Augmented reality in bone tumour resection

Abstract

„ Intra-operative navigation systems reportedly help to define the extent of the tumour, and allow more precise surgery to be performed. „ a somewhat cumbersome registration process, additional surgical time and high cost are among some of the factors cited as hindering its routine use. „ We evaluated the accuracy of bone tumour resection in pig femurs using an augmented reality (aR)-based navigation which could be used on a tablet Pc. Key messages „ accuracy of tumour resection was satisfactory with the help of an aR navigation system, with the tumour shown as a virtual template. „ Even though most limb salvage surgery can be performed with conventional techniques , we believe that our aR-based navigation system deserves further attention. Strengths and limitations „ This study concluded that aR-based navigation improves accuracy of surgical margins in both experienced and inexperienced hands. „ The system can help guide the surgeon without a complex setup process or crowding in the operating room, with minimal additional time and cost. „ Use of this programme is confined to surgery for long bones. Augmented reality in bone tumour resection aN ExPERIMENTal sTUdy Objectives We evaluated the accuracy of augmented reality (AR)-based navigation assistance through simulation of bone tumours in a pig femur model. Methods We developed an AR-based navigation system for bone tumour resection, which could be used on a tablet pc. To simulate a bone tumour in the pig femur, a cortical window was made in the diaphysis and bone cement was inserted. A total of 133 pig femurs were used and tumour resection was simulated with AR-assisted resection (164 resection in 82 femurs, half by an orthropaedic oncology expert and half by an orthopaedic resident) and resec-tion with the conventional method (82 resection in 41 femurs). In the conventional group, resection was performed after measuring the distance from the edge of the condyle to the expected resection margin with a ruler as per routine clinical practice. Results The mean error of 164 resections in 82 femurs in the AR group was 1.71 mm (0 to 6). The mean error of 82 resections in 41 femurs in the conventional resection group was 2.64 mm (0 to 11) (p < 0.05, one-way analysis of variance). The probabilities of a surgeon obtaining a 10 mm surgical margin with a 3 mm tolerance were 90.2% in AR-assisted resections, and 70.7% in conventional resections. Conclusion We demonstrated that the accuracy of tumour resection was satisfactory with the help of the AR navigation system, with the tumour shown as a virtual template. In addition, this concept made the navigation system simple and available without additional cost or time. cite this article: Bone Joint Res 2017;6:137-143.