Direct Navigation of Surgical Instrumentation

O. Andres Barrera, H. Haider

Research output: Chapter in Book/Report/Conference proceedingChapter


Hip and knee arthroplasty have a big impact on population health and economics due to the large number of procedures and their relative high costs. Joint replacements are complex surgeries, which require skillful surgeons and numerous mechanical instruments. When many such instruments make contact with the patient’s tissue, they are bound to add to the overall infection risk. Newer patient-specific instruments address part of this burden but introduce new challenges due to the extra manufacturer planning, surgeon approval and custom jig manufacturing steps and their associated scalability and potential liability issues. Alternatively, real-time direct navigation of bones and bone resection instrumentation, which we call here Navigated Freehand Cutting (NFC), can help reduce implant-specific jigs for arthroplasty. It could also lead to cheaper, faster, easier and perhaps even better surgical procedures, by reducing the risk of infection. In this chapter we briefly contrast standard mechanical instrumentation for arthroplasty with modern variations and alternative approaches, including conventional navigation techniques (i.e. navigated jigs) and active and passive robotics. We also describe the progress citing various bench and cadaveric experiments on our approach of Navigated Freehand Cutting.

Original languageEnglish (US)
Title of host publicationComputer-Assisted Musculoskeletal Surgery
Subtitle of host publicationThinking and Executing in 3D
PublisherSpringer International Publishing
Number of pages15
ISBN (Electronic)9783319129433
ISBN (Print)9783319129426
StatePublished - Jan 1 2015


  • Computer aided orthopaedic surgery (CAOS)
  • Custom jigs
  • Freehand navigation
  • Navigated freehand cutting (NFC)
  • Passive/active robots
  • Total knee arthroplasty (TKR)

ASJC Scopus subject areas

  • General Medicine
  • General Biochemistry, Genetics and Molecular Biology


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