TY  - JOUR
T1  - Computer-Assisted and Robot-Assisted Technologies to Improve Bone-Cutting Accuracy When Integrated with a Freehand Process Using an Oscillating Saw
AU  - Cartiaux, Olivier
AU  - Paul, Laurent
AU  - Docquier, Pierre-Louis
AU  - Raucent, Benoît
AU  - Dombre, Etienne
AU  - Banse, Xavier
Y1  - 2010/09/01
N1  - 10.2106/JBJS.I.00457
JO  - The Journal of Bone & Joint Surgery
SP  - 2076
EP  - 2082
VL  - 92
IS  - 11
N2  - Background: 
  In orthopaedic surgery, many interventions involve freehand bone cutting with an oscillating saw. Such freehand procedures can produce large cutting errors due to the complex hand-controlled positioning of the surgical tool. This study was performed to investigate the potential improvements in cutting accuracy when computer-assisted and robot-assisted technologies are applied to a freehand bone-cutting process when no jigs are available.Methods: 
  We designed an experiment based on a geometrical model of the cutting process with use of a simulated bone of rectangular geometry. The target planes were defined by three variables: a cut height (t) and two orientation angles (ß and ?). A series of 156 cuts were performed by six operators employing three technologically different procedures: freehand, navigated freehand, and robot-assisted cutting. After cutting, we measured the error in the height t, the absolute error in the angles ß and ?, the flatness, and the location of the cut plane with respect to the target plane.Results: 
  The location of the cut plane averaged 2.8 mm after use of the navigated freehand process compared with 5.2 mm after use of the freehand process (p < 0.0001). Further improvements were obtained with use of the robot-assisted process, which provided an average location of 1.7 mm (p < 0.0001).Conclusions: 
  Significant improvements in cutting accuracy can be achieved when a navigation system or an industrial robot is integrated into a freehand bone-cutting process when no jigs are available. The procedure for navigated hand-controlled positioning of the oscillating saw appears to be easy to learn and use.Clinical Relevance: 
  These findings support a recommendation for further study to determine if the improvements in cutting accuracy observed in vitro are possible in vivo.
SN  - 0021-9355
M3  - doi: 10.2106/JBJS.I.00457
UR  - http://dx.doi.org/10.2106/JBJS.I.00457
ER  -