Computer Assisted Orthopedics Surgery 

Computer Assisted Orthopedics Surgery : CAOS

Basic Principle

CAOS is developed in two different categories.

1. Robotic system : assist surgeon, Tele-operation, operate with autonomy
2. Navigation system : guidance, surgical planning

Robotic surgery is used mainly in handling replacement arthroplasty, but navigation system is surgical guidance. Since metal implantation for fracture or spinal fixation and arthroplasty are rapidly developed, navigation system is gradually involved.

Orthopedic surgeons are used to creating 3D images from 2D images such as plain X-rays films, for surgical planning or even during operation. However, 2D and 3D images from real time fluoroscopy are available intra-operatively, but increase risk of radiation exposure.

Navigation system can create 3D images for pre-operative and intra-operative planning without radiation hazard. It is precise and reproducible.

Do we need CAOS ?

Recently, Orthopedics surgical technique and instruments are complicated and rapidly developed to ensure the best result and safety for patients. The main problem of artificial joint replacement is mal-alignment resulting early loosening and failure, even in the expert's hands. The proper placement of spinal instrument fixation reduces surgical risk or complication and increases stability for the best outcome and patient safety. The longivity of prosthesis depends on accuracy of surgical technique.

CAOS will help surgeon to cope many pitfalls during operation. There were so many reports concluded that CAOS reduced complications from mal-alignment or outlier.

Navigation system

The first step is registration. Surgeon must apply tracker to the bone in order to send signal and tell the computer concerning the location of bone that should be operated. Computer can locate the position and axis of all registered bones. The bone morphology is told to computer by imaged or imageless technique depended on type of operation and the software.

Next step is operation. Surgeon can perform the operation step by step according to computer software for individual surgery. Each step is similar to standard operation but surgeon can confirm or make decision by navigation guidance. However, it takes a little bit more time to make familiar with the system.