Navigation and Robotics in Total Joint and Spine Surgery PDF
Preview Navigation and Robotics in Total Joint and Spine Surgery
James B. Stiehl Werner H. Konermann Rolf G. Haaker Navigation and Robotics in Total Joint and Spine Surgery Springer Berlin Heidelberg New York Hongkong London Milano Paris Tokyo James B. Stiehl Werner H. Konermann Rolf G. Haaker Navigation and Robotics in Total Joint and Spine Surgery With 460 Figures, 355 in Colors and 31 Tables , Springer Stiehl, James B., Associate Professor, M.D. Orthopaedic Hospital of Wisconsin 575 West Riverwood, Parkway, Suite 204 Milwaukee 53212, USA Konermann, Werner H., Professor, M.D. Orthopaedic Hospital Am Muhlenberg, 37235 Hessisch-Lichtenau, Germany Haaker, Rolf G., Associate Professor, M.D. Orthopaedic Hospital, st. Vincenz-Hospital Danziger StraBe 17,33034 Brakel, Germany ISBN-13:978-3-642-63922-7 e-ISBN-13:978-3-642-59290-4 001: 10.10071978-3-642-59290-4 Cataloging-in Publication Data applied for Bibliographic information published by Die Deutsche Bibliothek Die Deutsche Bibliothek lists this publication in the Deutsche Nationalbibliografie; detailed bibliographic data is available in the Internet at <http://dnb.ddb.de> This work is subject to copyright. All rights are reserved, whether the whole or part ofthe material is concerned, specifically the rights of translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on microfilms or in any other way, and storage in data banks. Duplication of this publication or parts thereof is permitted only under the provisions of the German Copyright Law of September 9, 1965, in its current version, and permission for use must always be obtained from Springer-Verlag. Violations are liable for prosecution under the German Copyright Law. Springer-Verlag Berlin Heidelberg New York a member of BertelsmannSpringer Science+Business Media GmbH http://www.springer.de ©Springer-Verlag Berlin Heidelberg 2004 Softcover reprint of the hardcover 1st edition 2004 The use of general descriptive names, registered names, trademarks, etc. in this publication does not imply, even in the absende of a specific statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use. Product leability:The publishers cannot guarantee the accuracy of any information about dosage and application contained in this book. In every individual case the user must check such information by consulting the relevant literature. Editorial:Thomas Gunther, Heidelberg Production: Rainer Kusche, Sinzheim Cover design: Design & Production, Heidelberg Typesetting: Goldener Schnitt, Sinzheim Printed on acid-free paper 18 /3130 - 5 4 3 2 1 0 10889375 v Foreword Orthopaedic surgery is currently just a few moments past the sunrise of computer implementation for the per formance of surgery itself. OUT specialty has always seemed to have a nearly unique. over arching characteristic - it deals almost exclusively with alteration, typically rebuilding or reconstituting. structure. What we do has more of a structural impact than a physiologic one, even when compared to the structural alterations introduced by vascular and cardiac surgery_ This structural reconstitution contrasts strongly with the largely excisional characteristic of most other surgical fields. The relevance of Ihis feature is thai OUf specialty, as much as any, and more than most, needs precision of cuning, alignment, and replacemenl.As we contrast the rudimentary tools, we use in our operating rooms with the sophis ticated robotic, computerized, and more extensively mechanized equipment of industry, we seem very far behind. We are almost ancient considering the pace of development and change over the last fifty years. Many question the need, practicality, expense and therefore ultimate acceptance of these methods into ortho paedics. However, the quality I mention above, leads me to believe that eventually, hi-tech involving computer assis tance and including robotic tools, will almost take over. The current era is and will be appreciated as a beginning a time when new equipment and techniques are introduced, bugs worked out, and valuable tools refined. nearly perfected, with costs lowered. Today every country feels the constraint of cost containment in health care. The social, economic environment seems, in the minds of many, to prohibit substantial incorporation of this methodology. This writer has confidence Ihat real improvements from the incorporation of hi-technology will be recognized. And, considering the impor lance to each individual patient of the life-event that is his or her orthopaedic surgery, demand for best practice not cheapest will sustain. Along with social order there is perhaps nothing more important to an individual than health and therefore, healthcare. The dollars will be found. The choices made. In this marvelous volume compiled by Doctors Stiehl, Konermann, and Haaker we are treated to the early logbook for a worldwide advance into this new age of high technology orthopaedics. The field is covered both widely and in depth. Contributions are from the pioneers and developers of these methods. Kenneth A. Krackow Buffalo, New York, USA October 1003 VII Short Biography of the Editors Stiehl, James e., Associate Professor, M.D. Orthopaedic Hospital of Wisconsin 575 West Riverwood Parkway, Suite 204 Milwaukee 53211, USA Aboul the Editor: Born in 1949,Adult Reconstructive Orthopaedic Surgeon. Residency at the Universi ty of Texas Health Science Center in San Antonio Texas under Drs. Charles Rock wood and David Green, and Fellowships at the Princess Margaret Rose Hospital, Edinburgh and Swiss AQ Fellowship,Zurich. He is in private practice at Columbia 51 Mary's Hospital in Milwaukee, Wisconsin, USA. His main interests are in tOlal joint arthroplasty and adult reconstructive surgery and he has a longstanding interest in biomechanical research in orthopaedics. Konermann, Werner H., Professor, M.D. Hospital of Orthopaedics and Traumatology Am MUhlenberg 3, 0-37135 Hessisch·Uchtenau, Germany About the Editor: Born in 1959, Specialist Orthopaedic Surgeon and Rheumatologist. Residencies in three German Universities at TIlbingen,Milnster and Mannheim. His thesis was done in biomechanics of the lumbar spine. He is now a Consultant Orthopaedic Surgeon for orthopaedics and traumatology in Hessisch Lichtenau, Germany. His main interest is in knee and hip arthroplasty and computer-assisted surgery. Haaker, Rolf G., Associate Professor, M.D. Hospital for Orthopaedics and Rheumatology St. Vincen1-Hospital, Danziger Str. 17,33034 Brake!, Germany About the Editor: Born in 1959,Specialist Orthopaedic Surgeon and Rheumatologist. Residencies at the Sportsmedical Devision, Military Hospital in Warendorf and Koblenz followed by a recidency at the University in Bochum, Germany. His thesis was done in biomecha nics of the multilevel lumbar spinal fusion. He is now a Chief Consultant Orthopa edic Surgeon in Bad Driburg-Brakel. Germany. He has a main interests in revision surgery of hip and knee arthroplasty, spine surgery and computer assisted surgery. IX .. Thecurrenl discoveries ltach U5t hat whatever we thought is true ae lually was wrong. II appears \0 me thallhc only knowledge we can still trust is the faeltha! light speed is the fastesllhing on earth. POSSibly .• EDWARD TEll..ER Preface With the advance of the technology age, the known body of knowledge composing medical science has tripled since 1960. Many important new treatments and methods have envolved during this period. For example. tolal joint arthroplasty, a recent innovation, has benefited millions of patients and is now one of the most common surgical procedures in medical practice. Yel, despite this success, basic issues such as component alignment and positioning are not always ideal, and may lead 10 unsatisfactory clinical results with early loosening or failure of the implants. Computer navigation and robotics are considered to be controversial tools, but recent experience has revealed promising applications in hip and knee arthroplasty, spine surgery, ACLr econstruction and other operations. At the first symposium for computer navigation and robotics in Bochum, Germany.an international faculty con sisting of orthopaedic,trauma, and neurosurgeons as well as engineers, reported a wide range of applications for this technology and its current practical use. A state of the art publication resulted which also includ~ the current technology development of several commercial interests. This groundwork leads to an overview of the current prac tical use of navigation and robotics. In this book, an important premise was that the contributing authors reported honestly on their personal ex periences, including both success and failures. Because the basic technologies of computer navigation and robotics have many applications. we felt compelled to combine the experiences in many surgical disciplines. Finally, we re cognize the swift evolution of computer software and technology in this field. and we have attempted to highlight the evolutionary improvements to time-tested surgical methods as well as to offer new vistas in advanced surgical technique. We are al the b~inning of a new and revolutionary development in medicine, which will not replace the surgeon, but will help to improve accuracy and consistency of high precision in standard operations. In America, great enthusiasm has arisen for minimally invasive techniques especially in total joint replacement. Many opinions find navigation a critical element to the efficacy of the approach which can be found in this book. We consider this book a guideline and reference for navigational and robotic surgical tools as well as help for medicolegal concerns re garding minimizing risks, quality control and documentation. We would like to express our sincere thanks to all authors who have generously contributed to this project. It is only through their efforts and dedication to advancing medical science that this book is possible. We would like to thank our colleague Jens Boldt, St.-Vincent Hospital, Dusseldorf, for his tireless effort in trans lating many of the enclosed chapters from the original book published in the German language. We are also very grateful to the publisher Springer-Verlag, Heidelberg, Germany, with special thanks to the editor, Thomas GOnther, for expediting the production of this book. James B. Stiehl Werner H. Konermann Rolf G. Haaker October lOO) XIII Contents I. Computer.Assisted Planning and Computer-Assisted Navigation oflotal Hip Arthroplasty Ortho~edlc 5u~.1')' USing the Navitrack and mediCAD System .. 82 j. Babisch, F. Layher, R.A. Venbrocks 11 Hip Cup Implantation Using the 9. Basics of Computer-Assisted Orthopaedic SurgiGATESystem .................... Surgery (CAOS) .......................... 3 M. Srockheim, J. Kramer L.-P. No/re, F. Lang/olz 12 Hip Navigation Using the SurgiGATESystem 9. 2 CT -Based Navigation Systems. _. . _. . . . . . . . , 0 in Dysplastic and Revision Cases .......... B. jaramaz, A.M. DiGioia Iff R.G. Haaker 3 ( -Arm-Based Navigation ..... _. . _ ..... _. _ 17 13 Femoral Stem Navigation with the A. Hebecker SurgiGATE System .................. ,.2 4 CT-Free-Based·Navigation Systems ... _. . _.2 4 I. F. Langlorz, A. Marx. M. Kubiak·Langer, S.D. Stu/berg G. Zheng. U. Langlotz S Bone Morphlng:3D Reconstruction Minimally Invasive Hip Surgery with Without Pre-or Intraoperative Imaging Imageless Navigation ................... 11. Concept and Applications .... _. . _. . _. . _. . 39 M. Nogler, M. Kr;smer, F. Rachbauer, J. Sledge E. Stindel,/.-L. Briard, S. Laval/ee, F. Dubrana, S. Piaweski, P. Mer/oz, C. Leftvre, J. Troccaz 1 S Robotic Hip Surgery and Current Development with the ROSODOC System .. 119 tv. Bargar • BasJes ofTotal Hlp Replacement Surgery .. _ 49 16 Robotically Milled Bone Cavities B.J. Thomas, f.B. Stiehl in Comparison with Hand·Broaching in Total Hip Replacement .................. 123 M. Thomsen 17 An Anatomically Shaped Prosthesis Stem 132 K. Knabe. C. Hurschler, C. Stukenborg·Colsman, F. Gosse 18 Clinical Experiences with ROBODOC 7 Mini-Incision Techniques and Navigation in Total Hip Arthroplasty , ............... 140 M. BlJrner, U. Wiesel forTotalHip •...••...•................... 61 A.M. DiGioia III, A. Y. Plakseychuk, B. Jaramaz 19 Minimally Invasive Total Hip Replacement 8 Acetabular Cup Navigation with the Application of Intraoperative Navigation OrthoPilot System ........................ 70 and Robotics ........................... 14S H. Kiefer F. Kerschbaumer, S. Kuenzler, J. Wa},rbllrg 9 AcetabularCup Navigation with the 20 Cement Removal with the ROBODOC System Vector Vision System ...................... 76 in Total Hip Arthroplasty Stem - Revision . 1S1 WH. Kluge. I. Babisch, R.A. Venhrocks M. Nogfer, M. Krismer XIV COnll!nlS 21 Advantages of Custom-Made Stems 33 Computer-Assisted Navigation Using Adaptiva Components ........... . 155 with the OrthoPiiot System Using the G. Grubu Search Evolution TKA Prosthesis ......... 234 " Computer-Assisted Designed Hip U. Clemens, lV, H. Konermann, S. Kohler, Arthroplasty ...•.................... '.0 H. Kiefer, I. Y. lerllly, R.K. Miehlke I.-N. Argenson, X. Fleeher, j.-f.1. Aubaniae 34 The OrrhoPilot Navigation System 23 Navigation and Robotics in Joint and ,., in Total Knee Arthroplasty:Version 4.0 ... 242 Spine Surgery ......................... . R.K. Miehlke, R. G. Haaker, ~v: H. Konermann I. Hassenpjlug, M. Prymka 35 Navigated Implantation ofthe Columbus Total Knee Arthroplasty with the OrthoPilot System: Version 4.0 ................•.... 248 F. Lampe, E. Hille III Toul Kn .. Arthroplnty 3. CT-Free Navigation Including Soft-Tissue Balancing: lCS·TKA and VecrorVision Systems •••............................ 254 24 Total Knee Arthroplasty ................ . 175 ~v: H. KOllerman", S. Kistner F.F. Bueellel, I.B. Stiehl 37 Navigation and Soft-Tissue Balancing of 25 Why the Tibia Cut First in Mobile Bearing lCS Total Knee Arthroplasty ............. 266 TKA Technique? ....................... . 180 I.M. Strauss, W. RUther '.B. Stiehl 38 CT-Free Navigation with the LCS Surgeries 2. Femur First Approach in TKA- Station: A New Way of Balancing the Soft Surgical Techniques ................... . 185 TIssues in TKA Based on Bone Morphing .. 274 K.A. Krackow I.L. Briard, E. Slinde/, S. Ploweski, F. Dubrana, 27 Femoral Component Alignment in TKA ... 189 P. Mer/oz, C. Lefevre,}. Troccaz, F. Bertrand, I.G. Boldt N. Begoe, P. Solodky, M. Breysse 28 Computer-Assisted ligament Balancing 39 The Galileo System for Implantation of thl! Femoral Tibial Joint Using Pressures ofTotal Knee Arthroplasty .............. 281 Sensors. . . . . . .. . . . .. . .. . .. . . . .. .. . . .. .. 197 P. Rirschl, F. Machacek jun., R. Fuiko, R. Zettf. R.c. Wasielewski, D.O. Galat, R.D. Komistek B. Kotten 29 Computer-Assisted Pressure Measurement 40 Clinical Experiences with the in the Patellofemoral Joint with Surgeties System in TKA .........•....... 287 Ell!ctronic Pressure Sensors ............. 204 U 8Mling, J. Scholz, R. Nassutt, H. Grundei I. Mortier, L. Ziehrler 41 Navigation in TKA with the 30 Patellofemoral Arthroplasty ............. 209 Nail/frock System ....................... 293 I.-N. Argenson, X. Flecher, H. Vinel T. Mattes, W. Puhl 42 Clinical Experience with the CT -Based VectorVlson System ..................... 301 III A NovIgatton:T.tol KnH Arthroplasty M. Wiese, K. Schmidt, R.E. Willburger 43 CT ·Based and CT-Free Navigation with the BrainLAB VectorVision System in Total Knee 31 Postoperative Alignment of Conventional Arthroplasty ........................... 304 and Navigated Total Knee Arthroplasty. .. 219 L. Perlick, H. BiHllis, C LUring, M. Tingart, W.H. Konermann, M.A. Sailor }. Grifka 32 Computer-Assisted Implantation of Total 44 Extra-Medullary Computer-Assisted Total Knee Endoprosthesis with no Preoperative Knee Replacement: Imaging: the Kinematic Model. . . .•. . . . .. 226 Towards lesser Invasive Surgery .. . . . . .. . 311 D. S4ragagfia, F. Picard R.L Wixson
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