Abstract
BACKGROUND: A systematic review was conducted to provide an overview of the performance of optically tracked instrumented pointers in motion analysis. Due to the insights provided, relevant research on pointers using very similar principles in surgical navigation is also included. METHODS: English language articles published up until April of 2025 were searched with keywords like 'pointer', 'anatomical landmark' and 'motion analysis' that report on a measurement design adequate to assess pointer performance in appropriate detail. RESULTS: The included databases were Scopus, ScienceDirect, PubMed and Web of Science. The search resulted in a total of 192 unique articles. Two researchers screened the records and followed up on references that were potentially relevant based on their citation context. One hundred twenty-five additional articles were identified this way. A total of 24 papers were included in the final review: 16 related to surgical navigation, and 8 to motion analysis. CONCLUSIONS: Based on the narrative synthesis, motion capture-based pointers for motion analysis can have errors as large as 5 mm, while the expected errors of surgical navigation pointers are below 1 mm. The most critical factors in pointer performance, besides the measurement volume of the tracking system, are the instrument's length, the arrangement of the tracked instrumenting markers and the quality of the tip's calibration, which determines the relative position of the pointer tip compared to the instrumenting markers. The insights from the research covered in this review can help set a benchmark for performance for current and future localiser systems, both in motion analysis and in surgical navigation. Users of such systems can use this information to check and compare the performance of their systems, while developers and researchers can use the data to develop more accurate systems and pointers.