Figure 8.

Surgical simulation of drilling. Here, the 3D CT model of the humerus and the 3D MRI model of the articular cartilage are shown in gray and yellow, respectively. (a) An anteroposterior view of the magnetic resonance imaging-computed tomography fusion image (MCFI) of case 1. The articular surface was smooth with only a small fissure in area 1 (arrow). (b) MCFI with a transparent articular cartilage. The subchondral lesion with sclerosis is shown in red. (c) Simulation of drilling (enlarged anteroposterior view without the articular cartilage). We simulated to penetrate the spots with sclerosis and cyst formation. The entry point is shown as a red spot, and the target point is shown in green. (d) Posteroanterior view. To avoid iatrogenic articular cartilage damage, we simulated posteroanterior drilling in these cases. The green circle with a red spot represents the entry point for drilling. (e) Lateral view. We simulated the direction and depth of drilling.