Navigation in Computer Assisted Orthopaedic Surgery

Abstract

Originally developed for neurosurgery procedures, since late nineties Computer Assisted Surgery (CAS) systems have been used in orthopaedic interventions. Such systems assist the surgeon during the preoperative or the intra-operative planning phase from diagnostic data, during the intra-operative phases of registration and navigation. They provide quantitative information of the overall surgical outcome and allow controlling range of accuracy and repeatability. Despite recognized advance in introducing the computer in the orthopaedic operative room (OR), several aspects are still debated such as operative time prolongation, information provided to the surgeon and user interface management. The chapter is aimed at reviewing main navigation systems as far as the visual and interactive aspects are concerned and at suggesting useful tools in order to enhance the surgeon usability of a navigation system. We developed modules for Total Knee Replacement (TKR) and Total Hip Replacement (THR), named KneeLab and HipLab respectively. In the two applications, we coped with two main aspects of the navigation in knee and hip replacement combining new visualization methods and new working methods. In the chapter, the reader can find a detailed description of the solution proposed to overcome problems commonly found with navigation systems in orthopaedics. We introduced innovative methods and algorithms, new modality of vocal interface, fully 3D graphics, recovery session from file system. The development aimed at the fulfilment of the critical user requirements of the operating room, by providing the user with a tightly guided procedure and an immediate graphical virtual environment.