title: Navigation-assisted, minimally invasive implant removal following a triple pelvic osteotomy.
abstract: BACKGROUND
  Triple pelvic osteotomy is known as a surgical option in young patients suffering from severe hip dysplasia. In most patients, implant removal is performed after bony consolidation. Due to the pelvic anatomy, the conventional technique is often associated with soft-tissue damage and high X-ray exposure. Recent developments in the field of computer-assisted surgery may offer new alternatives. The aim of this case report was to investigate the feasibility of a fluoroscopy-supported navigation system for the implant removal after a triple pelvic osteotomy.
  
  
  METHODS
  Using the BrainLAB-VectorVision, a fluoroscopy-enhanced navigation system, implants were removed in a 24-year-old female patient 14 months after a triple pelvic osteotomy.
  
  
  RESULTS
  The navigation system showed a high feasibility in the instrument visualisation and implant localisation. The screws could be precisely located, simultaneously in different X-ray planes. The total X-ray exposure time was low, totalling 17 s.
  
  
  CONCLUSIONS
  Initial experiences are very promising and show impressively the advantages of fluoroscopy-supported navigation for minimally invasive implant removal. A considerably reduced X-ray exposure for patient and surgeon is possible. The removal of the inserted screw is possible through a stitch incision, with reduced OR trauma and a quicker reconvalescence.
authors.affiliation: Department of Orthopaedic Surgery, University of Regensburg, Postfach 100662, 93042 Regensburg, Germany. lars.perlick@klinik.uni-regensburg.de
authors.forename: Lars
authors.initials: L
authors.lastname: Perlick
authors.forename: Markus
authors.initials: M
authors.lastname: Tingart
authors.forename: Klaus
authors.initials: K
authors.lastname: Lerch
authors.forename: Holger
authors.initials: H
authors.lastname: Bäthis
mesh_terms: D000328:Adult; D020878:Device Removal / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006618:Hip Dislocation, Congenital / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D019060:Minimally Invasive Surgical Procedures / Q000379:methods; D010027:Osteotomy / Q000295:instrumentation / Q000379:methods*; D010147:Pain Measurement; D019736:Prostheses and Implants; D011859:Radiography; D018570:Risk Assessment; D025321:Surgery, Computer-Assisted / Q000379:methods*; D016896:Treatment Outcome