Robust registration for computer-integrated orthopedic surgery: laboratory validation and clinical experience

Area of Science:

• Orthopedic Surgery
• Medical Image Analysis
• Computer-Aided Surgery

Background:

• Accurate patient anatomy registration to medical images is crucial for computer-integrated orthopedic surgery.
• Traditional registration methods using least-squares optimization are sensitive to outliers in digitized bone surface points.
• Developing robust registration algorithms is essential for reliable surgical navigation.

Purpose of the Study:

• To develop and validate a statistically robust, surface-based registration algorithm for orthopedic surgery.
• To improve the accuracy and reliability of surgical navigation by effectively managing outliers.
• To provide a reliable method for registering patient anatomy in computer-integrated surgical procedures.

Main Methods:

• A statistically robust M-estimator was integrated with the iterative-closest-point algorithm for outlier detection and management.
• The algorithm utilizes digitized points from predefined bone regions for initial estimation, ensuring reliable localization.
• In vitro validation involved simulating the registration process using densely digitized surface points.

Main Results:

• The developed algorithm demonstrates statistically robust performance in surface-based registration.
• Automatic detection and management of outliers significantly improve registration accuracy compared to least-squares methods.
• The method has been successfully applied in clinical settings for high tibial osteotomy, distal radius osteotomy, and osteoid osteoma excision.

Conclusions:

• The developed statistically robust, surface-based registration algorithm enhances navigational guidance in computer-integrated orthopedic surgery.
• This algorithm offers improved accuracy and reliability by effectively handling spurious data points (outliers).
• The clinical application across various orthopedic procedures validates its efficacy and utility in surgical navigation.