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Intra-operative augmented reality in distal locking.

Roberto Londei1, Marco Esposito, Benoit Diotte

  • 1Chair for Computer Aided Medical Procedures, Technische Univ. Munchen, Munich, Germany.

International Journal of Computer Assisted Radiology and Surgery
|March 28, 2015
PubMed
Summary

This study introduces an augmented reality (AR) system for safer and faster intramedullary nailing. The AR solution successfully guided surgeons in distal locking, reducing procedure time and radiation exposure.

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Area of Science:

  • Orthopedic surgery
  • Medical imaging
  • Augmented reality applications

Background:

  • Intramedullary nailing procedures traditionally rely on X-ray guidance, leading to prolonged operation times and significant radiation exposure for patients and surgeons.
  • Distal locking is a critical step that can be challenging and time-consuming under conventional fluoroscopic guidance.

Purpose of the Study:

  • To develop and evaluate an augmented reality (AR) based navigation system to assist surgeons during the distal locking phase of intramedullary nailing.
  • To reduce the time and radiation exposure associated with traditional X-ray guided procedures.

Main Methods:

  • A novel AR solution was designed, utilizing 2D/3D registration for intramedullary (IM) nail positioning and video-tracked AR markers for patient leg pose estimation.
  • Real-time video guidance was employed, tracking the tip of an augmented radiolucent drill for precise distal locking.
  • A preclinical study was conducted on a dry bone phantom involving four orthopedic clinicians.

Main Results:

  • The AR system achieved a 100% success rate in down-the-beam positioning of the IM nail.
  • A 93% success rate was observed for distal locking.
  • The procedure was completed efficiently, utilizing only two X-ray images within an average of 100 seconds.

Conclusions:

  • Intraoperative navigation with augmented reality offers a viable alternative for performing distal locking in intramedullary nailing.
  • The developed AR system demonstrates potential for enhancing safety and efficiency in orthopedic surgical procedures.