Intraoperative manufacturing of patient specific instrumentation for shoulder arthroplasty: a novel mechatronic approach
Author(s)
Type
Journal Article
Abstract
Optimal orthopaedic implant placement is a major contributing factor to the long term success of all common joint arthroplasty procedures. Devices
such as three-dimensional (3D) printed, bespoke guides and orthopaedic robots are extensively described in the literature and have been shown
to enhance prosthesis placement accuracy. These technologies, however, have significant drawbacks, such as logistical and temporal inefficiency,
high cost, cumbersome nature and difficult theatre integration. A new technology for the rapid intraoperative production of patient specific instrumentation,
which overcomes many of the disadvantages of existing technologies, is presented here. The technology comprises a reusable table side
machine, bespoke software and a disposable element comprising a region of standard geometry and a body of mouldable material. Anatomical
data from Computed Tomography (CT) scans of 10 human scapulae was collected and, in each case, the optimal glenoid guidewire position was
digitally planned and recorded. The achieved accuracy compared to the preoperative bespoke plan was measured in all glenoids, from both a conventional
group and a guided group. The technology was successfully able to intraoperatively produce sterile, patient specific guides according to
a pre-operative plan in 5 minutes, with no additional manufacturing required prior to surgery. Additionally, the average guide wire placement accuracy
was 1.58 mm and 6.82◦ degrees in the manual group, and 0.55 mm and 1.76◦ degrees in the guided group, also demonstrating a statistically
significant improvement.
such as three-dimensional (3D) printed, bespoke guides and orthopaedic robots are extensively described in the literature and have been shown
to enhance prosthesis placement accuracy. These technologies, however, have significant drawbacks, such as logistical and temporal inefficiency,
high cost, cumbersome nature and difficult theatre integration. A new technology for the rapid intraoperative production of patient specific instrumentation,
which overcomes many of the disadvantages of existing technologies, is presented here. The technology comprises a reusable table side
machine, bespoke software and a disposable element comprising a region of standard geometry and a body of mouldable material. Anatomical
data from Computed Tomography (CT) scans of 10 human scapulae was collected and, in each case, the optimal glenoid guidewire position was
digitally planned and recorded. The achieved accuracy compared to the preoperative bespoke plan was measured in all glenoids, from both a conventional
group and a guided group. The technology was successfully able to intraoperatively produce sterile, patient specific guides according to
a pre-operative plan in 5 minutes, with no additional manufacturing required prior to surgery. Additionally, the average guide wire placement accuracy
was 1.58 mm and 6.82◦ degrees in the manual group, and 0.55 mm and 1.76◦ degrees in the guided group, also demonstrating a statistically
significant improvement.
Date Issued
2016-08-10
Date Acceptance
2016-05-23
Citation
Journal of Medical Robotics Research, 2016, 1 (4)
ISSN
2424-905X
Publisher
World Scientific
Journal / Book Title
Journal of Medical Robotics Research
Volume
1
Issue
4
Copyright Statement
© 2016 World Scientific Publishing Co Pte Ltd
Publication Status
Published
Article Number
1650005