CT-guided robotically-assisted infiltration of foot and ankle joints

It was our aim to describe a CT-guided robotically-assisted infiltration technique for diagnostic injections in foot and ankle orthopaedics. CT-guided mechatronically-assisted joint infiltration was performed on 16 patients referred to the orthopaedic department for diagnostic foot and ankle assessment. All interventions were performed using an INNOMOTION-assistance device on a multislice CT scanner in an image-guided therapy suite. Successful infiltration was defined as CT localization of contrast media in the target joint. Additionally, pre- and post-interventional VAS pain scores were assessed. All injections (16/16 joints) were technically successful. Contrast media deposit was documented in all targeted joints. Significant relief of pain was noted by all 16 patients (p<0.01). CT-guided robotically-assisted intervention is an exact, reliable and safe application method for diagnostic infiltration of midfoot and hindfoot joints. The high accuracy and feasibility in a clinical environment make it a viable alternative to the commonly used fluoroscopic-guided procedures.

[1]  Sharmila Majumdar,et al.  Osteoarthritis: MR imaging findings in different stages of disease and correlation with clinical findings. , 2003, Radiology.

[2]  K. Huch,et al.  CT-guided interventions in orthopedics , 2007, Archives of Orthopaedic and Trauma Surgery.

[3]  M. Regan,et al.  Importance of placement of intra-articular steroid injections. , 1993, BMJ.

[4]  D. Felson,et al.  Analysis of the discordance between radiographic changes and knee pain in osteoarthritis of the knee. , 2000, The Journal of rheumatology.

[5]  H. Dabke Accuracy of needle placement into the intra-articular space of the knee. , 2004, The Journal of bone and joint surgery. American volume.

[6]  C. Saltzman,et al.  Intraarticular foot and ankle injections to identify source of pain before arthrodesis. , 1996, AJR. American journal of roentgenology.

[7]  P Messmer,et al.  Medical technology integration: CT, angiography, imaging‐capable OR‐table, navigation and robotics in a multifunctional sterile suite , 2007, Minimally invasive therapy & allied technologies : MITAT : official journal of the Society for Minimally Invasive Therapy.

[8]  A. Grainger Image guidance of foot joint injections. , 2005, Clinical radiology.

[9]  D. W. Jackson,et al.  Accuracy of Needle Placement into the Intra-Articular Space of the Knee , 2002, The Journal of bone and joint surgery. American volume.

[10]  A. Jacob,et al.  Robotically assisted CT‐based procedures , 2007, Minimally invasive therapy & allied technologies : MITAT : official journal of the Society for Minimally Invasive Therapy.

[11]  D. Stoianovici,et al.  Interventional robotic systems: Applications and technology state‐of‐the‐art , 2006, Minimally invasive therapy & allied technologies : MITAT : official journal of the Society for Minimally Invasive Therapy.

[12]  A. Saifuddin,et al.  CT guided diagnostic foot injections. , 2005, Clinical radiology.

[13]  S. Hurwitz,et al.  Fluoroscopically guided injections into the foot and ankle: localization of the source of pain as a guide to treatment--prospective study. , 1997, Radiology.

[14]  B. Bresnihan,et al.  Comparison of the accuracy of steroid placement with clinical outcome in patients with shoulder symptoms , 1997, Annals of the rheumatic diseases.

[15]  E. Trepman,et al.  Subtalar Joint Arthrography. , 1998, Seminars in musculoskeletal radiology.

[16]  D. Sartoris,et al.  Localization of specific joint causing hindfoot pain: value of injecting local anesthetics into individual joints during arthrography. , 1995, AJR. American journal of roentgenology.

[17]  Thomas J. Vogl,et al.  MR-compatible assistance system for punction in a high-field system: device and feasibility of transgluteal biopsies of the prostate gland , 2007, European Radiology.