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Upon initiating the case, you will advance to the PRE-OP state, following the specific procedure and the side you have previously chosen. It is important to note that each subspecialty and procedure possesses unique characteristics.
PeekMed web autonomously generates all machine learning models outlined here, offering you a comprehensive overview of the patient's clinical status. In the center of this interface, you will observe the bone segmentation model with landmarks. If you are using X-ray imaging, a 2D segmentation will be presented. Conversely, when working with a CT scan, you will see a 3D segmentation accompanied by a multiplanar reconstruction (MPR) in 2D.
PeekMed web efficiently calculates the procedure measurements based on the landmarks, which you will need to validate. Each measurement name, along with its corresponding pre-value, is displayed in a floating window for your reference. If certain measurements share landmarks across multiple bones, they will be repeated for clarity. In the Pre-op window, you can easily select individual bones using the buttons labeled with their names whenever they are available. This allows you to view the pre-value measurements specific to each bone, ensuring you have the necessary information at hand. Additionally, this state provides the option to edit landmarks as needed.
In the PRE-OP state, you have the opportunity to thoroughly review and approve the bone model and anatomical landmarks associated with the bone(s), as well as confirm all pre-value measurements. It is essential to note that once this confirmation is made, the approval cannot be reversed; you will need to initiate a new case for any changes.
Warning: The automatically positioned landmarks are designed to enhance the efficiency of your planning process; however, they should not be considered a substitute for professional medical judgment. It is crucial that you validate the positions of all landmarks using your clinical expertise. If necessary, feel free to adjust the landmarks manually to ensure accuracy.
Access to this state is facilitated through the top menu bar by selecting the “PRE-OP" button in the navigation bar. Please be aware that in this reader mode, any previously approved changes cannot be modified.
Edit landmarks
The PeekMed web platform automatically assigns an initial position for each anatomical landmark. To make adjustments to the landmark's location, simply click the “Edit landmarks” button located in the PRE-OP window.
Anatomical landmarks serve as essential reference points displayed alongside the bone segmentation model. They pinpoint specific locations within the bone, enabling accurate measurement calculations.
While in the landmarks editing mode, hovering over a landmark within the bone model or the multiplanar reconstruction (MPR) will display its caption and representation in the floating window. It is important to review each landmark carefully, and if you find that the automatic placement does not meet your expectations, you have the flexibility to reposition the landmark to your preferred location.
To preserve the adjustments you've made, simply click the “Save” button within the “Edit landmarks” window. This will ensure that any measurements calculated using the newly positioned landmarks are updated accordingly. If you prefer to retain the original landmarks without making any changes, you may click on the “Go Back” button to revert to the previous settings.
Additional information
The PRE-OP state plays a crucial role in identifying the necessary corrections for the subsequent Plan state. During the planning of a Knee Osteotomy, you will encounter a slider that allows you to define the desired Weight Bearing Position (WBP), which indicates the percentage at which the mechanical axis line intersects the tibial plateau line. This slider can be adjusted from its default value to tailor the planning to your specific needs.
The "Frontal Plane Angle (FPA)" dropdown becomes accessible during the planning of an Hallux Valgus - Lapidus in 2D models, showcasing PeekMed's recommended measurement value. You have the flexibility to adjust this value as needed.
For further understanding, you can click the informative text button adjacent to the dropdown, which will display a message box with additional context regarding these measurements. If the dropdown menu is not opened, a prompt will appear asking you to confirm your agreement with the suggested value. This confirmation is necessary before you can proceed to approve the pre-op state.