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Image-guided navigation system for minimally invasive total hip arthroplasty (MITHA) using an improved position-sensing marker

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Abstract

Purpose

Minimally invasive total hip arthroplasty (MITHA) is a treatment for hip arthritis, and it causes less tissue trauma, blood loss, and recovery time. However, the limited incision makes it difficult for surgeons to perceive the instruments’ location and orientation. Computer-assisted navigation systems can help improve the medical outcome of MITHA. Directly applying existing navigation systems for MITHA, however, suffers from problems of bulky fiducial marker, severe feature-loss, multiple instruments tracking confusion, and radiation exposure. To tackle these problems, we propose an image-guided navigation system for MITHA using a novel position-sensing marker.

Methods

A position-sensing marker is proposed to serve as the fiducial marker with high-density and multi-fold ID tags. It results in less feature span and enables the use of ID for each feature, overcoming the problem of bulky fiducial markers and multiple instruments tracking confusion. And the marker can be recognized even when a large part of locating features is obscured. As for the elimination of intraoperative radiation exposure, we propose a point-based method to achieve patient-image registration based on anatomical landmarks.

Results

Quantitative experiments are conducted to evaluate the feasibility of our system. The accuracy of instrument positioning is achieved at 0.33 ± 0.18 mm, and that of patient-image registration is achieved at 0.79 ± 0.15 mm. And qualitative experiments are also performed, verifying that our system can be used in compact surgical spatial volume and can address severe feature-loss and tracking confusion problems. In addition, our system does not require any intraoperative medical scans.

Conclusion

Experimental results indicate that our proposed system can assist surgeons without larger space occupations, radiation exposure, and extra incision, showing its potential application value in MITHA.

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Funding

This work was supported by the National Natural Science Foundation of China (62003007) and the university-industry cooperation project in Fujian Province (2022Y4001).

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Authors and Affiliations

  1. School of Mechanical Engineering, Fuzhou University, Fuzhou, 350108, Fujian, China

    Xianzhong Xie, Mingzhu Zhu & Bingwei He

  2. Department of Orthopedic Surgery, Fujian Provincial Hospital, Fuzhou, 350013, Fujian, China

    Jie Xu

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  1. Xianzhong Xie
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Correspondence to Mingzhu Zhu.

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Xie, X., Zhu, M., He, B. et al. Image-guided navigation system for minimally invasive total hip arthroplasty (MITHA) using an improved position-sensing marker. Int J CARS 18, 2155–2166 (2023). https://doi.org/10.1007/s11548-023-02861-x

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