Computer-assisted surgery: Pros and cons

Abstract

Computer navigation is an important method in orthopedic surgery improving the accuracy and precision of surgical interventions. The basic technology of digital imaging with digital cameras has improved to submicron accuracy. The ability to make the surgical targets virtual on a monitor has evolved to the point where the capabilities have exceeded the limitations of cost, complexity, and inefficiency. In addition, various parallel technologies such as intraoperative computed tomography will automate the registration process to a few seconds. Patient-specific cutting guides are another example of the example utilizing preoperative imaging to create custom cutting guides. National joint registry data from Australia have show that long-term revision rates are lower in patients who have had navigated total knees. Detractors still identify the precision problems of imageless registration, and pin complications for the bone anchoring of trackers have a small risk of stress fracture. The overall impression is that various digital imaging systems including robotics, intraoperative computed tomography, and other parallel technologies will produce a “better than not” scenario for the practicing surgeon.