In joint replacement surgery, Patient Specific Surgical Guides (PSSGs) are used for accurate alignment of implant components. PSSGs are designed preoperatively to have a geometric fit with the patient’s bone such that the incorporated guidance for drilling or cutting is instantly aligned (a). It is essential that the position of the PSSG is maintained, and hence, the influence of the location and direction of the pushing force should be minimal. The extent that the pushing force may vary is what we refer to as docking robustness. In this article, we present a docking robustness framework comprising quantitative measures and graphical tool. The contact efficiency and guide efficiency measures can successively be used to find appropriate contact locations and an appropriate location for the application surface. Robustness maps (b) graphically depict for a chosen contact set the allowed variation in the surgeons pushing force. An optimization of the PSSG dimensions for the distal femur shows that twelve contacts already result in a relatively high contact efficiency. The re-located application surface S2 (b) increases the guide efficiency as it is located in brighter parts of the robustness map.
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