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Six sigma analysis of computer-assisted surgery tracking protocols in TKA
1Medical College of Wisconsin, Columbia St Mary's Hospital, Milwaukee, WI, USA. jbstiehl@aol.com
Clinical Orthopaedics and Related Research
|July 17, 2007
Summary
Electromagnetic tracking showed precision for mechanical axis assessment in computer-assisted surgery, but outliers raised concerns. Optical tracking was also satisfactory for this axis, though neither system precisely measured other key anatomical axes.
Area of Science:
- Orthopedic Surgery
- Medical Imaging
- Surgical Navigation
Background:
- Computer-assisted surgery (CAS) relies on precise tracking technologies.
- Electromagnetic (EM) tracking is an alternative to optical tracking in CAS.
Purpose of the Study:
- To compare the clinical performance of EM tracking versus optical tracking in CAS.
- To evaluate the precision of EM and optical tracking for specific anatomical axis measurements in lower extremity surgery.
Main Methods:
- A pilot study utilized a CAS system on a cadaveric lower extremity.
- Three-dimensional computed tomography and direct measurements established baseline anatomical axes.
- Repeatability and reproducibility of optical and EM tracking were assessed for mechanical, transepicondylar, and Whiteside anteroposterior axes.
Main Results:
- Both optical and EM tracking demonstrated satisfactory precision for mechanical axis assessment.
- EM tracking exhibited outliers during mechanical axis assessment, raising efficacy concerns.
- Neither optical nor EM tracking provided satisfactory precision for transepicondylar or anteroposterior axis measurements.
Conclusions:
- While EM tracking shows potential for mechanical axis assessment in CAS, its outliers require further investigation.
- Current optical and EM tracking systems are not sufficiently precise for evaluating the transepicondylar or anteroposterior axes in this context.
