SARCOMA DIVISION Development of Computer Assisted Surgery for Orthopaedic Oncology Applications: Preliminary report of the first American Series David.

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SARCOMA DIVISION Development of Computer Assisted Surgery for Orthopaedic Oncology Applications: Preliminary report of the first American Series David Cheong, Dylan Nugent, Eric R Henderson, German Marulanda, G Douglas Letson

SARCOMA DIVISION Disclosure: No financial support was received in the production of this presentation, data being presented, surgical procedures, or instrumentation

SARCOMA DIVISION Navigation

SARCOMA DIVISION

Computer Navigated Oncology Surgeries since Distal Femur Replacement 3Internal Hemi-pelvectomy 2Proximal Tibia Replacement 1Proximal Femur Replacement 6Sacro-iliac Instrumentation Primary Malignant Bones Tumors Multiple Myeloma Benign Aggressive Bone Tumors Aggressive Soft Tissue Sarcoma Metastatic Disease

SARCOMA DIVISION

Image Based

SARCOMA DIVISION

Navigated Cautery Pencil

SARCOMA DIVISION Navigated Osteotome

SARCOMA DIVISION

Navigated Hemi-pelvectomy Plane Planning

SARCOMA DIVISION

Accuracy of Resection

SARCOMA DIVISION Limb Length

SARCOMA DIVISION Navigated Proximal Femur

SARCOMA DIVISION Finding anatomical structures for optimum screw placement Replicate screw dimensions – Head size – Length – Diameter Set head point and screw axis Multiple screw plans Screw Planning

SARCOMA DIVISION Screw Planning

SARCOMA DIVISION Navigated Screws

SARCOMA DIVISION

Potential!!! Accuracy of Resection – Navigated instrumentation – Blending real time imaging Accuracy of Reconstruction – Re-establishing the joint line – Reducing limb length discrepancies Intra-operative Execution of the Pre-operative plan

SARCOMA DIVISION