Kim Youngjun, Lee Byung Hoon, Mekuria Kinde, Cho Hyunchul, Park Sehyung, Wang Joon Ho, Lee Deukhee
Center for Bionics, Korea Institute of Science and Technology, 5, Hwarangno 14-gil, Seongbuk-gu, Seoul 02792, Republic of Korea; Department of Biomedical Engineering, Korea University of Science and Technology, 217 Gajungro, Yuseong-gu, Daejeon 305-350, Republic of Korea.
Department of Orthopaedic Surgery, Kang-Dong Sacred Heart Hospital, Hallym University Medical School Center, Gil-dong, Seoul 134-701, Republic of Korea.
Knee. 2017 Mar;24(2):329-339. doi: 10.1016/j.knee.2016.12.007. Epub 2017 Feb 9.
Recently, surgical navigation systems have been widely used to improve the results of various orthopaedic surgeries. However, surgical navigation has not been successful in anterior cruciate ligament reconstruction, owing to its inaccuracy and inconvenience. This study investigated the registration of preoperative and intraoperative data, which are the key components in improving accuracy of the navigation system.
An accurate registration method was proposed using new optical tracking markers and landmark retake. A surgical planning and navigation system for anterior cruciate ligament reconstruction was developed and implemented. The accuracy of the proposed system has been evaluated using phantoms and eight cadaveric knees. The present study investigated only the registration accuracy excluding the errors of optical tracking hardware and surgeon.
The target registration errors of femoral tunnelling for anterior cruciate ligament reconstruction in phantoms were found to be 0.24±0.03mm and 0.19±0.10° for the tunnel entry position and tunnel direction, respectively. The target registration errors measured using cadavers were 0.9mm and 1.94°, respectively.
The preclinical experimental results showed that the proposed methods enhanced the registration accuracy of the developed system. As the system becomes more accurate, surgeons could more precisely position and orient the femoral and tibial tunnels to their original anatomical locations.
近年来，手术导航系统已被广泛应用于改善各种骨科手术的效果。然而，由于其准确性和便利性不足，手术导航在前交叉韧带重建中尚未取得成功。本研究调查了术前和术中数据的配准，这是提高导航系统准确性的关键组成部分。
提出了一种使用新型光学跟踪标记和地标重新获取的精确配准方法。开发并实现了一种用于前交叉韧带重建的手术规划和导航系统。使用模型和八个尸体膝关节对所提出系统的准确性进行了评估。本研究仅调查了配准精度，排除了光学跟踪硬件和外科医生的误差。
在前交叉韧带重建的模型中，股骨隧道的目标配准误差在隧道入口位置和隧道方向分别为0.24±0.03mm和0.19±0.10°。使用尸体测量的目标配准误差分别为0.9mm和1.94°。
临床前实验结果表明，所提出的方法提高了所开发系统的配准精度。随着系统变得更加准确，外科医生可以更精确地将股骨和胫骨隧道定位并定向到其原始解剖位置。
