Three-dimensional navigation assisted pediatric foot and ankle surgery: Operative technique and safety profile

Computer-assisted surgery (CAS) is an innovative technology that provides surgeons with three-dimensional navigation (TDN) to optimize intraoperative visualization and guidance. Computer-assistance after intraoperative cone beam computed tomography is predominantly found in spinal surgery. The senio...

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Main Authors: Ramez Sakkab, DPM, Hafsah Dean, DPM, Scott Shoemaker, MD, Ryan O'Shea, MD
Format: Article
Language:English
Published: Elsevier 2025-01-01
Series:Foot & Ankle Surgery: Techniques, Reports & Cases
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Online Access:http://www.sciencedirect.com/science/article/pii/S2667396725000175
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author Ramez Sakkab, DPM
Hafsah Dean, DPM
Scott Shoemaker, MD
Ryan O'Shea, MD
author_facet Ramez Sakkab, DPM
Hafsah Dean, DPM
Scott Shoemaker, MD
Ryan O'Shea, MD
author_sort Ramez Sakkab, DPM
collection DOAJ
description Computer-assisted surgery (CAS) is an innovative technology that provides surgeons with three-dimensional navigation (TDN) to optimize intraoperative visualization and guidance. Computer-assistance after intraoperative cone beam computed tomography is predominantly found in spinal surgery. The senior authors have applied the same principles and techniques to some lower extremity pathologies. The present study reviews lower extremity operative technique and safety profile with three-dimensional real-time navigation at a single institution. Technique for retrograde drilling of osteochondral lesions of the talus and pedal coalition resection(s) are presented. At our institution, thirty-five computer-assisted foot and ankle cases were identified from 2015 to 2022. Complications occurred in 8.6 % of cases (3/35). Over the past decade, the authors have employed a low dose protocol for intraoperative cone beam computed tomography. Doses from each tarsal coalition and talar osteochondral defect case were averaged, resulting in 1.48 and 1.14 milliGrays (mGy), respectively. Both surgeries demonstrate below 25 % of the annual background radiation dose (6.2 mGy). Further research is needed regarding three-dimensional navigation in foot and ankle surgery along with comparisons to radiation exposure via intraoperative fluoroscopy in similar cases.
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series Foot & Ankle Surgery: Techniques, Reports & Cases
spelling doaj-art-fff2feabba104ad997b9bf9009a8d1a72025-08-20T03:24:03ZengElsevierFoot & Ankle Surgery: Techniques, Reports & Cases2667-39672025-01-015210048210.1016/j.fastrc.2025.100482Three-dimensional navigation assisted pediatric foot and ankle surgery: Operative technique and safety profileRamez Sakkab, DPM0Hafsah Dean, DPM1Scott Shoemaker, MD2Ryan O'Shea, MD3Fellow, Phoenix Foot & Ankle Institute, Scottsdale, AZ, USA; Corresponding author: 4077 5th Ave, GME Dept - MER 35, San Diego, California, 92103, USA.Resident, Scripps Mercy Hospital, San Diego, CA, USAOrthopedic Surgeon, Kaiser Permanente, San Diego, CA, USAOrthopedic Surgeon, Kaiser Permanente, San Diego, CA, USAComputer-assisted surgery (CAS) is an innovative technology that provides surgeons with three-dimensional navigation (TDN) to optimize intraoperative visualization and guidance. Computer-assistance after intraoperative cone beam computed tomography is predominantly found in spinal surgery. The senior authors have applied the same principles and techniques to some lower extremity pathologies. The present study reviews lower extremity operative technique and safety profile with three-dimensional real-time navigation at a single institution. Technique for retrograde drilling of osteochondral lesions of the talus and pedal coalition resection(s) are presented. At our institution, thirty-five computer-assisted foot and ankle cases were identified from 2015 to 2022. Complications occurred in 8.6 % of cases (3/35). Over the past decade, the authors have employed a low dose protocol for intraoperative cone beam computed tomography. Doses from each tarsal coalition and talar osteochondral defect case were averaged, resulting in 1.48 and 1.14 milliGrays (mGy), respectively. Both surgeries demonstrate below 25 % of the annual background radiation dose (6.2 mGy). Further research is needed regarding three-dimensional navigation in foot and ankle surgery along with comparisons to radiation exposure via intraoperative fluoroscopy in similar cases.http://www.sciencedirect.com/science/article/pii/S2667396725000175CoalitionTalus osteochondral lesionThree-dimensional navigationO-ArmIntraoperative computed tomographyCone beam computed tomography
spellingShingle Ramez Sakkab, DPM
Hafsah Dean, DPM
Scott Shoemaker, MD
Ryan O'Shea, MD
Three-dimensional navigation assisted pediatric foot and ankle surgery: Operative technique and safety profile
Foot & Ankle Surgery: Techniques, Reports & Cases
Coalition
Talus osteochondral lesion
Three-dimensional navigation
O-Arm
Intraoperative computed tomography
Cone beam computed tomography
title Three-dimensional navigation assisted pediatric foot and ankle surgery: Operative technique and safety profile
title_full Three-dimensional navigation assisted pediatric foot and ankle surgery: Operative technique and safety profile
title_fullStr Three-dimensional navigation assisted pediatric foot and ankle surgery: Operative technique and safety profile
title_full_unstemmed Three-dimensional navigation assisted pediatric foot and ankle surgery: Operative technique and safety profile
title_short Three-dimensional navigation assisted pediatric foot and ankle surgery: Operative technique and safety profile
title_sort three dimensional navigation assisted pediatric foot and ankle surgery operative technique and safety profile
topic Coalition
Talus osteochondral lesion
Three-dimensional navigation
O-Arm
Intraoperative computed tomography
Cone beam computed tomography
url http://www.sciencedirect.com/science/article/pii/S2667396725000175
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