J Korean Orthop Assoc.  2009 Feb;44(1):68-75. 10.4055/jkoa.2009.44.1.68.

Comparison of Accuracy of Navigation between Infrared Optical and Electromagnetic Systems

Affiliations
  • 1Department of Orthopedics, Center for Joint Disease, Chonnam National University Hwasun Hospital, Hwasun, Korea. park5962@paran.com

Abstract

PURPOSE: This study compared the accuracy of mechanical axis measurement between infrared optical and electromagnetic navigation.
MATERIALS AND METHODS
We compared the preoperative mechanical axes of 20 TKAs using both navigation systems. Experimentally, the mechanical axes of the synthetic bone model were compared and the true mechanical axis was determined using the ORTHODOC. Additionally, a surgeon intentionally registered incorrect landmarks and then measured the amount of mechanical axis change in the two navigation methods.
RESULTS
Clinically, AxiEM provided greater varus (10.25degrees+/-5.10degrees) than Orthopilot (9.02degrees+/-5.18degrees). The mean mechanical axis difference was 1.23degrees and a difference greater than 3degrees in the same patient occurred in 15% of patients. For the synthetic bone, the true mechanical axis was varus 1.25degrees, OrthoPilot displayed varus 1.10degrees+/-0.64degrees and AxiEM varus 1.78degrees+/-0.79degrees. The mechanical axis differences were not significantly different, but OrthoPilot had more reproducibility. When anatomical landmarks were erroneously identified, AxiEM showed a greater change in the mechanical axis.
CONCLUSION
Both navigation systems provided high mechanical axis accuracy and reproducibility under experimental conditions. Infrared optical navigation was more reproducible than electromagnetic navigation. In the clinical setting, there was a disparity of mechanical axis difference greater than 3degrees in 15% between the two navigation methods in the same patient.

Keyword

Infrared optical navigation; Electromagnetic navigation; Accuracy; Total knee arthroplasty

MeSH Terms

Axis, Cervical Vertebra
Humans
Intention
Magnets

Figure

  • Fig. 1 Synthetic bone models. The hip, knee and ankle joint are made of titanium which have no effect on electromagnetic field and the knee joint is constrained not allowing varus or valgus motion.

  • Fig. 2 (A-E) Proceeding of ORTHODOC system: (A) Femoral head center, (B) Center of distal femur, (C) Center of proximal tibia, (D) Ankle center, and (E) Measurement of mechanical axis.

  • Fig. 3 (A-C) Erroneous identification of anatomical landmarks: (A) Distal femur, (B) Proximal tibia, and (C) Ankle.

  • Fig. 4 Results of mechanical axis evaluation using Orthopilot and AxiEM navigation system. Orthopilot read mechanical axis as 0, 1, 2° varus and AxiEM did 0 to 3° varus. Orthopilot showed more reproducibility. Both navigations demonstrated 1 or 2° varus in 86%. But, this study revealed two systems could make 3° of mechanical axis difference in the worst scenario. MA, mechanical axis; EM, Electromagnetic navigation; -, negative symbol indicates varus.


Cited by  1 articles

Navigation Guided Open Wedge High Tibial Osteotomy
Jong-Keun Seon, Ha-Sung Kim, Do-Youn Kim, Eun-Kyoo Song
J Korean Orthop Assoc. 2014;49(2):107-117.    doi: 10.4055/jkoa.2014.49.2.107.


Reference

1. Amin DV, Kanade T, DiGioia AM 3rd, Jaramaz B. Ultrasound registration of the bone surface for surgical navigation. Comput Aided Surg. 2003. 8:1–16.
Article
2. Anderson KC, Buehler KC, Markel DC. Computer assisted navigation in total knee arthroplasty: comparison with conventional methods. J Arthroplasty. 2005. 20(7):Suppl 3. S132–S138.
3. Bäthis H, Perlick L, Tingart M, Lüring C, Zurakowski D, Grifka J. Alignment in total knee arthroplasty. A comparison of computer-assisted surgery with the conventional technique. J Bone Joint Surg Br. 2004. 86:682–687.
4. Bolognesi M, Hofmann A. Computer navigation versus standard instrumentation for TKA: a single-surgeon experience. Clin Orthop Relat Res. 2005. 440:162–169.
5. Chen TK, Abolmaesumi P, Pichora DR, Ellis RE. A system for ultrasound-guided computer-assisted orthopaedic surgery. Comput Aided Surg. 2005. 10:281–292.
Article
6. Huitema RB, Hof AL, Postema K. Ultrasonic motion analysis system-measurement of temporal and spatial gait parameters. J Biomech. 2002. 35:837–842.
Article
7. Hummel J, Figl M, Birkfelner W, et al. Evaluation of a new electromagnetic tracking system using a standarized assessment protocol. Phys Med Biol. 2006. 51:205–210.
8. Jenny JY, Boeri C, Picard F, Leitner F. Reproducibility of intra-operative measurement of the mechanical axes of the lower limb during total knee replacement with a non-image-based navigation system. Comput Aided Surg. 2004. 9:161–165.
Article
9. Jenny JY, Clemens U, Kohler S, Kiefer H, Konermann W, Miehlke RK. Consistency of implantation of a total knee arthroplasty with a non-image-based navigation system: a case-control study of 235 cases compared with 235 conventionally implanted prostheses. J Arthroplasty. 2005. 20:832–839.
10. Khadem R, Yeh CC, Sadeghi-Tehrani M, et al. Comparative tracking error analysis of five different optical tracking systems. Comput Aided Surg. 2000. 5:98–107.
Article
11. Lionberger R. Stiehl JB, Konermann W, Hacker R, editors. The attraction of electromagnetic computer-assisted navigation in orthopaedic surgery. Navigation and MIS in orthopaedic surgery. 2006. Heidelberg, Germany: Springer Verlag;44–53.
Article
12. Maculé-Beneyto F, Hernández-Vaquero D, Segur-Vilalta JM, et al. Navigation in total knee arthroplsty. A multicenter study. Int Orthop. 2006. 30:536–540.
13. Pitto RP, Graydon AJ, Bradley L, Malak SF, Walker CG, Anderson IA. Accuracy of computer-assisted navigation system for total knee replacement. J Bone Joint Surg Br. 2006. 88:601–605.
14. Poulin F, Amiot LP. Interference during the use of an electromagnetic tracking system under OR conditions. J Biomech. 2002. 35:733–737.
Article
15. Rosenow JM, Sootsman WK. Application accuracy of an electromagnetic field-based image-guided navigation system. Stereotact Funct Neurosurg. 2007. 85:75–81.
Article
16. Saragaglia D, Picard F, Chaussard C, Montbarbon E, Leitner F, Cinquin P. Computer-assisted knee arthroplasty: comparison with a conventional procedure. Results of 50 cases in a prospective randomized study. Rev Chir Orthop Reparatrice Appar Mot. 2001. 87:18–28.
17. Schicho K, Figl M, Donat M, et al. Stability of miniature electromagnetic tracking systems. Phys Med Biol. 2005. 50:2089–2098.
Article
18. Stiehl JB, Heck DA. Six sigma analysis of computer-assisted surgery tracking protocols in TKA. Clin Orthop Relat Res. 2007. 464:105–110.
Article
19. Stöckl B, Nogler M, Rosiek R, Fischer M, Krismer M, Kessler O. Navigation improves accuracy of rotational alignment in total knee arthroplasty. Clin Orthop Relat Res. 2004. 26:180–186.
20. Stulberg SD, Loan P, Sarin V. Computer-assisted navigation in total knee replacement: results of an initial experience in thirty-five patients. J Bone Joint Surg Am. 2002. 84:Suppl 2. S90–S98.
21. Yau WP, Leung A, Chiu KY, Tang WM, Ng TP. Intraobserver errors in obtaining visually selected anatomic landmarks during registration process in nonimage-based navigation-assisted total knee arthroplasty: a cadaveric experiment. J Arthroplasty. 2005. 20:591–601.
Full Text Links
  • JKOA
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr