[Future implications of navigation in total knee arthroplasty]

[Trends in navigation-handheld systems]

Navigation-assisted surgical procedures in orthopedics and trauma surgery have become increasingly widespread over the last 20 years. In addition to applications in spinal surgery, they are primarily available for knee and hip endoprosthetics. On the one hand, computer-assisted procedures have been increasingly expanded with robotic assistance systems in recent years, and on the other hand, so-called handheld navigation systems have been developed, which enable specialized use directly in the operating field at lower acquisition costs. The aim of this overview is to describe current handheld systems and to present the respective technical principles and the available scientific results. Three handheld systems for TKA use, two for THA use and one system to support pedicle screw placement on the spine are presented.

[Does navigation still have a value in trauma surgery?]

BACKGROUND

Navigation systems are supposed to increase precision and support surgeons while they perform certain interventions. 2D, or nowadays 3D, systems are used in image-based approaches. Image-free navigation uses 3D printing.

INDICATIONS

There are several studies on navigation procedures in trauma surgery. In contrast to limb surgery, the use of 3D navigation in pelvic and spine surgery is already well established. Navigation is especially regularly used to treat fractures of the posterior pelvic ring and for posterior stabilization of the cervical spine.

REQUIREMENTS

To be able to utilize navigation systems optimally, the learning curve should be completed, and the technique should be used regularly. In addition, the surgeon should know the surgical technique without navigation in order to recognize potential errors of the navigation.

ADVANTAGES AND DISADVANTAGES

Advantages include increased patient safety, reduction in radiation exposure and less invasive surgical procedures. However, among other disadvantages, initial costs are high.