This article explains what landmarks and anatomical axes are, why they matter, and how to review and adjust landmarks in the editor. It also explains what to do if a planning result looks wrong.
What are landmarks?
Landmarks are anatomical reference points used for:
Measurements
Planning logic
PSI design features
In the landmark step, you review the landmarks of your case, adjust them if needed and confirm them.
Why landmarks are critical
CustoMED orients bones using anatomical axes.
Axes are derived from landmarks.
Changing landmarks may change the axes, the measurements, the implant orientation and the PSI outputs.
Reviewing and adjusting landmarks
In the landmark step, check each landmark in the 3D view and in the CT slice views.
To move a landmark, drag it along the bone surface in the 3D view, or drag it in a slice view.
If you move one by mistake, click Undo or press Ctrl+Z (Cmd+Z on Mac).
Click Save to keep your work, or Confirm Landmarks to finish the step.
Note: If Confirm Landmarks is disabled, hover over it. The tooltip lists any required landmarks that are missing. You can move existing landmarks, but you cannot add new ones. If one is missing, contact CustoMED support.
For the landmarks and measurements used in each procedure, see Total Knee Replacement (TKR): Landmarks & Measurements Guidelines and Total Shoulder Arthroplasty: Landmarks & Measurements Guidelines.
If a result looks incorrect or unexpected
Everything you see in a step is there for you to review and adjust. Landmarks, implant positions and other planning elements shown in a step are intended to support review and planning. They do not represent medical judgment, final decisions or recommended placement. Final placement and clinical decisions must always be reviewed and verified by the treating clinician.
If you believe an implant, landmark or planning element is not positioned correctly, correct it using the tools provided in the platform:
Adjust or move landmarks.
Modify the implant position, orientation or parameters.
Review the placement against the underlying imaging.
Communicate with collaborators using comments when applicable.
The platform is designed to support fine-tuning and collaboration, so you can bring the plan to the correct clinical position before approval and export. If something cannot be corrected with the available tools, or if you are unsure how to proceed, contact the CustoMED team. We are happy to review the case with you and help make sure the plan reflects your intended outcome.
Video: landmarks in a knee replacement (TKR) case
These walkthroughs show the femoral and tibial landmarks being reviewed in a TKR case.
Best practice
Review every landmark position, and adjust it if needed.
Confirm the landmark step before you move on to planning.