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TECHNOLOGY OR TRAINING: WHICH MATTERS MORE IN SURGERY TODAY?



Abstract

32 students of surgical technology were instructed in hip resurfacing, and shown detailed plans of the desired operative outcome for the 3 cam type hips. They then used conventional instruments, image-free navigation (brainlab) and image based navigation(Acrobot).

Only image based navigation performed well enough at navigating these difficult cam type hips with novice surgeons. Conventional instruments were not sufficient, with a tendency for the novice to put the hip in varus and translated low on the femoral neck. Image free navigation was more accurate than conventional instruments, avoiding the serious complication of notching but the range of error was 18mm and 10ยก.

Image based navigation appears to be fit for purpose in delivering both the accuracy and the precision needed by the novice surgeon in the skills laboratory who needs timely feedback so his clinical experience may start substantially further along the learning curve of this or any other technically demanding operation.

Correspondence should be addressed to Major M Butler RAMC, 44 Theynes Croft, Long Ashton, Bristol, BS41 9NA, England.