Articles: surgery.
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J Bone Joint Surg Am · Jan 2008
Randomized Controlled TrialComputer-assisted minimally invasive total knee arthroplasty compared with standard total knee arthroplasty. A prospective, randomized study.
There is little information on the feasibility of computer navigation when using a minimally invasive approach for total knee arthroplasty, during which the anatomic landmarks for registration may be obscured. The purpose of the present study was to determine the radiographic accuracy of this technique and to compare the rate of functional recovery between patients who underwent computer-assisted minimally invasive arthroplasty and those who underwent conventional total knee arthroplasty. ⋯ Although specific clinical parameters reflect an early increased rate of functional recovery in association with computer-assisted minimally invasive total knee arthroplasty within the first postoperative month, the main advantage of this technique over conventional total knee arthroplasty is improved postoperative radiographic alignment without increased short-term complications.
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Stud Health Technol Inform · Jan 2008
Randomized Controlled TrialTransfer of systematic computer game training in surgical novices on performance in virtual reality image guided surgical simulators.
We report on a pilot study that investigates the transfer effect of systematic computer game training on performance in image guided surgery. In a group of 22 surgical novices, subjects were matched and randomized into one group training with a 3-D first person shooter (FPS) game and one group training with a 2-D non-FPS game. We also included a control group. ⋯ Furthermore subjects who underwent systematic FPS game training performed better in the MIST-VR than those training with a 2-D game. Our findings indicate a transfer effect and that experience of video games are important for training outcome in simulated surgical procedures. Video game training can become useful when designing future skills training curricula for surgeons.
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J Bone Joint Surg Br · Apr 2007
Randomized Controlled TrialComputer navigation versus conventional total knee replacement: no difference in functional results at two years.
We previously compared the component alignment in total knee replacement using a computer-navigated technique with a conventional jig-based method. We randomly allocated 71 patients to undergo either computer-navigated or conventional replacement. An improved alignment was seen in the computer-navigated group. ⋯ At two years postoperatively, the frequency of mild to severe anterior pain was not significantly different (p = 0.818), varying between 44% (14) for the computer-navigated group, and 47% (14) for the conventionally-replaced group. The Bartlett Patellar score and the Oxford knee score were also not significantly different (t-test p = 0.161 and p = 0.607, respectively). The clinical outcome of the patients with a computer-navigated knee replacement appears to be no different to that of a more conventional jig-based technique at two years post-operatively, despite the better alignment achieved with computer-navigated surgery.
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J. Cardiovasc. Electrophysiol. · Apr 2007
Randomized Controlled TrialComputed tomography-fluoroscopy image integration-guided catheter ablation of atrial fibrillation.
This study examines the feasibility of atrial fibrillation (AF) ablation using registered three-dimensional computed tomography (CT) images of the left atrium with fluoroscopy. ⋯ CT-fluoroscopic-guided left atrial ablation is feasible and allows appropriate catheter manipulation in the left atrium.
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Randomized Controlled Trial Comparative Study
Assessment of CAOS as a training model in spinal surgery: a randomised study.
The objectives of this study were (1) to quantify the benefit of computer assisted orthopaedic surgery (CAOS) pedicle screw insertion in a porcine cadaver model evaluated by dissection and computed tomography (CT); (2) to compare the effect on performance of four surgeons with no experience of CAOS, and varying experience of pedicle screw insertion; (3) to see if CT with extended windows was an acceptable method to evaluate the position of the pedicle screws in the porcine cadaver model, compared to dissection. This was a prospective, randomised, controlled and blinded porcine cadaver study. Twelve 6-month-old porcine (white skinned Landrace) lumbar spines were scanned pre-operatively by spiral CT, as required for the CAOS computer data set. ⋯ The experienced general orthopaedic surgeon did not benefit from CAOS (P = 0.5). CT compared to dissection showed an intra-observer reliability of 99.4% and inter-observer reliability of 92.6%. The conclusions of this study were as follows: (1) an increased number of pedicle screws were ideally placed using the CAOS electromagnetic guidance system compared to the conventional freehand technique; (2) junior surgeons benefited most from CAOS; (3) we believe CAOS (Navitrak) with porcine lumbar spines evaluated by post operative CT, represents a useful model for training junior surgeons in pedicle screw placement; (4) experienced spine surgeons, who have never used CAOS, may find CAOS less helpful than previously reported.