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Arthroscopic Debridement of Elbow Osteoarthritis Using CT-Based Computer-Aided Navigation Systems Is Accurate
Ryoya Shiode1, Kunihiro Oka1, Atsuo Shigi2
1Department of Orthopaedic Surgery, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan.
Arthroscopy, Sports Medicine, and Rehabilitation
|January 3, 2022
Summary
Computer-aided navigation systems enhance arthroscopic debridement accuracy for elbow osteoarthritis, improving bony impingement lesion removal. This technology offers real-time tracking, addressing technical challenges in elbow surgery.
Area of Science:
- Orthopedic Surgery
- Medical Technology
- Biomedical Engineering
Background:
- Elbow osteoarthritis often involves bony impingement lesions requiring arthroscopic debridement.
- Accurate identification and removal of these lesions are technically challenging during arthroscopic surgery.
- Computer-aided navigation systems offer potential solutions for improving surgical precision.
Purpose of the Study:
- To evaluate the accuracy of computer-aided navigation systems in removing bony impingement lesions during arthroscopic elbow surgery.
- To assess the feasibility of using 3-dimensional (3D)-printed bone models for mock surgery simulations.
- To determine if planned resection of bony impingement lesions can be achieved accurately in mock surgical settings.
Main Methods:
- Mock surgery was performed on 3D-printed humerus bone models from 15 patients with elbow osteoarthritis.
- Three surgeons conducted 45 trials to assess overall surgical accuracy and inter-rater reliability.
- Intra-rater reliability was evaluated by one surgeon performing 30 trials.
Main Results:
- The mean spatial error in the entire elbow joint was 1.13 mm.
- Resection volume averaged 8% more than planned, with 85% of the planned area resected.
- Surgical accuracy was significantly lower in the anterior compared to the posterior elbow joint; high intra- and inter-rater reliability (ICC > 0.8) was observed.
Conclusions:
- Computer-aided navigation systems provide accuracy comparable to other joints for arthroscopic debridement of the elbow.
- This technology can improve the accuracy of bony impingement lesion removal in elbow osteoarthritis.
- The system's real-time tracking capabilities can help overcome technical difficulties in elbow arthroscopic surgery.
