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International Journal of Computer Assisted Radiology and Surgery

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01-02-2016 | Original Article

Image-guided techniques improve accuracy of mosaic arthroplasty

Authors: Stephen Sebastyan, Manuela Kunz, A. James Stewart, Davide D. Bardana

Published in: International Journal of Computer Assisted Radiology and Surgery | Issue 2/2016

Abstract

Purpose

Mosaic arthroplasty is a surgical technique in which a set of cylindrical osteochondral grafts is transplanted from non-load-bearing areas of the joint to repair damaged articular cartilage. Incongruity between the graft surface and the adjacent cartilage at the repair site results in inferior clinical outcomes. This paper compares technical outcome using three mosaic arthroplasty techniques (conventional, optoelectronic, and patient-specific template) on femur models.

Methods

Three distinct sets of femur models with defects were created. Preoperatively, the harvest and delivery sites were planned using custom software. Five orthopedic surgeons were recruited; each surgeon performed each of the three surgical techniques on each of the three bone models with defect. During the optoelectronic trials, the instrument position and orientation were tracked and superimposed onto the surgical plan. For the patient-specific template trials, plastic templates were manufactured to fit over the defects with cylindrical holes to guide the surgical tools according to the plan. Postoperatively, the femur models were computer tomography and laser scanned. Several measures were made to compare surgical techniques: operative time; surface congruency; defect coverage; graft surface area that is proud or recessed; air volume below the grafts; and distance and angle of the grafts from the surgical plan.

Results

The patient-specific template and optoelectronic techniques resulted in improved surface congruency, defect surface coverage, and below-graft air gap volume in comparison with the conventional technique. However, the conventional technique had a shorter operative time.

Conclusions

Image-guided techniques can improve the accuracy of mosaic arthroplasty, which could result in better clinical outcomes.

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Title: Image-guided techniques improve accuracy of mosaic arthroplasty
Authors: Stephen Sebastyan
Manuela Kunz
A. James Stewart
Davide D. Bardana
Publication date: 01-02-2016
Publisher: Springer Berlin Heidelberg
Published in: International Journal of Computer Assisted Radiology and Surgery / Issue 2/2016
Print ISSN: 1861-6410
Electronic ISSN: 1861-6429
DOI: https://doi.org/10.1007/s11548-015-1249-3

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Image-guided techniques improve accuracy of mosaic arthroplasty

Abstract

Purpose

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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