A novel mechatronic tool for computer-assisted arthroscopy

This paper describes a novel mechatronic tool for arthroscopy, which is at the same time a smart tool for traditional arthroscopy and the main component of a system for computer-assisted arthroscopy. The mechatronic arthroscope has a cable-actuated servomotor-driven multi-joint mechanical structure, is equipped with a position sensor measuring the orientation of the tip and with a force sensor detecting possible contact with delicate tissues in the knee, and incorporates an embedded microcontroller for sensor signal processing, motor driving and interfacing with the surgeon and/or the system control unit. When used manually, the mechatronic arthroscope enhances the surgeon's capabilities by enabling him/her to easily control tip motion and to prevent undesired contacts. When the tool is integrated in a complete system for computer-assisted arthroscopy, the trajectory of the arthroscope is reconstructed in real time by an optical tracking system using infrared emitters located in the handle, providing advantages in terms of improved intervention accuracy. The computer-assisted arthroscopy system comprises an image processing module for segmentation and three-dimensional reconstruction of preoperative computer tomography or magnetic resonance images, a registration module for measuring the position of the knee joint, tracking the trajectory of the operating tools, and matching preoperative and intra-operative images, and a human-machine interface that displays the enhanced reality scenario and data from the mechatronic arthroscope in a friendly and intuitive manner. By integrating preoperative and intra-operative images and information provided by the mechatronic arthroscope, the system allows virtual navigation in the knee joint during the planning phase and computer guidance by augmented reality during the intervention. This paper describes in detail the characteristics of the mechatronic arthroscope and of the system for computer-assisted arthroscopy and discusses experimental results obtained with a preliminary version of the tool and of the system.