Department of Orthopaedics, Balgrist University Hospital, Forchstrasse 340, 8008, Zürich, Switzerland.
Computer-Assisted Research and Development Group, Balgrist University Hospital, Zurich, Switzerland.
BMC Musculoskelet Disord. 2020 Jun 17;21(1):438. doi: 10.1186/s12891-020-03373-4.
An optimal osteotomy angle avoids shortening of the first metatarsal bone after hallux valgus surgery and therefore reduces the risk of transfer-metatarsalgia. The purpose of the present ex-vivo study was to investigate whether augmented reality (AR) would improve accuracy of the distal osteotomy during hallux valgus surgery.
Distal osteotomies of the first metatarsals were performed on a foot model by two surgeons with different levels of surgical experience each with (AR, n = 15 × 2) or without (controls, n = 15 × 2) overlay of a hologram depicting an angle of osteotomy perpendicular to the second metatarsal. Subsequently, the deviation of the osteotomy angle in the transverse plane was analyzed.
Overall, AR decreased the extent of deviation and the AR guided osteotomies were more accurate (4.9 ± 4.2°) compared to the freehand cuts (6.7 ± 6.1°) by tendency (p = 0.2). However, while the inexperienced surgeon performed more accurate osteotomies with AR with a mean angle of 6.4 ± 3.5° compared to freehand 10.5 ± 5.5° (p = 0.02), no significant difference was noticed for the experienced surgeon with an osteotomy angle of around 3° in both cases.
This pilot-study suggests that AR guided osteotomies can potentially improve accuracy during hallux valgus correction, particularly for less experienced surgeons.
在拇外翻手术中,选择一个理想的截骨角度可以避免第一跖骨缩短,从而降低转移性跖痛的风险。本体外研究的目的是探讨增强现实(AR)技术是否能提高拇外翻手术中远端截骨的准确性。
通过两位具有不同手术经验的外科医生在足模型上进行第一跖骨的远端截骨,其中一位医生(AR 组,n=15×2)在截骨时使用叠加有与第二跖骨垂直的截骨角度全息图,另一位医生(对照组,n=15×2)不使用该技术。随后,分析横向截骨角度的偏差。
总体而言,AR 组减少了截骨角度的偏差,且 AR 引导的截骨更准确(4.9±4.2°),比徒手截骨(6.7±6.1°)更有优势(p=0.2)。然而,经验不足的外科医生使用 AR 进行截骨时,截骨角度更准确,平均为 6.4±3.5°,而徒手截骨时为 10.5±5.5°(p=0.02);但对于经验丰富的外科医生,两种情况下截骨角度均约为 3°,没有显著差异。
这项初步研究表明,AR 引导的截骨术可能会提高拇外翻矫正手术的准确性,尤其是对经验不足的外科医生。