Navigation-assisted anchor insertion in shoulder arthroscopy: a validity study
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RESEARCH ARTICLE
Open Access
Navigation-assisted anchor insertion in shoulder arthroscopy: a validity study Kyunghwa Jung1†, Hyojune Kim2†, Erica Kholinne2,3, Dongjun Park2, Hyunseok Choi1, Seongpung Lee1, Myung-Jin Shin2, Dong-Min Kim2, Jaesung Hong1, Kyoung Hwan Koh2 and In-Ho Jeon2*
Abstract Background: This study aimed to compare conventional and navigation-assisted arthroscopic rotator cuff repair in terms of anchor screw insertion. Methods: The surgical performance of five operators while using the conventional and proposed navigation-assisted systems in a phantom surgical model and cadaveric shoulders were compared. The participating operators were divided into two groups, the expert group (n = 3) and the novice group (n = 2). In the phantom model, the experimental tasks included anchor insertion in the rotator cuff footprint and sutures retrieval. A motion analysis camera system was used to track the surgeons’ hand movements. The surgical performance metric included the total path length, number of movements, and surgical duration. In cadaveric experiments, the repeatability and reproducibility of the anchor insertion angle were compared among the three experts, and the feasibility of the navigation-assisted anchor insertion was validated. Results: No significant differences in the total path length, number of movements, and time taken were found between the conventional and proposed systems in the phantom model. In cadaveric experiments, however, the clustering of the anchor insertion angle indicated that the proposed system enabled both novice and expert operators to reproducibly insert the anchor with an angle close to the predetermined target angle, resulting in an angle error of < 2° (P = 0.0002). Conclusion: The proposed navigation-assisted system improved the surgical performance from a novice level to an expert level. All the experts achieved high repeatability and reproducibility for anchor insertion. The navigation-assisted system may help surgeons, including those who are inexperienced, easily familiarize themselves to of suture anchors insertion in the right direction by providing better guidance for anchor orientation. Level of evidence: A retrospective study (level 2). Keywords: Navigation assisted, Shoulder arthroscopy, Suture anchor, Motion analysis
Background Although arthroscopic rotator cuff repair with suture anchor fixation is one of the most common orthopedic surgeries, it is frequently associated with suture anchorrelated complications such as anchor protrusion and anchor pullout, which could result in surgical failure [11, * Correspondence: [email protected] † Kyunghwa Jung and Hyojune Kim are Co-first authors 2 Department of Orthopedic Surgery, Asan Medical Center, College of Medicine, University of Ulsan, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Republic of Korea Full list of author information is available at the end of the article
14]. Among the various factors that should be considered during anchor insertion, insertion location and angle are possibly the most importa
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