[Basic concept in computer assisted surgery].
OBJECTIVE
To investigate application of medical digital imaging systems and computer technologies in orthopedics.


METHODS
The main computer-assisted surgery systems comprise the four following subcategories.


RESULTS
(1) A collection and recording process for digital data on each patient, including preoperative images (CT scans, MRI, standard X-rays), intraoperative visualization (fluoroscopy, ultrasound), and intraoperative position and orientation of surgical instruments or bone sections (using 3D localises). Data merging based on the matching of preoperative imaging (CT scans, MRI, standard X-rays) and intraoperative visualization (anatomical landmarks, or bone surfaces digitized intraoperatively via 3D localiser; intraoperative ultrasound images processed for delineation of bone contours). (2) In cases where only intraoperative images are used for computer-assisted surgical navigation, the calibration of the intraoperative imaging system replaces the merged data system, which is then no longer necessary. (3) A system that provides aid in decision-making, so that the surgical approach is planned on basis of multimodal information: the interactive positioning of surgical instruments or bone sections transmitted via pre- or intraoperative images, display of elements to guide surgical navigation (direction, axis, orientation, length and diameter of a surgical instrument, impingement, etc. ). And (4) A system that monitors the surgical procedure, thereby ensuring that the optimal strategy defined at the preoperative stage is taken into account.


CONCLUSIONS
It is possible that computer-assisted orthopedic surgery systems will enable surgeons to better assess the accuracy and reliability of the various operative techniques, an indispensable stage in the optimization of surgery.
Service de Chirurgie Orthopédique, CHU A. Michallon, BP 217 38043 Grenoble, France. PMerloz@chu-grenoble.fr
Philippe
P
Merloz
Hao
H
Wu
D006801:Humans; D008279:Magnetic Resonance Imaging; D025321:Surgery, Computer-Assisted; D014057:Tomography, X-Ray Computed