Improvement and Validation of a Surgical Navigation Device for Arthroscopic Cartilage Repair

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The Ohio State University

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Knee articular cartilage defects are very painful and are presumed to be a precursor for osteoarthritis. Due its avascular nature, this tissue is unable to repair itself causing surgery to be the main option for treatment. Current surgical algorithms use defect area as the primary attribute to determine which procedure to use for each patient. Unfortunately, current techniques of calculating defect area are very poor, with errors ranging from -78.81% to 236.61% for surgeon area estimation, the current gold standard. Previously a cartilage navigation system was developed in our lab to improve surgeon accuracy in calculating defect area. However, when this system was used in cadaver knees it failed due to slipping of the surgical probe leading to a larger area calculation and tracing of the defect multiple times leading to a cumulative area calculation. The objectives of this project were to update the MATLAB code of the previous device to overcome these tracing errors, to develop new functions to increase the usability of the device, and to compare the use of this system to current area approximation techniques using shapes cut into plastic and artificial defects of known area. It was shown that this system produced more accurate area approximations than other current area approximation techniques with a significant decrease in error below that of use of a 5mm arthroscopic probe and use of a retractable arthroscopic probe. However, it was unable to reach the goal of less than 5% error. Modifications of this system are possible to further increase the accuracy of these area calculations. After these modifications are made, this system can be used by surgeons to quickly and accurately calculate the area of a cartilage defect. The use of that modified system may help them choose the proper procedure for each defect leading to better surgical outcomes for patients.



knee, cartilage, surgery, arthroscopy, navigation