Development of Computer-Aided Surgery System for High Tibial Osteotomy Using Tracking-Pin and Fluoroscopic G-arm Images

Tracking-Pin과 Fluoroscopic G-arm 이미지를 이용한 경골근위부절골술 지원시스템 개발

  • 구본열 (한양대학교 기계공학부) ;
  • 김철웅 (고려대학교/(주)트리플씨메디칼) ;
  • 이순혁 (고려대학교 의과대학 정형외과) ;
  • 배지훈 (고려대학교 의과대학 정형외과) ;
  • 박철우 (한양대학교 기계공학부) ;
  • 김재정 (한양대학교 기계공학부)
  • Received : 2011.04.18
  • Accepted : 2011.06.28
  • Published : 2011.10.01

Abstract

High tibial osteotomy (HTO) is a widely accepted treatment for unicompartmental osteoarthritis of the knee and other lower extremity deformities, particularly for young and active patients. However, it is generally recognized as a technically demanding procedure. Thus the limitations of conventional surgical methods have been reported. Currently, the use of computer-aided surgery (CAS) system for successful surgery was increased. However it has been reported many problems such as expensive equipment, infection or fracture caused by inserting half-pin and delaying surgery. Therefore we propose a novel method which can be tracked by using tracking-pin inserted in arbitrary locations of the femur and tibia, and fluoroscopic images obtained from G-arm of antero-posterior and lateral-medial.

Keywords

References

  1. Billings, A., Scott, D. F. and Camargo, M. P., "High Tibial Osteotomy with a Calibrated Osteotomy Guide, Rigid Internal Fixation, and Early Motion Long-term Follow-up," J. Bone Joint Surg [Am], Vol. 82, pp. 70-79, 2000.
  2. Coventry, M. B., Ilstrup, D. M. and Wallrichs, S. L., "Proximal Tibial Osteotomy. A Critical Longterm Study of Eighty-seven Cases," J. Bone Joint Surg. [Am], Vol. 75, pp. 196-201, 1993. https://doi.org/10.2106/00004623-199302000-00006
  3. Hernigou, P. and Ma, W., "Open Wedge Tibial Osteotomy with Acrylic Bone Cement as Bone Substitute," Knee, Vol. 8, pp. 103-110, 2001. https://doi.org/10.1016/S0968-0160(00)00061-2
  4. Koshino, T., Murase, T., Takagi, T. and Saito, T., "New Bone Formation Around Porous Hydroxyapatite Wedge Implanted in Opening Wedge High Tibial Osteotomy in Patients with Osteoarthritis," Biomaterials, Vol. 22, Issue 12, pp. 1579-1582, 2001. https://doi.org/10.1016/S0142-9612(00)00318-5
  5. Murphy, S. B., "Tibial Osteotomy for Genu Varum Indications, Preoperative Planning, and Technique," Orthop. Clin. North [Am], Vol. 25, No. 3, pp. 477-482, 1994.
  6. Naudie, D., Bourne, R. B., Rorabeck, C. H. and Bourne, T. J., "The Install Award Survivorship of the High Tibial Valgus Osteotomy. A 10- to -22- year Followup Study," Clin. Orthop., Vol. 367, pp. 18-27, 1999.
  7. Mathews, J., Cobb, A. G. and Richardson, S., "Distal Femoral Osteotomy for LMeral Compartment Osteoarthritis of the Knee," Orthopedics, Vol. 21, pp. 437-440, 1998.
  8. Noyes, F. R., Barber-Westin, S. D. and Hewett, T. E., "High Tibial Osteotomy and Ligament Reconstruction for Varus anguLMed Anterior Cruciate Ligament- deficient Knees," J. Sports Med. [Am], Vol. 28, pp. 282-296, 2000.
  9. Rudan, J. F. and Simurda, M. A., "Valgus High Tibial Osteotomy. A Long-term Follow-up Study," Clin. Orthop, pp. 157-160, 1991.
  10. Marti, C. B., Gautier, E., Wachtl, S. W. and Jakob, R. P., "Accuracy of Frontal and Sagittal Plane Correction in Open-wedge High Tibial Osteotomy," Arthroscopy, Vol. 20, pp. 366-372, 2004. https://doi.org/10.1016/j.arthro.2004.01.024
  11. Poilvache, P., "Osteotomy for the Arthritic Knee. A European Perspective", In: Scott WN ed. Surgery of the Knee. 4th ed. Philadelphia, Elsevier Inc., pp. 1321-1366, 2006.
  12. Giffin, J. R., Vogrin, T. M., Zantop, T., Woo, S. L. and Harner, C. D., "Effects of Increasing Tibial Slope on the Biomechanics of the Knee," Am. J. Sports Med., Vol. 32, No. 2, pp. 376-382, 2004. https://doi.org/10.1177/0363546503258880
  13. Hohmann, E., Bryant, A. and Imhoff, A. B., "The Effect of Closed Wedge High Tibial Osteotomy on Tibial Slope: A Radiographic Study," Knee Surg. Sports Traumatol Arthosc., Vol. 14, pp. 454-459, 2006. https://doi.org/10.1007/s00167-005-0700-3
  14. Kazakos, K. J., Chatzipapas, C., Verettas, D., Galanis, V., Xarchas, K. C. and Psillakis, I., "Mid-term Results of Total Knee Arthroplasty after High Tibial Osteotomy," Arch Orthop. Trauma Surg., Vol. 128, pp. 167-173, 2008. https://doi.org/10.1007/s00402-007-0488-3
  15. Lee, J. Y., Seon, J. K., Yoon, T. R., Cheon, S. Y. and Lim, K. Y., "Comparison of High Tibial Osteotomy: Opening Versus Closing Wedge Osteotomy," J. Korean Orthop. Assoc., Vol. 39, pp. 790-796, 2004. https://doi.org/10.4055/jkoa.2004.39.7.790
  16. Nakamura, E., Mizuta, H., Takagi, K. and Sakamoto, K., "Open-wedge Osteotomy of the Proximal Tibia Hemicallotasis," J. Bone Joint Surg. Br., Vol. 83, pp. 1111-1115, 2001. https://doi.org/10.1302/0301-620X.83B8.11993
  17. Hernigou, P., Medevielle, D., Debeyre, J. and Goutallier, D., "Proximal Tibial Osteotomy for Osteoarthritis with Varus Deformity. A Ten to Thirteenyear Follow-up Study," J. Bone Joint Surg. [Am], Vol. 69, Issue. 3, pp. 332-354, 1987. https://doi.org/10.2106/00004623-198769030-00005
  18. Jacques, M., Victoria, D. and Daniel, F., "Computer- Assisted Open-Wedge High Tibial Osteotomy," Operative Technique in Orthopaedics, Elsevier Inc, pp. 210-214, 2008.
  19. Dahl, M. T., "Preoperative Planning in Deformity Correction and Limb Lengthening Surgery," Instr. Course Lect., Vol. 49, pp. 503-509, 2000.
  20. Wright, J. G., Treble, N. and Feinstein, A. R., "Measurement of Lower Limb Alignment Using Long Radiographs," J. Bone Joint Surg. [Br], Vol. 73, pp. 721-723, 1991.
  21. Frrti, C. B., Gautier, E., Wachtl, S. W. and Jakob, R. P., "Accuracy of Frontal and Sagittal Plane Correction in Open-wedge High Tibial Osteotomy," Arthroscopy, Vol. 20, pp. 366-372, 2004. https://doi.org/10.1016/j.arthro.2004.01.024
  22. Chao, E. Y. and Sim, F. H., "Computer-aided Preoperative Planning in Knee Osteotomy," Iowa Orthop J., Vol. 15, pp. 4-18, 1995.
  23. Lin, H., Birch, J. G. and Samchukov, M. L., "Computer- assisted Surgery Planning for Lower Extremity Deformity Correction by the Ilizarov Method," J. Image Guid Surg., Vol. 1, pp. 103-108, 1995. https://doi.org/10.1002/(SICI)1522-712X(1995)1:2<103::AID-IGS5>3.0.CO;2-E
  24. Tsumura, H., Himeno, S. and Kawai, T., "The Computer simuLMion on the Correcting Osteotomy of Osteoarthritis of the Knee," Journal of Japanese Orthopaedic Association, Vol. 58, pp. 565-566, 1984.
  25. Wirz, P. and Jakob, R. P., "Knee Joint simuLMor: an Anatomical Reconstruction of the Joint Surfaces and of the Ligamentous Structures of the Knee Joint for Teaching Purposes," Knee Surg Sports Traumatol Arthrosc., Vol. 7, pp. 59-62, 1999. https://doi.org/10.1007/s001670050121
  26. Bae, D. K, Yoon, K. H., Kim, S. G. and Park, K. J., "Efficacy of Computer Assisted Surgery in Revision Total Knee Arthroplasty," Journal of Korean Orthopedic Association, Vol. 41, No. 6, pp. 974-980, 2006. https://doi.org/10.4055/jkoa.2006.41.6.974
  27. Agneskirchner, J. D., Hurschler, C., Stukenborg- Colsman, C., Imhoff, A. B. and Lobenhoffer, P., "Effect of High Tibial Flexion Osteotomy on Cartilage Pressure and Joint Kinematics: A Biomechanical Study in Human Cadaveric Knees," Arch Orthop Trauma Surg., Vol. 124, pp. 575-584, 2004. https://doi.org/10.1007/s00402-004-0728-8
  28. Muller, W., Kentsch, A. and Schafer, N., "The Elastic High Tibia Valgus Osteotomy in the Varus Deformity," Oper. Tech. Sports Med., Vol. 8, pp. 19-26, 2000. https://doi.org/10.1016/S1060-1872(00)80020-9
  29. Hankemeier, S., Hufner, T., Wang, G., Kendoff, D., Zeichen, J., Zheng, G. and Krettek, C., "Navigated Open-wedge High Tibial Osteotomy: Advantages and Disadvantages Compared to the Conventional Technique in a Cadaver Study," Knee Surg Sports Traumatol Arthrosc, Vol. 14, pp. 917-921, 2006. https://doi.org/10.1007/s00167-006-0035-8
  30. Song, E. K., Seon, J. K., Chung, J. Y., Cho, S. G. and Il Kyo Kong, "Comparison of Results of Total Knee Arthroplasty Performed using a Navigation System and the Conventional Technique," Journal of Korean Orthopedic Association, Vol. 41, No. 6, pp. 1002-1007, 2006. https://doi.org/10.4055/jkoa.2006.41.6.1002
  31. Wright, J. G., Treble, N. and Feinstein, A. R., "Measurement of Lower Limb Alignment Using Long Radiographs," J. Bone Joint Surg. [Br], Vol. 73, pp. 721-723, 1991.
  32. Gunay, M., Shim, M. B. and Shimada, K., "Costand Time-effective Three-dimensional Bone-shape Reconstruction from X-ray Images," Int. J. Med. Robotics Computer Assist Surgery, Vol. 3, pp. 323-335, 2007. https://doi.org/10.1002/rcs.162