Statistical shape and pose modeling for automated planning in robot-assisted reduction of the ankle syndesmosis.

Accurate, image-based planning of joint reduction based on intraoperative cone-beam CT forms the basis for precise robotic assistance and quantitative fluoroscopic guidance. The proposed approach combines statistical shape and pose modeling of the ankle joint to: (1) automatically segment individual bones; and (2) identify the target pose for the dislocated fibula to establish a plan for reduction. Leave-one-out analysis of the atlas members demonstrated accurate segmentation with 0.6 mm mean surface distance error and predicted the fibula pose within 1.6 mm and 1.8°. Future work will expand evaluation and analyze the appropriateness of the contralateral ankle as a patient-specific template.