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Development of Computer Assisted Surgery for Orthopaedic Oncology Applications: Preliminary report of

the first American Series

David Cheong, Dylan Nugent, Eric R Henderson, German Marulanda,

G Douglas Letson

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Disclosure:

No financial support was received in the production of this presentation, data

being presented, surgical procedures, or instrumentation

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Navigation

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Computer Navigated Oncology Surgeries since 2008

6 Distal Femur Replacement

3 Internal Hemi-pelvectomy

2 Proximal Tibia Replacement

1 Proximal Femur Replacement

6 Sacro-iliac Instrumentation

•Primary Malignant Bones Tumors•Multiple Myeloma •Benign Aggressive Bone Tumors• Aggressive Soft Tissue Sarcoma•Metastatic Disease

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Image Based

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Navigated Cautery Pencil

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Navigated Osteotome

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Navigated Hemi-pelvectomyPlane Planning

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Accuracy of Resection

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Limb Length

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Navigated Proximal Femur

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• Finding anatomical structures for optimum screw placement

• Replicate screw dimensions– Head size– Length– Diameter

• Set head point and screw axis• Multiple screw plans

Screw Planning

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Screw Planning

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Navigated Screws

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Potential!!!

• Accuracy of Resection– Navigated instrumentation– Blending real time imaging

• Accuracy of Reconstruction– Re-establishing the joint line– Reducing limb length discrepancies

• Intra-operative Execution of the Pre-operative plan

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