Desenvolvimento e avaliação de usabilidade de aplicação web de planejamento em artroplastias totais do joelho

Abstract

Preoperative planning for total knee arthroplasty (TKA) enables the anticipation of intraoperative challenges, increases the likelihood of surgical success, and reduces complications. A structured planning methodology implemented through a web-based application, eliminating the need for printed radiographic films or photographing examinations, and capable of directly utilizing DICOM-format Imaging, may streamline the planning process and contribute to improved outcomes in TKA.The objectives of this study were: to develop a web application for preoperative planning in TKA; to implement, within this application, the preoperative planning protocol previously developed and incorporated by the author into the ATJ® mobile application; to evaluate its usability by comparing it to the ATJ® mobile application; to measure and compare the time required for planning between the developed web application and the ATJ® mobile application; and to compare the accuracy of the web application in measuring the angle between the anatomical and mechanical axes of the femur (AAMF) relative to the ATJ® application.The application was developed using the React® framework, the JSXGraph® library, the pydicom library, the SQLite® database, and the CloudflareR2® service, with communication between the interface and server established via HTTPS protocol and SSL/TLS encryption. Following development, the application underwent usability testing, evaluated by 24 volunteers: 8 orthopedic surgeons affiliated with the Brazilian Society of Knee Surgery (SBCJ), 8 orthopedic surgeons not affiliated with the SBCJ, and 8 orthopedic surgery residents.Using the System Usability Scale (SUS) questionnaire, a SUS score of 90.3 was obtained, corresponding to grade A in the Bangor classification and A+ on the Sauro and Lewis scale. Compared to the ATJ® application, the new web application reduced the time required for planning by 41%. It enabled preoperative TKA planning through direct use of DICOM-format radiographic exams, implementing a guided planning protocol previously adopted in the ATJ® mobile application. The web application demonstrated excellent usability, proved accurate in AAMF measurement, and significantly reduced average planning time compared to the mobile version, positioning itself as a technological alternative to conventional planning approaches.