Image-Guided Orthopaedic Surgery: Advancing Therapeutic Procedures

Ankle osteoarthritis is a condition that causes pain and stiffness in the ankle joint. Traditional treatments like joint fusion can limit mobility. An alternative procedure called ankle distraction arthroplasty has been gaining some traction, but how well does it hold up in the long term? 

A recent study by Greenfield et al. (2019) investigated this very question. They conducted a survival analysis of ankle distraction arthroplasty for ankle osteoarthritis. Their findings suggest that this procedure may be a viable option for some patients. 

Key takeaways from the study: 

  • Ankle distraction arthroplasty showed promising results, with an 84% survival rate at 5 years. This is better than some previously reported outcomes. 
  • The study also identified factors that can influence the success of the procedure. Avascular necrosis of the talus (bone death) was associated with a lower survival rate. Additionally, sex may play a role, with the study suggesting potential gender differences in long-term outcomes. 

What this means for patients: 

Ankle distraction arthroplasty offers a potential option for preserving joint mobility in patients with ankle osteoarthritis. This study provides valuable data for surgeons and patients to consider when making treatment decisions. 

Important to note: 

  • This was a retrospective study, meaning researchers analyzed past data. More robust research designs are needed to confirm these findings. 
  • The study involved a relatively small group of patients. Larger studies are necessary to draw more definitive conclusions. 

Overall, this research suggests that ankle distraction arthroplasty may be a valuable tool for treating ankle osteoarthritis. However, more research is needed to solidify its place as a standard treatment option. 

ReferenceGreenfield, S., Matta, K. M., McCoy, T. H., Rozbruch, S. R., & Fragomen, A. (2019). Ankle distraction arthroplasty for ankle osteoarthritis: a survival analysis. Strategies in trauma and limb reconstruction, 14(2), 65.,and%2037%25%20within%205%20years


This blog is for informational purposes only and should not be considered as medical advice. Always consult with a qualified healthcare professional to discuss your individual treatment options.

Image-Guided Orthopaedic Surgery: Advancing Therapeutic Procedures
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“The secret of health for both mind and body is not to mourn for the past, not to worry about the future, or not to anticipate troubles, but to live in the present moment wisely and earnestly.”- Buddhist saying

There are a variety of orthopaedic conditions that often result in orthopaedic surgical procedures as a treatment option. While surgery is often the plan of last resort, when the option is the only treatment method, your orthopaedic surgeon will determine the best course of action that will yield the best results. The factors that are always calculated in your treatment include determining the most minimally invasive mode of treatment, the effectiveness of your treatment, and your recovery time. 

What is Image-Guided Orthopaedic Surgery?

Orthopaedic surgical procedures, along with all other aspects of medicine are evolving. Advances in technology are here to benefit both the patient and the doctor. With the ability of surgical specialists to see into the body, surgical procedures are now more successful than ever. The best way to determine the course of any process is to have a detailed plan that will outline how the desired outcome will be achieved. Imaging technology is utilized by orthopaedic surgeons either before or during surgery to determine your best custom treatment. 

One type of technology that enables surgical accuracy is the Image-Guided Operating System (IGOS). Introduced into the medical realm a few decades ago, the technology was predominantly based on the results of pre-operatively acquired computed tomography (CT) scans. The CT scan quality was such that internal patient conditions could clearly be discerned. Critical parameters that doctors favored included clear bone-tissue contrast. With a clear picture, a surgical plan could be established.

With every technology, there are initial learning curves in the evolutionary process. With patient bodies being dynamic, bone morphology changes are not captured in a still image. To overcome this problem, intra-operative CT scanning is now the integrated technology that will enable real time imaging to be conducted and integrated into surgical procedures.

Implementing new technologies that will enable surgeons to perform better procedures will require physical infrastructure changes and capital expenditure for implementation, strategic plans have to be put into place for hospitals to have these capabilities. Image intensifiers have also been implemented into orthopaedic procedures, in order to integrate with IGOS systems. They too provide the capabilities of intra-operative CT machines, in an easier to operate manner. Instrument calibration will be key to ensuring that image quality is applicable for a number of clinical applications. A sample of the visual output of an IGOS is outlined below. 


This image is an output of a fluoroscopy based navigation for fracture reduction. The doctor has various planning mechanisms that can be implemented once the patient results are generated by the system. The system provides a menu of options that can be navigated. These include the options to zoom into or out of the image. Close ups will identify critical details of the fracture. Knowing the fracture classification, the doctor can then get a full 360 degree view of the condition and plan how the patient will be treated. The system options provide various plane views, and actually has a predictive mechanism that will identify the best treatment for the patient based on the root cause of the fracture. 

The availability of 3-D image data via methods such as fluoroscopy is enabled by a motorised, iso-centric C-arm that takes 50-100 2D images, and then fuses them to form the 3-D result. The technology is gaining traction in medical imagery and is applied to several disciplines in the medical realm. As the technology advances, improved capabilities will be accessible by medical personnel. These include improved views and even faster time to acquisition once the technology is ordered. 

Knowing that modern surgery is improving from a predictive standpoint, patients can feel more confident that future orthopaedic treatments will be more effective, cost effective and with shorter recovery times. Talk to your orthopaedic specialist today, to find out what methods they apply when planning your course of treatment. 

Reference Article: 

[1] Image Guided Orthopaedic Surgery:

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Dr. Gordon Slater

Dr. Slater is one of the first foot and ankle surgeons in Australia to adopt minimally invasive surgical techniques. He routinely uses MIS to treat a range of conditions, including bunions.

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Dr Gordon Slater is a highly-skilled surgeon specialising in foot and ankle conditions and sports injuries. Dr Slater is one of the first foot and ankle surgeons in Australia to adopt minimally invasive surgical techniques. He routinely uses MIS to treat a range of conditions, including bunions. MIS  has many advantages including shorter operating times, reduced post-operative pain, reduced risk of infection, minimal scarring and better cosmetic outcomes.

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