CorectiAR

In Augmented Reality for training visualise the mechanical axis to be corrected by tibia osteotomy without buying an expensive Computer Assisted system.

CorectiAR is an app developed for Augmented Reality for training purposes and offers :

• calculations in a instant of the mechanical axis deviation (in mm) MAD, anatomical and mechanical femoral axes angle (aMFA), mechanical lateral proximal femoral angle (mLPFA), mechanical lateral distal femoral angle(mLDFA), joint line convergence angle (JLCA), mechanical medial proximal tibial angle (mMPTA), mechanical lateral distal tibial angle (mLDTA), Hip Knee Ankle line (HKA) and Mid joint line (MJL). orientation that gives the surgeon valuable objective informations. -evaluation in real time the success of osteotomy taken into account the kinematic alignment of the knee (KAO) thus avoiding residual joint obliquity or malalignment. -visualisation of the mechanical axis and its position which is updated in real time, aiming the planned mechanical axis to pass at the preferred percentage (Fujisawa point) . -osteotomy wedge size, joint line orientation and tibial plateau slope, hinge planes, are monitored during correction.
• The app works as a whole interchangable interacting unit in AR which allows to modify in instant parameters, enabling user to achieve an optimally balanced leg alignment.
• to combine correction - namely biplanar- at coronal plane (a angle) and sagittal plane (β angle) by real time measuring the previous angles, tibia slope, tibia torsion and provides the direction of the osteotomy plane (ω angle) in which (open or closed) should be made, the height the opening or closing of the wedge and the correction angle (Δ angle) which values are update in real time continuously.

Disclaimer Before you use the software. The software should be used only for educational purpose namely training Orthopaedic Residents etch. Never use in real Surgery regarding its plausibility, validation is pending. The app is for educational use. Clinical judgment and experience are required to properly use the software.These instructions alone do not replace in depth training in planning for osteotomies. It only serves as a general guideline. All information received from the software output must be reviewed before any actual attempt at lab i.e. cutting saw bone for training purpose! The App indicated for assisting during training the Operator. Judgment and experience are required to properly use the App. The software is not for primary image interpretation. Any influence to the operators in making decisions remains Surgeons own responsibility and experience. App does not dispense medical advice.

Reference

1. Hernigou J et all Computer Navigation Technique for Simultaneous Total Knee Arthroplasty and Opening Wedge High Tibial Osteotomy in Patients with Large Tibial Varus Deformity Surg Tech Internal. 2020 Nov 28;37:265-274.
2. Sang Jun Song et all  Computer-Assisted Navigation in High Tibial Osteotomy Clin Orth Surg 2016 Dec;8(4):349-357.
3. Schröter S, et all Surgical accuracy in high tibial osteotomy: coronal equivalence of computer navigation and gap measurement. Knee Surg Sports Traumatol Arthrosc. 2016;24:3410­-7.
4. D. Saragaglia, et all. Role of computer-assisted surgery in osteotomies around the knee. Knee volume; 24 pages3387–3395 (2016)
5. D.Paley: Principles of Deformity Correction 
6.Marti CB, et al (2004) Accuracy of frontal and sagittal plane correction in open-wedge high tibial osteotomy. Arthroscopy 20:366–372
6. Song et all Navigated open wedge high tibial osteotomy. Sports Med Arthrosc (2008) 16(2):84–90 8.Billings A, Scott DF, Camargo MP et al (2000) High tibial osteotomy with a calibrated osteotomy guide, rigid internal fixation, and early motion. Long-term follow-up. J Bone Joint Surg Am 82:70–79 9.H Gottschling, M Roth and R Burgkart: Intraoperative, fluoroscopy-based planning for complex osteotomies of the proximal femur: The International Journal of Medical Robotics and Computer Assisted Surgery MRJ010303.3d 10. Tobias Huefner, Rupert Meller: The Role of Navigation in Knee Surgery: Elsevier Inc.