Computer-Aided Preoperative Planning and Virtual Simulation in Orthopedic Surgery

  • Jiing-Yih LaiEmail author
  • Zhang Yuanzhi
  • Y. Z. Zhang

Computer-Aided Preoperative Planning

Significance of Computer-Aided Three-Dimensional (3D) Preoperative Planning

Two-dimensional (2D) X-ray and CT images are conventionally used for the evaluation and planning in orthopedic surgery. Although CT images can provide more information than X-ray images, current 2D imaging platform faces many difficulties. The first one is that the surgeon must rebuild the 3D status of the bone structure and imagine its fracture in mind, which may not be easy for junior surgeons. The second difficulty is that the preoperative planning is generally implemented by freehand sketch because the surgeon almost can do nothing but look at the 2D images slice by slice. Substantial estimation must be done as it is difficult to perform surgical simulation in 2D imaging platform. With the development of 3D medical technologies, more and more studies have been conducted to explore and develop computer-aided 3D preoperative planning for orthopedic surgery.

For surgeons to...


  1. 1.
    Winkelbach S, Westphal R, Goesling T. Pose estimation of cylindrical fragments for semi-automatic bone fracture reduction. Pattern Recogn. 2003:566–73.Google Scholar
  2. 2.
    Tockus L, Joskowicz L, Simkin A, et al. Computer-aided image-guided bone fracture surgery: modeling, visualization, and preoperative planning, Medical Image Computing and Computer-Assisted Interventation-MICCAI’98; 1998, p. 29–38.Google Scholar
  3. 3.
    Koo TK, Chao EY, Mak AF. Development and validation of a new approach for computer-aided long bone fracture reduction by using unilateral external fixator. J Biomech. 2006;39(11):2104–12.CrossRefGoogle Scholar
  4. 4.
    Nakajima Y, Tashiro T, Okada T, et al. Computer-assisted fracture reduction of proximal femur by using preoperative CT data and intraoperative fluoroscopic images. Proc Comput Assist Radiol. 2004;1268:620.Google Scholar
  5. 5.
    Okada T, Iwasaki Y, Koyama T, et al. Computer-assisted preoperative planning for reduction of proximal femoral fracture by using 3-D-CT data. IEEE Trans Biomed Eng. 2009;56(3):749–59.CrossRefGoogle Scholar
  6. 6.
    Harders M, Barlit A, Gerber C, Hodler J, et al. An optimized surgical planning environment for complex proximal humerus fractures, MICCAI workshop on interaction in medical image analysis and visualization; 2007.Google Scholar
  7. 7.
    Fornaro J, Keel M, Harders M, et al. An interactive surgical planning tool for acetabular fractures: initial results. J Orthop Surg Res. 2010;5:50.CrossRefGoogle Scholar
  8. 8.
    Munjal S, Leopold SS, Kornreich D, et al. CT-generated 3-dimensional models for complex acetabular reconstruction. J Arthroplast. 2000;15:644.CrossRefGoogle Scholar
  9. 9.
    Citak M, Gardner MJ, Kendoff D, et al. Virtual 3D planning of acetabular fracture reduction. J Orthop Res. 2008;26:547–52.CrossRefGoogle Scholar
  10. 10.
    Brown GA, Firoozbakhsh K, Gehlert RJ. Three-dimensional CT modeling versus traditional radiology techniques in treatment of acetabular fractures. Iowa Orthop J. 2001;21:20–4.PubMedPubMedCentralGoogle Scholar
  11. 11.
    Schweizer P, Fürnstahl M, Harders G, et al. Complex radius shaft malunion: osteotomy with computer-assisted planning. Hand. 2010;5(2):171–8.CrossRefGoogle Scholar
  12. 12.
    Drapikowski P, Tyrakowski M, Czubak J, et al. Computer assisted SCFE osteotomy planning. Int J Cars. 2008;3:421–6.CrossRefGoogle Scholar
  13. 13.
    Miyake J, Murase T, Ka KO, et al. Computer-assisted corrective osteotomy for malunited diaphyseal forearm fractures. J Bone Joint Surg. 2012;94(20):e150.1–11.CrossRefGoogle Scholar
  14. 14.
    Briem D, Linhart W, Lehmann W, et al. Computer-assisted screw insertion into the first sacral vertebra using a three-dimensional image intensifier: results of a controlled experimental investigation. Eur Spine J. 2006;15:757–63.CrossRefGoogle Scholar
  15. 15.
    Schlenzka D, Laine T, Lund T. Computer-assisted spine surgery. Eur Spine J. 2000;9(Suppl 1):57–64.CrossRefGoogle Scholar
  16. 16.
    Iampreechakul P, Chongchokdee C, Tirakotai W. The accuracy of computer-assisted pedicle screw placement in degenerative lumbrosacral spine using single-time, paired point registration alone technique combined with the surgeon’s experience. J Med Assoc Thail. 2011;94(3):337–45.Google Scholar
  17. 17.
    Huang CY, Luo LJ, Lee PY, et al. Efficient segmentation and construction of 3d bone models in medical images. J Med Biol Eng. 2011;31(6):375–86.CrossRefGoogle Scholar
  18. 18.
    Kwan FY, Cheung KC, Gibson I. Automatic extraction of bone boundaries from CT scans using an intelligence-based approach. In: Proceedings of the 15th International Conference on Pattern Recognition, Washington, DC, USA; 2000.Google Scholar
  19. 19.
    Kang Y, Engelke K, Kalender WA. A new accurate and precise 3-D segmentation method for skeletal structures in volumetric CT data. IEEE Trans Med Imaging. 2003;22(5):586–98.CrossRefGoogle Scholar
  20. 20.
    Zoroofi RA, Sato Y, Sasama T, et al. Automated segmentation of acetabulum and femoral head from 3-D CT images. IEEE Trans Inf Technol Biomed. 2003;7(4):329–42.CrossRefGoogle Scholar
  21. 21.
    Westin CF, Warfield S, Bhalerao Q, et al. Tensor controlled local structure enhancement of CT images for bone segmentation. Proceedings of the first international conference on medical image computing and computer-assisted intervention, London, UK; 1998.Google Scholar
  22. 22.
    Huang CY, Lee PY, Lai JY, et al. Simultaneous segmentation of bone regions using multiple-level threshold. Comput Aid Design Appl. 2011;8(2):269–88.CrossRefGoogle Scholar
  23. 23.
    Sectra’s orthopaedic solutions.
  24. 24.
    MediCAD-The orthopaedic solution.
  25. 25.
  26. 26.
    Lee PY, Lai JY, Hu YS, et al. Virtual 3D planning of pelvic fracture reduction and implant placement. Biomed Eng. 2012;24(3):245–62.Google Scholar

Copyright information

© Springer Nature B.V. and People's Medical Publishing House 2018

Authors and Affiliations

  1. 1.Mechanical Engineering Department, National Central UniversityTaoyuanTaiwan
  2. 2.Department of OrthopedicsAffiliated Hospital of Inner Mongolia Medical UniversityHohhotChina
  3. 3.The Affiliated Hospital of Inner Mongolia Medical UniversityHohhotChina

Personalised recommendations