A novel surgical navigation technology for placement of implants in slipped capital femoral epiphysis

Int J Med Robot. 2020 Feb;16(1):e2070. doi: 10.1002/rcs.2070. Epub 2020 Jan 8.

Abstract

Background: Fixation with a single screw is the recommended treatment for slipped capital femoral epiphysis (SCFE). Achieving optimal implant positioning can be difficult owing to the complex geometry of the proximal femur in SCFE. We assessed a novel navigation technology incorporating an inertial measurement unit to facilitate implant placement in an SCFE model.

Methods: Guidewires were placed into 30 SCFE models, using a navigation system that displayed the surgeon's projected implant trajectory simultaneously in multiple planes. The accuracy and the precision of the system were assessed as was the time to perform the procedure.

Results: Implants were placed an average of 5.3 mm from the femoral head center, with a system precision of 0.94 mm. The actual trajectory of the implant deviated from the planned trajectory by an average of 4.9° ± 2.2°. The total average procedure time was 97 seconds.

Conclusion: The use of computer-based navigation in a SCFE model demonstrated good accuracy and precision in terms of both implant trajectory and placement in the center of the femoral head.

Keywords: bone; computer-assisted surgery; imaged-guided surgery; orthopedic; pediatrics; pelvic.

MeSH terms

  • Bone Screws
  • Fluoroscopy
  • Humans
  • Orthopedic Procedures
  • Prosthesis Implantation / methods*
  • Slipped Capital Femoral Epiphyses / surgery*
  • Surgery, Computer-Assisted / methods*