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Published in: BMC Musculoskeletal Disorders 1/2020

Open Access 01-12-2020 | Hallux Valgus | Research article

Augmented reality guided osteotomy in hallux Valgus correction

Authors: Arnd Fredrik Viehöfer, Stephan Hermann Wirth, Stefan Michael Zimmermann, Laurenz Jaberg, Cyrill Dennler, Philipp Fürnstahl, Mazda Farshad

Published in: BMC Musculoskeletal Disorders | Issue 1/2020

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Abstract

Background

An optimal osteotomy angle avoids shortening of the first metatarsal bone after hallux valgus surgery and therefore reduces the risk of transfer-metatarsalgia. The purpose of the present ex-vivo study was to investigate whether augmented reality (AR) would improve accuracy of the distal osteotomy during hallux valgus surgery.

Methods

Distal osteotomies of the first metatarsals were performed on a foot model by two surgeons with different levels of surgical experience each with (AR, n = 15 × 2) or without (controls, n = 15 × 2) overlay of a hologram depicting an angle of osteotomy perpendicular to the second metatarsal. Subsequently, the deviation of the osteotomy angle in the transverse plane was analyzed.

Results

Overall, AR decreased the extent of deviation and the AR guided osteotomies were more accurate (4.9 ± 4.2°) compared to the freehand cuts (6.7 ± 6.1°) by tendency (p = 0.2). However, while the inexperienced surgeon performed more accurate osteotomies with AR with a mean angle of 6.4 ± 3.5° compared to freehand 10.5 ± 5.5° (p = 0.02), no significant difference was noticed for the experienced surgeon with an osteotomy angle of around 3° in both cases.

Conclusion

This pilot-study suggests that AR guided osteotomies can potentially improve accuracy during hallux valgus correction, particularly for less experienced surgeons.
Literature
1.
go back to reference Roddy E, Zhang WDoherty M. Prevalence and associations of hallux valgus in a primary care population. Arthritis Rheum. 2008;59:857–62.CrossRef Roddy E, Zhang WDoherty M. Prevalence and associations of hallux valgus in a primary care population. Arthritis Rheum. 2008;59:857–62.CrossRef
2.
go back to reference Potenza V, Caterini R, Farsetti P, Forconi F, Savarese E, Nicoletti SIppolito E. Chevron osteotomy with lateral release and adductor tenotomy for hallux valgus. Foot Ankle Int. 2009;30:512–6.CrossRef Potenza V, Caterini R, Farsetti P, Forconi F, Savarese E, Nicoletti SIppolito E. Chevron osteotomy with lateral release and adductor tenotomy for hallux valgus. Foot Ankle Int. 2009;30:512–6.CrossRef
3.
go back to reference Cassinelli SJ, Herman RHarris TG. Distal metatarsal osteotomy for moderate to severe hallux Valgus. Foot Ankle Int. 2016;37:1137–45.CrossRef Cassinelli SJ, Herman RHarris TG. Distal metatarsal osteotomy for moderate to severe hallux Valgus. Foot Ankle Int. 2016;37:1137–45.CrossRef
4.
go back to reference Helmy N, Vienne P, von Campe AEspinosa N. Treatment of hallux valgus deformity: preliminary results with a modified distal metatarsal osteotomy. Acta Orthop Belg. 2009;75:661–70.PubMed Helmy N, Vienne P, von Campe AEspinosa N. Treatment of hallux valgus deformity: preliminary results with a modified distal metatarsal osteotomy. Acta Orthop Belg. 2009;75:661–70.PubMed
5.
go back to reference Biz C, Corradin M, Petretta IAldegheri R. Endolog technique for correction of hallux valgus: a prospective study of 30 patients with 4-year follow-up. J Orthop Surg Res. 2015;10:102.CrossRef Biz C, Corradin M, Petretta IAldegheri R. Endolog technique for correction of hallux valgus: a prospective study of 30 patients with 4-year follow-up. J Orthop Surg Res. 2015;10:102.CrossRef
6.
go back to reference Biz C, Fosser M, Dalmau-Pastor M, Corradin M, Roda MG, Aldegheri RRuggieri P. Functional and radiographic outcomes of hallux valgus correction by mini-invasive surgery with Reverdin-Isham and akin percutaneous osteotomies: a longitudinal prospective study with a 48-month follow-up. J Orthop Surg Res. 2016;11:157.CrossRef Biz C, Fosser M, Dalmau-Pastor M, Corradin M, Roda MG, Aldegheri RRuggieri P. Functional and radiographic outcomes of hallux valgus correction by mini-invasive surgery with Reverdin-Isham and akin percutaneous osteotomies: a longitudinal prospective study with a 48-month follow-up. J Orthop Surg Res. 2016;11:157.CrossRef
8.
go back to reference Badiali G, Ferrari V, Cutolo F, Freschi C, Caramella D, Bianchi AMarchetti C. Augmented reality as an aid in maxillofacial surgery: validation of a wearable system allowing maxillary repositioning. J Craniomaxillofac Surg. 2014;42:1970–6.CrossRef Badiali G, Ferrari V, Cutolo F, Freschi C, Caramella D, Bianchi AMarchetti C. Augmented reality as an aid in maxillofacial surgery: validation of a wearable system allowing maxillary repositioning. J Craniomaxillofac Surg. 2014;42:1970–6.CrossRef
9.
go back to reference Cutolo F, Meola A, Carbone M, Sinceri S, Cagnazzo F, Denaro E, Esposito N, Ferrari MFerrari V. A new head-mounted display-based augmented reality system in neurosurgical oncology: a study on phantom. Comput Assist Surg (Abingdon). 2017;22:39–53.CrossRef Cutolo F, Meola A, Carbone M, Sinceri S, Cagnazzo F, Denaro E, Esposito N, Ferrari MFerrari V. A new head-mounted display-based augmented reality system in neurosurgical oncology: a study on phantom. Comput Assist Surg (Abingdon). 2017;22:39–53.CrossRef
10.
go back to reference Dutra-Medeiros M, Nascimento J, Henriques J, Barrao S, Fernandes-Fonseca A, Aguiar-Silva N, Moura-Coelho NAgoas V. Three-dimensional head-mounted display system for ophthalmic surgical procedures. Retina. 2017;37:1411–4.CrossRef Dutra-Medeiros M, Nascimento J, Henriques J, Barrao S, Fernandes-Fonseca A, Aguiar-Silva N, Moura-Coelho NAgoas V. Three-dimensional head-mounted display system for ophthalmic surgical procedures. Retina. 2017;37:1411–4.CrossRef
11.
go back to reference Kihara K, Fujii Y, Masuda H, Saito K, Koga F, Matsuoka Y, Numao NKojima K. New three-dimensional head-mounted display system, TMDU-S-3D system, for minimally invasive surgery application: procedures for gasless single-port radical nephrectomy. Int J Urol. 2012;19:886–9.CrossRef Kihara K, Fujii Y, Masuda H, Saito K, Koga F, Matsuoka Y, Numao NKojima K. New three-dimensional head-mounted display system, TMDU-S-3D system, for minimally invasive surgery application: procedures for gasless single-port radical nephrectomy. Int J Urol. 2012;19:886–9.CrossRef
12.
go back to reference Meola A, Cutolo F, Carbone M, Cagnazzo F, Ferrari MFerrari V. Augmented reality in neurosurgery: a systematic review. Neurosurg Rev. 2017;40:537–48.CrossRef Meola A, Cutolo F, Carbone M, Cagnazzo F, Ferrari MFerrari V. Augmented reality in neurosurgery: a systematic review. Neurosurg Rev. 2017;40:537–48.CrossRef
13.
go back to reference Wu JR, Wang ML, Liu KC, Hu MHLee PY. Real-time advanced spinal surgery via visible patient model and augmented reality system. Comput Methods Prog Biomed. 2014;113:869–81.CrossRef Wu JR, Wang ML, Liu KC, Hu MHLee PY. Real-time advanced spinal surgery via visible patient model and augmented reality system. Comput Methods Prog Biomed. 2014;113:869–81.CrossRef
14.
go back to reference Schweizer A, Furnstahl PNagy L. Three-dimensional correction of distal radius intra-articular malunions using patient-specific drill guides. J Hand Surg Am. 2013;38:2339–47.CrossRef Schweizer A, Furnstahl PNagy L. Three-dimensional correction of distal radius intra-articular malunions using patient-specific drill guides. J Hand Surg Am. 2013;38:2339–47.CrossRef
15.
go back to reference Jenny JYPicard F. Learning navigation - learning with navigation. a review. SICOT J. 2017;3:39.CrossRef Jenny JYPicard F. Learning navigation - learning with navigation. a review. SICOT J. 2017;3:39.CrossRef
16.
go back to reference Zhang FQ, Pei BY, Wei ST, Zhao HT, Li ZY, Gao JGZhang YZ. Correlative study between length of first metatarsal and transfer metatarsalgia after osteotomy of first metatarsal. Zhonghua Yi Xue Za Zhi. 2013;93:3441–4.PubMed Zhang FQ, Pei BY, Wei ST, Zhao HT, Li ZY, Gao JGZhang YZ. Correlative study between length of first metatarsal and transfer metatarsalgia after osteotomy of first metatarsal. Zhonghua Yi Xue Za Zhi. 2013;93:3441–4.PubMed
Metadata
Title
Augmented reality guided osteotomy in hallux Valgus correction
Authors
Arnd Fredrik Viehöfer
Stephan Hermann Wirth
Stefan Michael Zimmermann
Laurenz Jaberg
Cyrill Dennler
Philipp Fürnstahl
Mazda Farshad
Publication date
01-12-2020
Publisher
BioMed Central
Published in
BMC Musculoskeletal Disorders / Issue 1/2020
Electronic ISSN: 1471-2474
DOI
https://doi.org/10.1186/s12891-020-03373-4

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