A novel intraoperative method to project osteotomy lines for accurate resection of primary bone sarcomas.

Abstract

Accurate reproduction of a preoperative plan is critical in wide resection of bone sarcomas. Recent advances in computer navigation and 3D-custom jigs have increased resection accuracy, although with certain practical drawbacks. We developed a novel "projector method" that projects the preoperative osteotomy lines onto the bone. A sawbone study was conducted to evaluate accuracy in reproducing preoperative resection plans. An additional cadaver experiment was conducted to evaluate feasibility in a more realistic operating room setting. Based on the results of experiments conducted on sawbones, the proposed light projector method was more accurate at depicting desired osteotomy lines than a traditional manual method, reducing the corner deviation from 2.53 mm to 0.35 mm, angular deviation from 2.10° to 0.31°, and point deviation from 4.66 mm to 0.48 mm (p < 0.001). Results of the cadaver experiment were consistent with those of sawbone experiments. The new projector method can accurately assist surgeons in visualizing the preoperative plan of osteotomy lines accurately in surgery.