Evidence map›Paper›PMID 38501722›Full record

ArticleFoot & ankle international2024

Conventional vs Augmented Reality-Guided Lateral Calcaneal Lengthening Simulated in a Foot Bone Model.

Maksym Polt, Arnd F Viehöfer, Fabio A Casari, Florian B Imhoff, Stephan H Wirth, Stefan M Zimmermann

Abstract readComparative Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Foot & ankle international, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

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2citing papers in PubMed
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1 · What the graph read from it

What it found

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2 · The registry

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3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

6 authors.

Maksym PoltDepartment of Orthopaedics, Balgrist University Hospital, University of Zürich, Zürich, Switzerland.ORCID 0000-0003-0476-6006
Arnd F ViehöferDepartment of Orthopaedics, Balgrist University Hospital, University of Zürich, Zürich, Switzerland.
Fabio A CasariDepartment of Orthopaedics, Balgrist University Hospital, University of Zürich, Zürich, Switzerland.
Florian B ImhoffDepartment of Orthopaedics, Balgrist University Hospital, University of Zürich, Zürich, Switzerland.ORCID 0000-0002-2159-2071
Stephan H WirthDepartment of Orthopaedics, Balgrist University Hospital, University of Zürich, Zürich, Switzerland.
Stefan M ZimmermannDepartment of Orthopaedics, Balgrist University Hospital, University of Zürich, Zürich, Switzerland.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAcquired adult flatfoot deformity (AAFD) results in a loss of the medial longitudinal arch of the foot and dysfunction of the posteromedial soft tissues. Hintermann osteotomy (H-O) is often used to treat stage II AAFD. The procedure is challenging because of variations in the subtalar facets and limited intraoperative visibility. We aimed to assess the impact of augmented reality (AR) guidance on surgical accuracy and the facet violation rate.

methodsSixty AR-guided and 60 conventional osteotomies were performed on foot bone models. For AR osteotomies, the ideal osteotomy plane was uploaded to a Microsoft HoloLens 1 headset and carried out in strict accordance with the superimposed holographic plane. The conventional osteotomies were performed relying solely on the anatomy of the calcaneal lateral column. The rate and severity of facet joint violation was measured, as well as accuracy of entry and exit points. The results were compared across AR-guided and conventional osteotomies, and between experienced and inexperienced surgeons.

resultsExperienced surgeons showed significantly greater accuracy for the osteotomy entry point using AR, with the mean deviation of 1.6 ± 0.9 mm (95% CI 1.26, 1.93) compared to 2.3 ± 1.3 mm (95% CI 1.87, 2.79) in the conventional method (

conclusionApplication of AR guidance during H-O was associated with improved accuracy for experienced surgeons, demonstrated by a better accuracy of the osteotomy entry point. More crucially, AR guidance prevented full violation of the posterior facet in the experienced group. Further research is needed to address limitations and test this technology on cadaver feet. Ultimately, the use of AR in surgery has the potential to improve patient and surgeon safety while minimizing radiation exposure. CLINICAL RELEVANCE: Subtalar facet injury during lateral column lengthening osteotomy represents a real problem in clinical orthopaedic practice. Because of limited intraoperative visibility and variable anatomy, it is hard to resolve this issue with conventional means. This study suggests the potential of augmented reality to improve the osteotomy accuracy.

Indexed as

Augmented RealityCalcaneusFlatfootOsteotomyBone LengtheningHumansModels, AnatomicSurgery, Computer-AssistedAcquired adult flatfoot deformityAugmented realityCalcaneusHintermann osteotomyHoloLensLateral column lengthening osteotomyOsteotomySubtalar facetsSurgery

Identifiers

PMID38501722
PMCPMC11290017

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