Planning and simulation of complex osteotomies

Planning and simulation of complex osteotomies

Corrective osteotomies on the lower extremeties are usually elective procedures with the objective of achieving an anatomical realignment of the mechanical axes and angles. Restoration of physiological biomechanical joint stress prevents formation of arthrosis or reduces the dynamics of existing arthrosis.

Surgical procedures that are largely preventative in nature require careful pre-operational planning and simulation as well as precise methods for operational realization. Creation of a corrective plan and a corrective drawing is encouraged. As digital radiography becomes more widespread, the surgeon in many cases no longer has access to standardized full-leg standing radiographs, which serve as a planning foundation.

Paper printouts of digital radiography are usually of inadequate quality for primary planning and analog conversions to radiograph film are too time-consuming and costly for routine use. Digital planning software with full corrective-planning and axis-simulation capabilities is essential for fulfilling quality expectations of corrective osteotomies of the extremities.

In this spirit, we began co-development of the Osteotomy Module II, a PC-based planning program, in 1997. The software has been continuously improved since that time and adapted to cutting-edge surgical requirements as well as common operating systems and PACS systems. Osteotomy Module II is a CAD system that is optimized for orthopaedic surgery and axis correction.
Standardized digital full-leg standing radiographs (FLS) serve as the planning foundation. Image data may be imported and exported in all current image and DICOM formats or exchanged via direct links with electronic patient records. The planning drawing and simulation can be reproduced intraoperatively as a 1:1 printout to aid in achieving the planning objective. Osteotomy Module II significantly shortens the time needed for planning and simulating complex multiple osteotomies on an extremity.

Integrated automatisms directly visualize effects that may result from displacement of the axis of correction of angulation, or ACA. This makes it possible to quickly determine the best possible osteotomical position in consideration of biomechanical modifications to the axis progression and joint angle at the hip, knee, and upper ankle. The extensive simulation capabilities, coupled with significant time savings, as well as convenient documentation and archiving options afforded by electronic planning drawings make Osteotomy Module II clearly superior to conventional planning and it is highly recommended for elective preventative orthopedic surgery of corrective osteotomies.

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2008