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G Rau - One of the best experts on this subject based on the ideXlab platform.

  • image guided orthopedic Surgery using individual templated experimental results and aspects of the development of a demonstrator for Pelvis Surgery
    CVRMed-MRCAS '97 Proceedings of the First Joint Conference on Computer Vision Virtual Reality and Robotics in Medicine and Medial Robotics and Compute, 1997
    Co-Authors: Klaus Radermacher, F Portheine, A Zimolong, Ch Eichhorn, Hans Walter Staudte, G Rau
    Abstract:

    Individual templates for Orthopedic Surgery provide a precise intraoperative reproduction of the geometries of work on bone planned preoperatively on the base of CT-image data. The general feasibility concerning the adaptation to different surgical applications has already been demonstrated in various in-vitro studies as well as within clinical application1,2,3,4,5. Within the framework of the European IGOS-project a demonstrator for image guided Pelvis Surgery as an exemplary clinical application will be developed. In contrast to initial feasibility studies with our first labtyp systems, the introduction into clinical routine induces additional constraints. To provide an adequate level of reliability and usability additional efforts are necessary especially concerning quality assurance, ergonomic design and standardisation of the related chain of image acquisition and surgical planning, manufacturing of individual templates and finally the intraoperative execution. Aspects of the integration into clinical routine as well as laboratory investigations concerning accuracy and integrated manufacturing are discussed.

  • CVRMed - Image-guided orthopedic Surgery using individual templated - experimental results and aspects of the development of a demonstrator for Pelvis Surgery
    Lecture Notes in Computer Science, 1997
    Co-Authors: Klaus Radermacher, F Portheine, A Zimolong, Ch Eichhorn, Hans Walter Staudte, G Rau
    Abstract:

    Individual templates for Orthopedic Surgery provide a precise intraoperative reproduction of the geometries of work on bone planned preoperatively on the base of CT-image data. The general feasibility concerning the adaptation to different surgical applications has already been demonstrated in various in-vitro studies as well as within clinical application1,2,3,4,5. Within the framework of the European IGOS-project a demonstrator for image guided Pelvis Surgery as an exemplary clinical application will be developed. In contrast to initial feasibility studies with our first labtyp systems, the introduction into clinical routine induces additional constraints. To provide an adequate level of reliability and usability additional efforts are necessary especially concerning quality assurance, ergonomic design and standardisation of the related chain of image acquisition and surgical planning, manufacturing of individual templates and finally the intraoperative execution. Aspects of the integration into clinical routine as well as laboratory investigations concerning accuracy and integrated manufacturing are discussed.

H. Schöll - One of the best experts on this subject based on the ideXlab platform.

  • IMAGE-BASED GUIDED TREATMENT OF METATARSAL V FRACTURES
    2018
    Co-Authors: Michael Kraus, C. Dehner, C. Riepl, G. Krischak, Florian Gebhard, H. Schöll
    Abstract:

    In orthopaedic Surgery, as in many other surgical fields, there is a clear tendency towards the use of minimally invasive procedures. These techniques are increasingly being implemented almost routinely for procedures such as spine and Pelvis Surgery. However, for fracture treatment and for applications involving small bones, such as hand and foot Surgery, these systems are hardly ever used. We introduce a new system for image based guidance in traumatology.We included 20 patients with a fracture of the fifth metatarsal. They were randomised on admission into two groups. Ten patients in the metatarsal group were operated conventionally and ten were operated with the assistance of a new image guidance system. This system is based on 2D-fluoro images which are acquired with a conventional c-arm and are transferred to the system workstation. After detecting marked tools, it can be used to display trajectories for K-wire guidance in the c-arm shot.The average duration of Surgery (time from incision to suture)...

  • IMAGE-BASED GUIDED TREATMENT OF METATARSAL V FRACTURES
    Journal of Bone and Joint Surgery-british Volume, 2013
    Co-Authors: Michael Kraus, C. Dehner, C. Riepl, G. Krischak, Florian Gebhard, H. Schöll
    Abstract:

    In orthopaedic Surgery, as in many other surgical fields, there is a clear tendency towards the use of minimally invasive procedures. These techniques are increasingly being implemented almost routinely for procedures such as spine and Pelvis Surgery. However, for fracture treatment and for applications involving small bones, such as hand and foot Surgery, these systems are hardly ever used. We introduce a new system for image based guidance in traumatology. We included 20 patients with a fracture of the fifth metatarsal. They were randomised on admission into two groups. Ten patients in the metatarsal group were operated conventionally and ten were operated with the assistance of a new image guidance system. This system is based on 2D-fluoro images which are acquired with a conventional c-arm and are transferred to the system workstation. After detecting marked tools, it can be used to display trajectories for K-wire guidance in the c-arm shot. The average duration of Surgery (time from incision to suture) in the image-based group was 12.7 minutes ± 5.5 (min. 6, max. 23), in the conventional group it was 17 minutes ± 6.5 (min. 7, max. 28) (p=0.086). The average duration of radiation was 18 seconds ± 8.5 (min. 6, max 36) in the image-based group vs. 32.4 seconds ± 19.4 (min. 12, max. 66) in the conventional group (p=0.057). An average of 4.7 C-arm shots ± 2 (min 2, max 9) were necessary in the image-based group to position the K-wire. For the conventional group, 8.2 shots ± 2.3 (min 4, max 12) were used (p=0.0073). It took 1.6 trials ± 0.7 (min.1, max. 3) to position the K-wire for the image-based procedures, in the conventional group 2.7 trials ± 0.9 (min. 1, max 4) were necessary (p=0.0084). There were no malfunctions or adverse events in any of the image-based navigational cases. No screws needed to be replaced in the image-based group. In the conventional group, two screws were replaced intra-operatively because they were too short in the control c-arm shot, and the screw threads did not bridge the fracture gap completely, leading to insufficient compression. In this pilot study with only a small sample size, the image-based guidance system could be integrated into the existing surgical workflow and was used for applications, where existing navigation systems are not commonly used. The technology gives the surgeon additional information and can reduce the number of trials for perfect implant positioning. This potentially increases the safety of the surgical procedure and spares intact bone substance which is essential for the footing of implants in small bones and fragment fixation. Whether these factors contribute to a reduction in complications or revision rate must be confirmed in larger prospective studies.

Klaus Radermacher - One of the best experts on this subject based on the ideXlab platform.

  • image guided orthopedic Surgery using individual templated experimental results and aspects of the development of a demonstrator for Pelvis Surgery
    CVRMed-MRCAS '97 Proceedings of the First Joint Conference on Computer Vision Virtual Reality and Robotics in Medicine and Medial Robotics and Compute, 1997
    Co-Authors: Klaus Radermacher, F Portheine, A Zimolong, Ch Eichhorn, Hans Walter Staudte, G Rau
    Abstract:

    Individual templates for Orthopedic Surgery provide a precise intraoperative reproduction of the geometries of work on bone planned preoperatively on the base of CT-image data. The general feasibility concerning the adaptation to different surgical applications has already been demonstrated in various in-vitro studies as well as within clinical application1,2,3,4,5. Within the framework of the European IGOS-project a demonstrator for image guided Pelvis Surgery as an exemplary clinical application will be developed. In contrast to initial feasibility studies with our first labtyp systems, the introduction into clinical routine induces additional constraints. To provide an adequate level of reliability and usability additional efforts are necessary especially concerning quality assurance, ergonomic design and standardisation of the related chain of image acquisition and surgical planning, manufacturing of individual templates and finally the intraoperative execution. Aspects of the integration into clinical routine as well as laboratory investigations concerning accuracy and integrated manufacturing are discussed.

  • CVRMed - Image-guided orthopedic Surgery using individual templated - experimental results and aspects of the development of a demonstrator for Pelvis Surgery
    Lecture Notes in Computer Science, 1997
    Co-Authors: Klaus Radermacher, F Portheine, A Zimolong, Ch Eichhorn, Hans Walter Staudte, G Rau
    Abstract:

    Individual templates for Orthopedic Surgery provide a precise intraoperative reproduction of the geometries of work on bone planned preoperatively on the base of CT-image data. The general feasibility concerning the adaptation to different surgical applications has already been demonstrated in various in-vitro studies as well as within clinical application1,2,3,4,5. Within the framework of the European IGOS-project a demonstrator for image guided Pelvis Surgery as an exemplary clinical application will be developed. In contrast to initial feasibility studies with our first labtyp systems, the introduction into clinical routine induces additional constraints. To provide an adequate level of reliability and usability additional efforts are necessary especially concerning quality assurance, ergonomic design and standardisation of the related chain of image acquisition and surgical planning, manufacturing of individual templates and finally the intraoperative execution. Aspects of the integration into clinical routine as well as laboratory investigations concerning accuracy and integrated manufacturing are discussed.

Michael Kraus - One of the best experts on this subject based on the ideXlab platform.

  • IMAGE-BASED GUIDED TREATMENT OF METATARSAL V FRACTURES
    2018
    Co-Authors: Michael Kraus, C. Dehner, C. Riepl, G. Krischak, Florian Gebhard, H. Schöll
    Abstract:

    In orthopaedic Surgery, as in many other surgical fields, there is a clear tendency towards the use of minimally invasive procedures. These techniques are increasingly being implemented almost routinely for procedures such as spine and Pelvis Surgery. However, for fracture treatment and for applications involving small bones, such as hand and foot Surgery, these systems are hardly ever used. We introduce a new system for image based guidance in traumatology.We included 20 patients with a fracture of the fifth metatarsal. They were randomised on admission into two groups. Ten patients in the metatarsal group were operated conventionally and ten were operated with the assistance of a new image guidance system. This system is based on 2D-fluoro images which are acquired with a conventional c-arm and are transferred to the system workstation. After detecting marked tools, it can be used to display trajectories for K-wire guidance in the c-arm shot.The average duration of Surgery (time from incision to suture)...

  • IMAGE-BASED GUIDED TREATMENT OF METATARSAL V FRACTURES
    Journal of Bone and Joint Surgery-british Volume, 2013
    Co-Authors: Michael Kraus, C. Dehner, C. Riepl, G. Krischak, Florian Gebhard, H. Schöll
    Abstract:

    In orthopaedic Surgery, as in many other surgical fields, there is a clear tendency towards the use of minimally invasive procedures. These techniques are increasingly being implemented almost routinely for procedures such as spine and Pelvis Surgery. However, for fracture treatment and for applications involving small bones, such as hand and foot Surgery, these systems are hardly ever used. We introduce a new system for image based guidance in traumatology. We included 20 patients with a fracture of the fifth metatarsal. They were randomised on admission into two groups. Ten patients in the metatarsal group were operated conventionally and ten were operated with the assistance of a new image guidance system. This system is based on 2D-fluoro images which are acquired with a conventional c-arm and are transferred to the system workstation. After detecting marked tools, it can be used to display trajectories for K-wire guidance in the c-arm shot. The average duration of Surgery (time from incision to suture) in the image-based group was 12.7 minutes ± 5.5 (min. 6, max. 23), in the conventional group it was 17 minutes ± 6.5 (min. 7, max. 28) (p=0.086). The average duration of radiation was 18 seconds ± 8.5 (min. 6, max 36) in the image-based group vs. 32.4 seconds ± 19.4 (min. 12, max. 66) in the conventional group (p=0.057). An average of 4.7 C-arm shots ± 2 (min 2, max 9) were necessary in the image-based group to position the K-wire. For the conventional group, 8.2 shots ± 2.3 (min 4, max 12) were used (p=0.0073). It took 1.6 trials ± 0.7 (min.1, max. 3) to position the K-wire for the image-based procedures, in the conventional group 2.7 trials ± 0.9 (min. 1, max 4) were necessary (p=0.0084). There were no malfunctions or adverse events in any of the image-based navigational cases. No screws needed to be replaced in the image-based group. In the conventional group, two screws were replaced intra-operatively because they were too short in the control c-arm shot, and the screw threads did not bridge the fracture gap completely, leading to insufficient compression. In this pilot study with only a small sample size, the image-based guidance system could be integrated into the existing surgical workflow and was used for applications, where existing navigation systems are not commonly used. The technology gives the surgeon additional information and can reduce the number of trials for perfect implant positioning. This potentially increases the safety of the surgical procedure and spares intact bone substance which is essential for the footing of implants in small bones and fragment fixation. Whether these factors contribute to a reduction in complications or revision rate must be confirmed in larger prospective studies.

F Gebhard - One of the best experts on this subject based on the ideXlab platform.

  • CLINICAL EXPERIENCE WITH A FLUOROSCOPY-BASED GUIDANCE SYSTEM IN ORTHOPAEDIC Surgery
    2018
    Co-Authors: Kraus M, F Gebhard
    Abstract:

    Beside spine and Pelvis Surgery, computer-assisted guidance systems are not used frequently for musculoskeletal injuries. Main reason is the dependence on a fixed reference array that must be firmly attached to all moving parts. We investigated a novel fluoroscopy-based image guidance system in orthopaedic trauma Surgery that uses a different technique. This was a prospective, not randomised single centre case series at a level I trauma centre. 45 patients with 46 injuries (foot 12, shoulder 10, long bones 7, hand and wrist 7, ankle 7, spine and Pelvis 4) were included. Different surgical procedures were examined following the basic principles of the AO/ASIF. Main outcome measurements were the number of trials for implant placement, total Surgery time, usability via user questionnaire and system failure rate. Furthermore we wanted to test the ability of the new system to be integrated in existing surgical workflows. In all cases, the trajectory function was used, inserting a total of 56 guided implants. T...

  • CLINICAL EXPERIENCE WITH A FLUOROSCOPY-BASED GUIDANCE SYSTEM IN ORTHOPAEDIC Surgery
    Journal of Bone and Joint Surgery-british Volume, 2016
    Co-Authors: Kraus M, F Gebhard
    Abstract:

    Beside spine and Pelvis Surgery, computer-assisted guidance systems are not used frequently for musculoskeletal injuries. Main reason is the dependence on a fixed reference array that must be firmly attached to all moving parts. We investigated a novel fluoroscopy-based image guidance system in orthopaedic trauma Surgery that uses a different technique. This was a prospective, not randomised single centre case series at a level I trauma centre. 45 patients with 46 injuries (foot 12, shoulder 10, long bones 7, hand and wrist 7, ankle 7, spine and Pelvis 4) were included. Different surgical procedures were examined following the basic principles of the AO/ASIF. Main outcome measurements were the number of trials for implant placement, total Surgery time, usability via user questionnaire and system failure rate. Furthermore we wanted to test the ability of the new system to be integrated in existing surgical workflows. In all cases, the trajectory function was used, inserting a total of 56 guided implants. The trajectory was the most popular feature used by surgeons (n=43, 93.5%), followed by the length measurement tool (n=29, 63%) and the bending function (n=17, 37%). The functions could be freely activated by the performing surgeon. The system failed when used in pelvic and spinal injuries, resulting in a total failure rate of 6.5% (n=3) of all included cases. The overall usability was rated as good, scoring 84.3%. This study examined the clinical application of a fluoroscopy-based image guidance system for different musculoskeletal injuries. Its major advantage is the high integrability in the accustomed surgical workflow and its connectivity with existing technical equipment. It can hardly be compared to known navigation solutions, since instruments are not tracked and fixed reference arrays are not required. Expected advantages should be explored in randomised studies.