Orthopaedic Surgery and Research |
| spelling | doaj.art-b628424e7c59493d9ec2359fa3532f232022-12-22T01:56:29ZengBMCJournal of Orthopaedic Surgery and Research1749-799X2020-11-011511810.1186/s13018-020-02066-xAugmented reality-guided periacetabular osteotomy—proof of conceptPascal Kiarostami0Cyrill Dennler1Simon Roner2Reto Sutter3Philipp Fürnstahl4Mazda Farshad5Stefan Rahm6Patrick O. Zingg7Department of Orthopaedics, Balgrist University Hospital, University of ZürichDepartment of Orthopaedics, Balgrist University Hospital, University of ZürichDepartment of Orthopaedics, Balgrist University Hospital, University of ZürichDepartment of Radiology, Balgrist University Hospital, University of ZürichComputer Assisted Research & Development Group, Balgrist University Hospital, University of ZürichDepartment of Orthopaedics, Balgrist University Hospital, University of ZürichDepartment of Orthopaedics, Balgrist University Hospital, University of ZürichDepartment of Orthopaedics, Balgrist University Hospital, University of ZürichAbstract Background The Ganz’ periacetabular osteotomy (PAO) consists of four technically challenging osteotomies (OT), namely, supraacetabular (saOT), pubic (pOT), ischial (iOT), and retroacetabular OT (raOT). Purpose We performed a proof of concept study to test (1) the feasibility of augmented reality (AR) guidance for PAO, (2) precision of the OTs guided by AR compared to the freehand technique performed by an experienced PAO surgeon, and (3) the effect of AR on performance depending on experience. Methods A 3D preoperative plan of a PAO was created from segmented computed tomography (CT) data of an anatomic plastic pelvis model (PPM). The plan was then embedded in a software application for an AR head-mounted device. Soft tissue coverage was imitated using foam rubber. The 3D plan was then registered onto the PPM using an anatomical landmark registration. Two surgeons (one experienced and one novice PAO surgeon) each performed 15 freehand (FH) and 15 AR-guided PAOs. The starting point distances and angulation between the planned and executed OT planes for the FH and the AR-guided PAOs were compared in post-intervention CTs. Results AR guidance did not affect the performance of the expert surgeon in terms of the mean differences between the planned and executed starting points, but the raOT angle was more accurate as compared to FH PAO (p = 0.0027). AR guidance increased the accuracy of the performance of the novice surgeon for iOT (p = 0.03). An intraarticular osteotomy performed by the novice surgeon with the FH technique could be observed only once. Conclusion AR guidance of osteotomies for PAOs is feasible and seems to increase accuracy. The effect is more accentuated for less-experienced surgeons. Clinical relevance This is the first proof of concept study documenting the feasibility of AR guidance for PAO. Based on these findings, further studies are essential for elaborating on the potential merits of AR guidance to increase the accuracy of complex surgical procedures.http://link.springer.com/article/10.1186/s13018-020-02066-x |
| spellingShingle | Pascal Kiarostami Cyrill Dennler Simon Roner Reto Sutter Philipp Fürnstahl Mazda Farshad Stefan Rahm Patrick O. Zingg Augmented reality-guided periacetabular osteotomy—proof of concept Journal of Orthopaedic Surgery and Research |
| title | Augmented reality-guided periacetabular osteotomy—proof of concept |
| title_full | Augmented reality-guided periacetabular osteotomy—proof of concept |
| title_fullStr | Augmented reality-guided periacetabular osteotomy—proof of concept |
| title_full_unstemmed | Augmented reality-guided periacetabular osteotomy—proof of concept |
| title_short | Augmented reality-guided periacetabular osteotomy—proof of concept |
| title_sort | augmented reality guided periacetabular osteotomy proof of concept |
| url | http://link.springer.com/article/10.1186/s13018-020-02066-x |
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