• Timo Stübig, Henning Windhagen, Christian Krettek, and Max Ettinger.
• Department of Traumatology, Hannover Medical School; Department of Orthopedic Surgery, Hannover Medical School, Annastift.
• Dtsch Arztebl Int. 2020 Nov 20; 117 (47): 793800793-800.

BackgroundThere are many ways in which computer-assisted orthopedic and trauma surgery (CAOS) procedures can help surgeons to plan and execute an intervention.MethodsThis study is based on data derived from a selective search of the literature in the PubMed database, supported by a Google Scholar search.ResultsFor most applications the evidence is weak. In no sector did the use of computer-assisted surgery yield any relevant clinical or functional improvement. In trauma surgery, 3D-navigated sacroiliac screw fixation has become clinically established for the treatment of pelvic fractures. One randomized controlled trial showed a reduction in the rate of screw misplacement: 0% with 3D navigation versus 20.4% with the conventional procedure und 16.6% with 2D navigation. Moreover, navigation-assisted pedicle screw stabilization lowers the misplacement rate. In joint replacements, the long-term results showed no difference in respect of clinical/functional scores, the time for which the implant remained in place, or aseptic loosening.ConclusionComputer-assisted procedures can improve the precision of certain surgical interventions. Particularly in joint replacement and spinal surgery, the research is moving away from navigation in the direction of robotic procedures. Future studies should place greater emphasis on clinical and functional results.

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