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Bridging theory and practice: A comprehensive algorithm for imageless total knee arthroplasty.

Muhammad Sohail1, Heung Soo Kim1

  • 1Department of Mechanical, Robotics and Energy Engineering, Dongguk University-Seoul, 30 Pildong-ro 1-gil, Jung-gu, Seoul, 04620, Republic of Korea.

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|May 31, 2024
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Summary

This study presents a new algorithm for imageless total knee arthroplasty (TKA) to precisely calculate bone alignment and resection depths. Validation showed promising accuracy, with potential for improvement using higher-accuracy cameras.

Keywords:
Bone resectionHipImageless navigatorKnee and ankle angle calculationTotal knee arthroplasty

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Area of Science:

  • Orthopedic Surgery
  • Biomedical Engineering
  • Surgical Navigation

Background:

  • Severe knee osteoarthritis often necessitates total knee arthroplasty (TKA).
  • Imageless TKA offers a minimally invasive approach with precise alignment capabilities.
  • Accurate intraoperative measurements are crucial for successful TKA outcomes.

Purpose of the Study:

  • To develop and validate a comprehensive algorithm for an imageless TKA device.
  • To calculate key surgical parameters including varus/valgus, flexion/extension angles, and resection depths.
  • To determine leg alignment angles such as hip-knee-ankle (HKA).

Main Methods:

  • Algorithm development for calculating TKA parameters using an imageless system.
  • Validation in a virtual environment with CT-scanned bone models.
  • Real-world validation using SoftBone models, comparing with conventional methods and direct measurements.

Main Results:

  • The algorithm accurately calculated varus/valgus, flexion/extension angles, and resection depths.
  • Virtual and SoftBone model validations demonstrated the algorithm's feasibility.
  • Real-world testing with an infrared camera (±0.5 mm accuracy) yielded approximately 1 mm error in resections, reducible with higher accuracy cameras.

Conclusions:

  • The proposed imageless TKA algorithm provides a viable method for precise surgical navigation.
  • The system demonstrates potential for accurate bone cut and alignment determination.
  • Further refinement with advanced imaging technology can enhance accuracy for clinical application.