Feasibility of a navigated registration technique in FAI surgery

Abstract

Arthroscopic femoral osteoplasties might be technically demanding, might cause prolonged operative times and restrict the intraoperative overview. An automated navigated matching process of preoperative CT-data and intraoperative fluoroscopy should allow for noninvasive registration for FAI-surgery. Six hip joints were used with a conventional navigation system. Defined osseous lesion (2 × 2 mm) in the femoral neck, head neck junction, and head region were created followed by automated segmentation including CT-fluoro image fusion by the navigation system. Precision of registration process was tested trough a lateral arthroscopic portal. In vivo distances between pointer tip to bone were measured. Secondary in vivo distances between an inserted navigated shaver and the osseous lesions were measured. Our results allow a CT-fluoroscopy matching procedure for noninvasive registration process for navigated FAI-surgery in multiplanar planes. Precision is more accurate at the femoral neck and head-neck junction than at the femoral head area. Future navigated applications might simplify and increase precision of FAI-surgery.