The Role of Intraoperative Navigation in Orthopaedic Surgery

被引:29
|
作者
Karkenny, Alexa J. [1 ]
Mendelis, Joseph R.
Geller, David S.
Gomez, Jaime A.
机构
[1] Montefiore Med Ctr, Childrens Hosp Montefiore, Dept Orthopaed Surg, New York, NY 10467 USA
关键词
PEDICLE SCREW PLACEMENT; ADOLESCENT IDIOPATHIC SCOLIOSIS; COMPUTER-ASSISTED NAVIGATION; TOTAL KNEE ARTHROPLASTY; DOSE O-ARM; RADIATION-EXPOSURE; ACCURACY; SYSTEM; FLUOROSCOPY; RECONSTRUCTION;
D O I
10.5435/JAAOS-D-18-00478
中图分类号
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学(修复外科学)];
学科分类号
摘要
An orthopaedic surgeon's knowledge of anatomical landmarks is crucial, but other modalities supplement this by providing guidance and feedback to a surgeon. Advances in imaging have enabled three-dimensional visualization of the surgical field and patient anatomy, whereas advances in computer technology have allowed for real-time tracking of instruments and implants. Together, these innovations have given rise to intraoperative navigation systems. The authors review these advances in intraoperative navigation across orthopaedic subspecialties, focusing on the most recent evidence on patient outcomes and complications, the associated learning curve, and the effects on operative time, radiation exposure, and cost. In spine surgery, navigated pedicle screw placement may increase accuracy and safety, especially valuable when treating complex deformities. Improved accuracy of pelvic and peri-articular tumor resection and percutaneous fixation of acetabular and femoral neck fractures has also been achieved using navigation. Early applications in arthroscopy have included surface-based registration for tunnel positioning for anterior cruciate ligament reconstruction and osteochondroplasty for femoro-acetabular impingement. Navigated arthroplasty techniques have addressed knee gap balancing and mechanical axis restoration as well as acetabular cup and glenoid baseplate positioning. Among these orthopaedic subspecialties, significant variation is found in the clinical relevance and dedication to research of navigation techniques.
引用
收藏
页码:E849 / E858
页数:10
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