title: Error range in proximal femoral osteotomy using computer tomography-based navigation.
abstract: PURPOSE  : The purpose of this preliminary study was to determine the error range compared with preoperative plans in proximal femoral osteotomy conducted using a computed tomography (CT)-based navigation system. METHODS  : Four patients (four hips) underwent transtrochanteric rotational osteotomy (TRO), and three patients (four hips) underwent curved varus osteotomy (CVO) using CT-based navigation. Volume registration of pre- and postoperative CT was performed for error assessment. RESULTS  : In TRO, the mean osteotomy angle error was [Formula: see text] (range [Formula: see text]) in the valgus direction and [Formula: see text] (range [Formula: see text]) in the retroversion direction. The mean osteotomy position error, with the femoral head side as positive, was -0.4 mm (range -1.4 to 0 mm). The bone fragment rotational movement error was [Formula: see text] (range [Formula: see text]). In CVO, the mean osteotomy position error, with the femoral head side as positive, was -0.2 mm (range -2.0 to 1.7 mm) at the level of the lesser trochanter and 0.8 mm (range 0-3.2 mm) at the level of the greater trochanter. Bone fragment varus accuracy was [Formula: see text] (range [Formula: see text]). CONCLUSIONS  : In proximal femoral osteotomy using CT-based navigation, the angle error of osteotomy was within [Formula: see text] and the positional error was within 4 mm. The rotational movement error of the proximal fragment was within [Formula: see text]. These margins of error should be considered in preoperative planning. To improve surgical accuracy, it would be necessary to develop a computer-assisted device which can track the osteotomized fragment.
authors.affiliation: Department of Orthopaedic Medical Engineering, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan. masaki-tko@umin.ac.jp.
authors.forename: Masaki
authors.initials: M
authors.lastname: Takao
authors.affiliation: Departments of Orthopaedic Surgery, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Sakai
authors.affiliation: Departments of Orthopaedic Surgery, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan.
authors.forename: Hidetoshi
authors.initials: H
authors.lastname: Hamada
authors.affiliation: Department of Orthopaedic Medical Engineering, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan.
authors.forename: Nobuhiko
authors.initials: N
authors.lastname: Sugano
mesh_terms: D000328:Adult; D005260:Female; D005270:Femur Head / Q000000981:diagnostic imaging* / Q000601:surgery; D050723:Fractures, Bone / Q000175:diagnosis / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010027:Osteotomy / Q000379:methods*; D015203:Reproducibility of Results; D025321:Surgery, Computer-Assisted / Q000379:methods*; D014057:Tomography, X-Ray Computed / Q000379:methods*
keywords: Accuracy; Computed tomography; Navigation; Proximal femoral osteotomy