Latest Research in Orthopedic Surgery

Traumatic pulmonary hemorrhage is uncommon and rarely results in respiratory failure requiring mechanical circulatory support. Indications for extracorporeal membrane oxygenation (ECMO) in injured patients are not well-defined, but recent work indicates a potential survival benefit. Additionally, coughing-induced hemorrhage requires a complex sedation strategy. We describe management of a young polytrauma patient with traumatic lung failure requiring advanced venovenous (VV)-ECMO support and novel sedation strategy to facilitate healing. An 18-year-old boy sustained a 40-foot fall and developed widespread traumatic hemorrhagic pneumatoceles leading to respiratory arrest, ultimately requiring parallel-circuit VV-ECMO support, as well as systemic isoflurane sedation achieved through the ECMO circuit. Orthopedic fixation was performed while on VV-ECMO. This young polytrauma patient had a primary traumatic pulmonary hemorrhagic process and orthopedic traumatic injuries that were successfully managed with parallel-circuit VV-ECMO and isoflurane sedation through the circuit.

This study examines gender-based variation in clinical characteristics of vehicle-related traumatic fractures (V-TFs) in elderly populations. A retrospective analysis evaluated medical records from 456 elderly patients (≥ 60 years) undergoing V-TFs treatment at a single trauma center between 2013 and 2019. Demographic characteristics, injury mechanisms, fracture patterns, and clinical outcomes were systematically compared between genders. The study population comprised 253 male and 203 female patients, with a mean age of 67.4 ± 6.4 years. Significantly higher rates of smoking (P < .001), alcohol consumption (P < .001), motor vehicle accidents involving drivers (MVAs) (P < .001), bicycle-related traffic crashes (TCs) (P = .038), and bicycle-related fall (P = .037) were observed in males compared to female. Conversely, hypertension (P = .012), osteoporosis (P < .001), and pedestrian-MVAs (P < .001) showed significantly higher prevalence in females than in male. Regarding fracture patterns, cervical spine (P = .002), skull (P = .048), patella (P = .036) and rib (P = .007) occurred more frequently in males. Higher fracture rates in the humerus (P < .001), ulna (P = .017) and radius (P < .001) were documented in females compared to males. Post-traumatic complications analysis revealed male predominance in coma after injury (CAI) (P = .011) and surgical site infection (P = .001) when compared to female individuals. Significant gender disparities exist in V-TFs patterns among elderly patients. Male patients predominantly experience active transportation injuries with axial skeleton involvement, while female patients more frequently sustain pedestrian injuries and upper extremity fractures. These findings highlight the need for gender-specific prevention strategies and clinical management protocols in elderly trauma care.

Real-time pose estimation is essential in various applications such as sports analysis, motion tracking, and healthcare, where understanding human movement in complex environments is critical. However, existing methods often struggle to balance accuracy and computational efficiency, particularly in crowded or dynamic scenes where occlusions and fast movements are common. To address these challenges, we propose a novel architecture that integrates the Detection Transformer (DETR) with a Graph Convolutional Transformer (GCT) and Gating Mechanisms. This model is designed to capture both spatial and temporal dependencies more effectively while optimizing feature selection, leading to improved pose estimation accuracy and efficiency. Our approach outperforms current state-of-the-art methods, particularly in challenging scenarios, as demonstrated through extensive experiments on the PoseTrack Dataset. Experimental results show that the proposed model achieves superior performance across key metrics such as mean Average Precision (mAP), PCK@0.5, and Recall, while maintaining real-time processing capabilities. This research contributes to the field by offering a more robust solution for pose estimation in real-world, complex environments, with potential applications in sports analysis, surveillance, and human-robot interaction.

The International Consensus Conference "Optimising Performance of the Elite Athlete," held in November 2024, brought together 29 scientists, some coaches, and athletes to establish evidence-based consensus statements aimed at enhancing elite athletic performance and health. The conference addressed critical themes including training strategies, nutrition, female athlete considerations, injury management, and emerging technologies. Key conclusions emphasize individualized, sport-specific approaches to training and nutrition, integrating concurrent training modalities to improve endurance, resilience, and efficiency. Nutrition strategies highlight the importance of tailored energy and macronutrient periodization, recognition of low energy availability risks, and cautious use of dietary supplements. Special attention was directed to female athletes, advocating for improved monitoring of menstrual cycles and hormonal status, while acknowledging current knowledge gaps in hormonal influences on performance and injury risk. Injury prevention remains a challenge, with tendon overuse and Achilles tendon ruptures significantly impacting athlete careers; rehabilitation should rely on criteria-based progression and multidisciplinary input. Emerging technologies, including wearable sensors and multi-omics analyses, hold promise for personalized training and nutrition but require further validation in elite contexts. Despite robust consensus, the panel identified substantial research gaps, particularly regarding female athletes, longitudinal training effects, and efficacy of novel interventions. This consensus provides a practical, scientifically grounded framework to optimize elite athlete performance and health, while underscoring the need for continued research to address outstanding questions and promote inclusive evidence-based practices.

To evaluate the trends, quality, and scope of orthopedic research output from Saudi Arabia between 2017 and 2022, providing insights for future research planning and development. A systematic search was conducted on the PubMed database to identify English-language orthopedic publications published from Saudi Arabia between January 2017 and December 2022. Articles were screened in stages and categorized based on subspecialty, study design, geographical origin, and citation metrics. Data analysis was performed using Stata 15 (Stata Corp LLC, Texas, USA). A total of 348 articles met the inclusion criteria. The annual publication rate increased significantly over the six years, peaking in 2022. The most frequently studied subspecialty was spine surgery, accounting for 75 articles (21.5%), followed by arthroplasty with 69 articles (19.8%). Case reports with 98 articles (28.1%) and cross-sectional studies with 90 articles (25.8%) were the most common study designs. Geographically, the central region produced the majority of publications, with 208 articles (59.7%). Citation analysis revealed the highest impact in spine surgery (H-index = 12), followed by sports medicine (H-index = 10) and pediatric orthopedics (H-index = 9). Orthopedic research in Saudi Arabia has shown steady growth, with particular strengths in spine and sports research. However, there is a need for broader subspecialty representation, enhanced research quality, and greater geographic diversity. Strategic investments in research infrastructure, mentorship, and high-impact studies are essential to elevate the visibility and clinical relevance of Saudi orthopedic research.

Erector spinae plane block (ESPB) improves recovery and reduces opioid use, while intraoperative blood pressure variability (IBPV) negatively impacts postoperative outcomes. This study evaluates ESPB's efficacy in reducing IBPV and improving perioperative outcomes in transforaminal lumbar interbody fusion (TLIF). We retrospectively analyzed TLIF patients with and without ESPB from January 2021 to June 2023. ESPB was performed under ultrasonography guidance by anesthesiologists or operators. Intraoperative arterial blood pressure was assessed. Coefficient of variation (CV) and mean arterial pressure difference (MAPD) were calculated as IBPV metrics. Secondary outcomes included blood loss, operation time, postoperative pain, morphine consumption, time to line removal, and discharge. Sixty patients (30 ESPB, 30 non-ESPB) were included, with median ages of 61.3 and 69.5 years, respectively. The ESPB cohort showed significantly lower MAPD (42.0 mmHg vs. 47.1 mmHg, p = 0.02), CV (13.0% vs. 14.7%, p = 0.01), blood loss (268.3 mL vs. 426.7 mL, p < 0.01), and blood loss per level (105.1 mL vs. 157.6 mL, p = 0.02). ESPB also reduced pain in the recovery room (4.7 vs. 6.7, p < 0.01) and on postoperative day 1 (2.3 vs. 2.8, p < 0.01) and accelerated nutritional recovery (1.7 days vs. 3.0 days, p < 0.01). The only complication was observed in the non-ESPB group. ESPB significantly reduced IBPV, blood loss, and postoperative pain in TLIF. It also resulted in lower morphine consumption and earlier mobilization, though these differences did not reach statistical significance. No ESPB-related complications were observed, supporting its safety and its role as an effective component of perioperative management in spine surgery.

Pediatric orthopedic care in Vietnam has experienced transformative growth over the past three decades, overcoming challenges unique to low-resource settings through innovation, collaboration, and dedication. This review explores Vietnam's progress in managing congenital deformities, trauma care, and rehabilitation, with a focus on decentralized care delivery, cost-effective surgical techniques, and capacity-building initiatives. Highlighting the critical roles played by the Vietnam Pediatric Orthopaedic Association and international collaborations, this analysis underscores the impact of tailored interventions and multidisciplinary approaches. By integrating technology, fostering education, and addressing systemic disparities, Vietnam exemplifies the potential for sustainable advancements in pediatric orthopedic care globally, even amidst resource constraints.

Wrist arthroscopy is a valuable tool in hand surgery. However, as with every tool, its use must be executed by the right hands with the right training and right instrumentation. In this article, four papers on arthroscopy were examined for their contribution to the literature and to reflect on the evolving role of arthroscopy in hand surgery. The dorsal sensory branch of the ulnar nerve remains vulnerable with the placements of ulnar portals. Building from previous work, a 'nerve density' concept was presented, as it relates to wrist pronation and supination. The advent of arthroscopy has allowed the closed repair of triangular fibrocartilage complex injuries with better healing potential. Well-defined anatomical landmarks allow more precise placement of suture materials which need to be used judiciously to avoid further injuries. Likewise, scaphoid non-union can be successfully treated as a closed procedure using arthroscopy. A surgeon's learning journey was revealed as a change in practice to obtain the best results. Perilunate injuries can also be treated arthroscopically, but the problems related to bone-ligament interface healing remain unsolved. These publications reflect the increasing usage of this valuable tool and the lessons learnt would further optimize results and avoid pitfalls. Major breakthroughs in wrist arthroscopy in the near future may be obtained through better training and education. Research into the healing of the bone-ligament interface would allow more judicious use of implants.

This systematic review summarizes the state of historically underrepresented minority and gender diversity in foot and ankle surgery (FA) at multiple levels, particularly leadership and research productivity. A literature search was performed following the PRISMA (Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA) guidelines. Included studies presented demographics regarding diversity within FA and provided trends in rank, leadership, or research. Ten cross-sectional studies were included and assessed for quality using the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) cross-sectional study checklist. Demographics on hundreds of FA applicants, attendings, fellowship directors, and researchers/research articles were collected. Results show disparity at each level, particularly in leadership with females accounting for one (5.5%) chair, three (15.8%) program directors, five (9.8%) division chiefs, three (4.4%) fellowship directors, and one (0.9%) professor. Although there has been an increase from 12% to 14% females in FA from 2010 to 2019, parity is not met. Recognition of the lack of diversity within FA will allow for targeted approaches to an equitable workforce. (Journal of Surgical Orthopaedic Advances 34(2):062-068, 2025).

The 2025 AANA Annual Meeting delivered a robust program featuring cutting-edge instructional course lectures, case-based debates, innovation spotlights, and original research presentations. The multidisciplinary scope-from shoulder and knee to hip, elbow, foot, and ankle-ensured relevance for arthroscopists at every stage of practice. We look forward to seeing you in the Valley of the Sun, Phoenix, Arizona, May 14-16, 2026, for AANA26.

Outpatient surgery is gaining in importance, not least due to the politically driven structural transformation in the German healthcare system. As a result, more and more trauma surgery and orthopedic procedures as well as corresponding inpatient services are being carried out on an outpatient basis. Assuming a correct selection of suitable patients and a comprehensive outpatient care structure, outpatient surgery is not only less expensive but is also associated with increased patient satisfaction and safety. While other countries already have established outpatient care systems in place, these still need to be developed and expanded in Germany. The outpatient trend in hospital medicine aims to relieve hospitals, create resources and counteract the rising costs in the healthcare system. This requires a financially sustainable, cost-effective and patient-centered approach that does not harm either the patient or the healthcare provider.

Fosbury flop tears (FFTs) are a type of rotator cuff tear characterized by the tendon flipping upon itself and adhering medially. These tears have been observed arthroscopically as either bursal-sided partial-thickness tears (BSPTTs) or full-thickness tears (FTTs), though the mechanism leading to FFTs in these tear types remains unclear. This study aimed to investigate the clinical features, acromial morphology, and treatment outcomes of FFTs, stratifying patients into BSPTT and FTT groups. We included patients with small-to-medium-sized supraspinatus tendon tears who underwent arthroscopic rotator cuff repair (ARCR). Those with BSPTTs were categorized as Group P, and those with FTTs as Group F. Variables such as age, sex, diabetes mellitus status, critical shoulder angle (CSA), lateral acromial angle (LAA), sagittal and coronal acromion morphologies, Japanese Orthopaedic Association (JOA) score, and retear rate were evaluated. Group P consisted of 13 patients, primarily younger males with traumatic tears, while Group F included 40 patients, with a higher proportion of females. There were no significant differences between the groups in CSA, LAA, JOA scores, or retear rates. Both groups had a high prevalence of double-floor type osteophytes in coronal acromial morphology. FFTs were frequently observed in both BSPTTs and FTTs, particularly in patients with double-floor osteophytes. BSPTTs with FFTs may be more common in younger patients with trauma. Overall, ARCR outcomes for FFTs were similar between BSPTTs and FTTs, suggesting similar efficacy in treatment across these tear types.

The long head of the biceps has traditionally been ignored, tenodesed, or tenotomized during shoulder arthroscopy. However, more recently, it has been recognized as robust autograft tissue that may be mobilized or harvested to aid in a range of augmentation and reconstructive procedures. Several applications are included in this infographic. An intertendinous augmentation (biologic superior capsular reconstruction) technique is indicated in massive tears that are either partially or completely reparable. The intact biceps tendon is mobilized from the groove, transposed and secured to the greater tuberosity, and used as a convergence post to augment the repair. Anterior cable reconstruction is indicated in supraspinatus tears with a deficient anterior cable. The intact biceps tendon is tenotomized in the groove and its most proximal portion is used to reconstruct and incorporate the deficient anterior cable. The insertional augmentation ("sandwich") technique is indicated in tears with inadequate lateral mobility. The biceps tendon is released from its proximal insertion, redirected along the greater tuberosity, and incorporated into the lateral rotator cuff margin to augment and offload the repair. The biceps autograft superior capsular reconstruction ("snake") technique is indicated in massive irreparable tears. The intact biceps tendon is released as distally as possible to maximize autograft and arthroscopically routed back and forth between the glenoid and greater tuberosity to fashion an autograft superior capsular reconstruction. The autograft patch ("biceps smash") technique offers an alternative to biologic patches. The patch can augment partial rotator cuff tears without repair or reinforce cuff repairs with compromised, degenerative tissue. The proximal biceps tendon is harvested, processed extracorporeally, and reintroduced to the shoulder. Finally, in upper border subscapularis repairs with excessive tension or poor tissue quality, the biceps can be released at its proximal insertion and secured to the subscapularis tendon to supplement and offload the repair. Although far from an exhaustive list of all biceps tendon applications, these techniques are useful additions for the toolbox of a shoulder arthroscopist.

Bilateral open knee dislocation is an extremely rare injury, with only one previously documented case in the literature. A 65-year-old male sustained bilateral open knee dislocations in an agricultural accident. The left knee was treated with early multiligamentous reconstruction, achieving full recovery. The right knee, complicated by infection and extensive bone loss, required multiple debridements, soft tissue coverage with a medial gastrocnemius flap, and primary arthrodesis. At 18 months, the patient walked independently, with full function in the left knee and a stable, painless right knee. This case highlights the importance of staged management and individualized treatment strategies in complex knee trauma.

Early accurate diagnosis of osseous and soft tissue injuries following acute knee trauma is crucial for guiding clinical management and preventing chronic instability. Radiography is the appropriate first imaging test applied to detect traumatic osseous injuries. CT is indicated based on clinical symptoms and radiographic concordance. In this acute phase, soft tissue injuries are often clinically overlooked due to swelling and restricted motion, which significantly limit comprehensive physical examination. Moreover, both x-ray and conventional CT imaging are insufficient for addressing this issue due to their limited soft tissue contrast resolution. If clinical suspicion of soft tissue injury persists, an MRI will be performed at a later stage. This may lead to undesirable delays in diagnosis and treatment, thereby potentially impacting patient outcomes. Photon-counting detector CT (PCD-CT) offers enhanced, integrated diagnostic possibilities. The use of spectral imaging data, including color-coded virtual non-calcium (VNCa) images, enables the detection of bone marrow edema (BME) and visualization of key stabilizing soft tissue structures, which may assist emergency department clinicians in determining initial treatment, follow-up, and the need for additional imaging. This technical note illustrates the integral use of ultra-high resolution spectral PCD-CT in a case of a knee injury following an alpine skiing accident. RELEVANCE STATEMENT: The integration of photon-counting detector computed tomography with spectral imaging in acute knee trauma enhances visualization of osseous and soft tissue structures, improving diagnostic accuracy. It may optimize early triage and guide initial treatment for soft tissue injuries. KEY POINTS: Photon-counting detector CT (PCD-CT) enables comprehensive fracture, edema, and soft tissue assessment. Case-based notable correlation between injuries suspected on color-coded spectral imaging and MRI. Photon-counting detector CT (PCD-CT) may enhance early clinical decision-making in knee trauma.

Background The study aimed to analyze the clinical factors influencing the surgical outcomes of distal humeral fractures in adults, providing a reference for improving prognosis. Methods from January 2017 to December 2023, clinical data from 130 patients were collected; 91 met inclusion criteria and were included in the analysis. Factors such as age, gender, BMI, laterality, causes of injury, whether the injury was open, fracture classification, use of arch support, and the quality of fracture reduction were analyzed for their impact on outcomes. Results Ninety-one patients were included in the study. Evaluation showed 67 patients had excellent outcomes, 11 had good outcomes, 10 fair, and 3 poor, with an excellent/good rate of 85.71%. Univariate analysis indicated that use of arch support, number of distal fragment screws, early joint range of motion, time to initiation of postoperative exercises, and duration of hospitalization were all significantly associated with outcomes (p < 0.05). Multivariate linear regression analysis revealed that the use of arch support, the number of screws, postoperative functional exercise, and duration of hospitalization were independent factors influencing surgical outcomes (p < 0.05). Correlation analysis showed that arch support, number of screws, postoperative exercise, patient satisfaction, and hospitalization duration were all significantly associated with functional outcome (p < 0.05). Conclusion Prolonged hospitalization was a risk factor for poor outcome, whereas use of arch support, postoperative functional exercise, and additional distal screws were protective factors. These findings may improve clinical management of distal humeral fractures.

Technological advancements in orthopaedic oncology continue to augment our approach to surgical interventions. However, the impact on patient outcomes following lower extremity bone tumor resections remains under-characterized. This systematic review identifies the impact of various technological advancements on post-operative outcomes. A systematic search of PubMed, Embase, and Cochrane Library databases (2014-2024) identified studies on lower extremity bone tumor resections involving 3D prostheses/patient-specific instruments (3D PSI), intraoperative navigation, and control conventional surgeries. Individual case reports, cadaveric, and animal studies were excluded. Two reviewers independently screened abstracts and extracted Musculoskeletal Tumor Society (MSTS) scores and data on complications (infections, fractures, revisions). Interventions were segmented by use of technology in surgery between 3D patient-specific instrumentation (PSI), intraoperative navigation and conventional approaches. Descriptive analysis was employed to calculate the weighted means, frequencies, and proportions of complications across technology subgroups. Out of 2841 studies screened, 40 studies with 606 patients met inclusion criteria. Average patient age was 30.7 ± 14.3 years with mean follow-up period of 32.9 ± 20.5 months. Overall complication rates were 11.9 ± 12.9 for 3D PSI, 16.4 ± 16.7% for intraoperative navigation, and 32.7 ± 2.8% for conventional. Weighted mean infection rates were 3.3 ± 6.2% for 3D PSI, 3.4 ± 4.3% for intraoperative navigation, and 7.2 ± 7.8% for conventional. Mean revision rates were 1.6 ± 5.4% for 3D PSI, 2.5 ± 5.6% for intraoperative navigation, and 7.2 ± 3.1% for conventional. Weighted mean MSTS scores were similar between groups (26.4 ± 4.4 3D PSI, 25.4 ± 2.8 intraoperative navigation, 26.2 ± 6.2 conventional). This Level III Evidence study's results suggest that application of technological advances to operative management of musculoskeletal tumors may decrease complication rates while maintaining MSTS scores.

As non-invasive targeted therapeutic modalities, photodynamic therapy (PDT) and sonodynamic therapy (SDT) have demonstrated significant clinical potential in orthopedic disorders management. PDT generates reactive oxygen species (ROS) through photosensitizer activation under specific light wavelengths, selectively inducing apoptosis in pathological cells. SDT employs sonosensitizers activated by low-intensity ultrasound to produce ROS while offering enhanced depth of tissue penetration. Current advancements reveal clinical efficacy in bone tumor ablation, management of osteomyelitic infections, intervention for degenerative bone diseases, and bone regeneration applications. However, clinical translation faces three principal challenges: i) PDT's photonic penetration constraints coupled with tumor tissue hypoxia; ii) SDT efficacy limitations from inhomogeneous energy dispersion in therapeutic acoustic fields and challenges in precise modulation of inertial cavitation thresholds; iii) Persistent standardization deficits in longitudinal biosafety assessment frameworks and treatment dosimetry. This review systematically elucidates molecular mechanisms and targeted regulatory pathways of PDT/SDT for orthopedic pathologies, critically evaluates therapeutic efficacy based on preclinical and clinical evidence, and proposes translational strategies focusing on novel sensitizer development, combination therapeutic strategies, and intelligent platform technologies. Future investigations should prioritize sensitizer structural optimization, establishment of standardized treatment protocols, and integration of multimodal image-guided systems to facilitate comprehensive clinical translation of PDT/SDT in precision orthopedics.

Artificial intelligence (AI) has garnered increasing attention in the medical field. As the core technology of AI, deep learning (DL) has been extensively applied to the imaging-based screening of orthopedic diseases, primarily including image classification, segmentation, and risk prediction. This review systematically summarizes recent research advances, methodologies, and clinical applications of AI-assisted diagnostic technologies in orthopedic imaging, highlighting the practical value and development trends of DL in this field. By retrieving literature published over the past five years in PubMed and the Web of Science Core Collection, this study emphasizes the application of DL-based techniques in the screening of orthopedic conditions, such as osteoarthritis (OA), osteoporosis (OP), and bone tumors. The results demonstrate that DL-based methods exhibit excellent diagnostic performance and considerable clinical potential. However, despite the rapid increase in research output, there are still several challenges in this field, including the lack of high-quality datasets, the limited cross-institutional generalizability of models, the absence of standardized quality control protocols, and the urgent demand for multicenter clinical validation. Overall, DL holds great promise for enhancing diagnostic accuracy and improving patient outcomes in orthopedic imaging.

Chondrosarcomas of the pelvis represent a challenge in clinical management because surgical resection is the only effective therapeutic option, given the resistance to radiotherapy and chemotherapy of malignant chondroid tumors. Reconstruction after resection involves critical structures, such as the acetabulum or hip joint, and is a demanding surgical procedure with high morbidity. Complications are frequent due to the complex anatomy of the pelvis, which on the one hand makes it difficult to obtain adequate surgical margins, and on the other hand, the various implants designed for reconstruction have shown a high rate of mechanical and infectious complications. In this report, we present an innovative technique for pelvic reconstruction after resection of the acetabular region (Enneking type II resection), whose planning included the use of a three-dimensional printed model (3D printing) of the patient's pelvis. We describe a case of a 39-year-old patient with a grade 2 central chondrosarcoma. Surgical treatment included 3D model planning, followed by tumor resection and reconstruction of the acetabulum using conventional implants. The main mechanical support of the technique in this case was achieved using threaded Schanz wires as osteosynthetic fixation of the anterior and posterior columns, on which an acetabular basket was cemented. Although at six months, a fracture of the remaining iliac bone and slight elevation of the hemipelvis occurred, this did not mean pain or impairment of the ability to walk with a cane. This particular cost-effective technique allowed the functional reconstruction of the hip, at least in the medium term, so it can be considered as an alternative in resections in zone II of the pelvis. In comparison to customized 3D-printed implants, this approach represents a more cost-effective option, particularly in settings with limited resources. While personalized implants offer superior anatomic fit, they require specialized manufacturing and high costs, often limiting their accessibility. In contrast, this technique utilizes standard implants with planning aided by 3D models, allowing surgeons to tailor reconstructions without reliance on custom hardware. Given these advantages, the method may be adaptable to a broader range of complex pelvic resections where institutional resources are constrained.

The primary objective of orthopedic oncologists is to perform bone tumor surgeries with tumor-free margins for malignant tumors and complete clearance of benign bone diseases. The functional outcome depends on the salvage of important structures and optimal reconstruction of the bony defect. On-going advances in technology have helped in 3-dimensional templating of patient's anatomy and real-time tracking of instruments during surgery. Computer navigation system joins patients' imaging information to real-time anatomy by using tracking and registration of pre- and/or intra-operative acquired images. We share our experience with 15 navigation-assisted surgeries performed at a single institute. We used BrainLab navigation system coupled with the Ziehm vision RFD 3D C-arm for intra-op registration in our cases. Our study did not compare the accuracy of the resection with the intended plan using imaging in all cases; however, margins were negative in all malignant cases. These patients were followed up for a short period. Multicenter comparative studies with longer follow-ups are required to establish their clinical effectiveness. Current evidence suggests that this technology may be applicable in challenging anatomical locations and joint/physis preserving tumor surgery to achieve precise resections or curettages that accurately match intended resection plans.