scholarly journals A Novel Computer-Assisted Workflow for Treatment of Osteochondral Lesions in the Knee

10.29007/m4z1 ◽  
2020 ◽  
Author(s):  
Fabio Tatti ◽  
Hisham Iqbal ◽  
Branislav Jaramaz ◽  
Ferdinando Rodriguez Y Baena
Keyword(s):  
Surgical Planning ◽  
Surgical Instruments ◽  
Osteochondral Lesions ◽  
Computer Assisted ◽  
Osteochondral Defects ◽  
Surgical Workflow ◽  
Computer Assisted Orthopaedic Surgery ◽  
Accuracy And Repeatability ◽  
Cause Of Pain ◽  
Surgical System

Computer-Assisted Orthopaedic Surgery (CAOS) is now becoming more prevalent, especially in knee arthroplasty. CAOS systems have the potential to improve the accuracy and repeatability of surgical procedures by means of digital preoperative planning and intraoperative tracking of the patient and surgical instruments.One area where the accuracy and repeatability of computer-assisted interventions could prove especially beneficial is the treatment of osteochondral defects (OCD). OCDs represent a common problem in the patient population, and are often a cause of pain and discomfort. The use of synthetic implants is a valid option for patients who cannot be treated with regenerative methods, but the outcome can be negatively impacted by incorrect positioning of the implant and lack of congruency with the surrounding anatomy.In this paper, we present a novel computer-assisted surgical workflow for the treatment of osteochondral defects. The software we developed automatically selects the implant that most closely matches the patient’s anatomy and computes the best pose. By combining this software with the existing capabilities of the Navio™ surgical system (Smith & Nephew inc.), we were able to create a complete workflow that incorporates both surgical planning and assisted bone preparation.Our preliminary testing on plastic bone models was successful and demonstrated that the workflow can be used to select and position an appropriate implant for a given defect.

scholarly journals An Exploration of Augmented Reality in Computer Assisted Orthopaedic Surgery

10.29007/72d4 ◽  
2018 ◽  
Author(s):  
He Liu ◽  
Edouard Auvinet ◽  
Joshua Giles ◽  
Ferdinando Rodriguez Y Baena
Keyword(s):  
Augmented Reality ◽  
Three Dimensional ◽  
Hole Drilling ◽  
Depth Information ◽  
Computer Assisted ◽  
Pilot Hole ◽  
Surgical Workflow ◽  
Processing Depth ◽  
Computer Assisted Orthopaedic Surgery ◽  
Preoperative Plan

Computer Aided Surgery (CAS) is helpful, but it clutters an already overcrowded operating theatre, and tends to disrupt the workflow of conventional surgery. In order to provide seamless computer assistance with improved immersion and a more natural surgical workflow, we propose an augmented-reality based navigation system for CAS. Here, we choose to focus on the proximal femoral anatomy, which we register to a plan by processing depth information of the surgical site captured by a commercial depth camera. Intra-operative three-dimensional surgical guidance is then provided to the surgeon through a commercial augmented reality headset, to drill a pilot hole in the femoral head, so that the user can perform the operation without additional physical guides. The user can interact intuitively with the system by simple gestures and voice commands, resulting in a more natural workflow. To assess the surgical accuracy of the proposed setup, 30 experiments of pilot hole drilling were performed on femur phantoms. The position and the orientation of the drilled guide holes were measured and compared with the preoperative plan, and the mean errors were within 2mm and 2°, results which are in line with commercial computer assisted orthopedic systems today.

scholarly journals Automatic Bone Surface Restoration for Markerless Computer-assisted Orthopaedic Surgery

2021 ◽  
Author(s):  
Xue Hu ◽  
Ferdinando Rodriguez y Baena
Keyword(s):  
Synthetic Data ◽  
Computer Assisted ◽  
Bone Surface ◽  
Tracking Accuracy ◽  
Surgical Workflow ◽  
Registration Algorithm ◽  
Computer Assisted Orthopaedic Surgery ◽  
Femur Geometry ◽  
Conventional Computer ◽  
Intact Femur

Abstract An automatic markerless knee tracking and registration algorithm has been proposed in the literature to avoid the marker insertion required by conventional computer-assisted knee surgery, resulting in a shorter and less invasive surgical workflow. However, such an algorithm considers intact femur geometry only. The bone surface modification is inevitable due to intra-operative intervention. The mismatched correspondences will degrade the reliability of registered target pose. To solve this problem, this work proposed a supervised deep neural network to automatically restore the surface of processed bone. The network was trained on a synthetic dataset that consists of real depth captures of a model leg and simulated realistic femur cutting. According to the evaluation on both synthetic data and real-time captures, the registration quality can be effectively improved by surface reconstruction. The improvement in tracking accuracy is only evident over test data, indicating the need for future enhancement of the dataset and network.

scholarly journals Towards Markerless 3D Pose Estimation for Computer Assisted Orthopaedic Surgery: a Comparison Study of Depth Cameras

10.29007/zfg2 ◽  
2020 ◽  
Author(s):  
Jérôme Ogor ◽  
Guillaume Dardenne ◽  
Salaheddine Sta ◽  
Julien Bert ◽  
Hoel Letissier ◽  
...  
Keyword(s):  
Surgical Navigation ◽  
Real Data ◽  
Surgical Instruments ◽  
Computer Assisted ◽  
Clinical Environment ◽  
3D Pose Estimation ◽  
Point Pair ◽  
Depth Cameras ◽  
Computer Assisted Orthopaedic Surgery ◽  
Novel Method

This abstract addresses the problem of localizing surgical instruments during orthopaedic surgeries. Compared to usual approaches based on surgical navigation with markers, we propose here a novel method that estimates the 6-DoF pose of surgical instruments without specific markers using a depth camera. The goal of this paper is to compare, on real data, the registration precision of an algorithm called Point Pair Features (PPF) according to consumer depth cameras available on the market. Experimental validation using sawbones has been conducted and 8 cameras have been tested in realistic clinical environment. The Kinect Azure reports the best precision with a registration error of 1.13mm ± 1.00mm.

Navigation in Computer Assisted Orthopaedic Surgery

2011 ◽  
pp. 205-222 ◽  
Author(s):  
Elena De Momi ◽  
Pietro Cerveri ◽  
Giancarlo Ferrigno
Keyword(s):  
Hip Replacement ◽  
Computer Assisted Surgery ◽  
Quantitative Information ◽  
Computer Assisted ◽  
Navigation Systems ◽  
Innovative Methods ◽  
Computer Assisted Orthopaedic Surgery ◽  
Operative Planning ◽  
Total Knee ◽  
Accuracy And Repeatability

Originally developed for neurosurgery procedures, since late nineties Computer Assisted Surgery (CAS) systems have been used in orthopaedic interventions. Such systems assist the surgeon during the preoperative or the intra-operative planning phase from diagnostic data, during the intra-operative phases of registration and navigation. They provide quantitative information of the overall surgical outcome and allow controlling range of accuracy and repeatability. Despite recognized advance in introducing the computer in the orthopaedic operative room (OR), several aspects are still debated such as operative time prolongation, information provided to the surgeon and user interface management. The chapter is aimed at reviewing main navigation systems as far as the visual and interactive aspects are concerned and at suggesting useful tools in order to enhance the surgeon usability of a navigation system. We developed modules for Total Knee Replacement (TKR) and Total Hip Replacement (THR), named KneeLab and HipLab respectively. In the two applications, we coped with two main aspects of the navigation in knee and hip replacement combining new visualization methods and new working methods. In the chapter, the reader can find a detailed description of the solution proposed to overcome problems commonly found with navigation systems in orthopaedics. We introduced innovative methods and algorithms, new modality of vocal interface, fully 3D graphics, recovery session from file system. The development aimed at the fulfilment of the critical user requirements of the operating room, by providing the user with a tightly guided procedure and an immediate graphical virtual environment.

scholarly journals Computerized image understanding system for reliable estimation of spinal curvature in idiopathic scoliosis

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Ananthakrishna Thalengala ◽  
Shyamasunder N. Bhat ◽  
H. Anitha
Keyword(s):  
Spinal Deformity ◽  
Medial Axis ◽  
Image Understanding ◽  
Spinal Curvature ◽  
Absolute Difference ◽  
Computer Assisted ◽  
Type I ◽  
Observer Variability ◽  
Curvature Estimation ◽  
Accuracy And Repeatability

AbstractAnalysis of scoliosis requires thorough radiographic evaluation by spinal curvature estimation to completely assess the spinal deformity. Spinal curvature estimation gives orthopaedic surgeons an idea of severity of spinal deformity for therapeutic purposes. Manual intervention has always been an issue to ensure accuracy and repeatability. Computer assisted systems are semi-automatic and is still influenced by surgeon’s expertise. Spinal curvature estimation completely relies on accurate identification of required end vertebrae like superior end-vertebra, inferior end-vertebra and apical vertebra. In the present work, automatic extraction of spinal information central sacral line and medial axis by computerized image understanding system has been proposed. The inter-observer variability in the anatomical landmark identification is quantified using Kappa statistic. The resultant Kappa value computed between proposed algorithm and observer lies in the range 0.7 and 0.9, which shows good accuracy. Identification of the required end vertebra is automated by the extracted spinal information. Difference in inter and intra-observer variability for the state of the art computer assisted and proposed system are quantified in terms of mean absolute difference for the various types (Type-I, Type-II, Type-III, Type-IV, and Type-V) of scoliosis.

Mesenchymal Stem Cells in the Treatment of Cartilage Defects of the Knee: A Systematic Review of the Clinical Outcomes

2021 ◽  
pp. 036354652098681
Author(s):  
Monketh Jaibaji ◽  
Rawan Jaibaji ◽  
Andrea Volpin
Keyword(s):  
Systematic Review ◽  
Stem Cells ◽  
Mesenchymal Stem Cells ◽  
Stem Cell ◽  
Mesenchymal Stem Cell ◽  
Osteochondral Lesions ◽  
Common Source ◽  
Significant Heterogeneity ◽  
Osteochondral Defects

Background: Osteochondral lesions are a common clinical problem and their management has been historically challenging. Mesenchymal stem cells have the potential to differentiate into chondrocytes and thus restore hyaline cartilage to the defect, theoretically improving clincal outcomes in these patients. They can also be harvested with minimal donor site morbidity. Purpose: To assess the clinical and functional outcomes of mesenchymal stem cell implantation to treat isolated osteochondral defects of the knee. A secondary purpose is to assess the quality of the current available evidence as well as the radiological and histological outcomes. We also reviewed the cellular preparation and operative techniques for implantation. Study Design: Systematic review. Methods: A comprehensive literature search of 4 databases was carried out: CINAHL, Embase, MEDLINE, and PubMed. We searched for clinical studies reporting the outcomes on a minimum of 5 patients with at least 12 months of follow-up. Clinical, radiological, and histological outcomes were recorded. We also recorded demographics, stem cell source, culture technique, and operative technique. Methodological quality of each study was assessed using the modified Coleman methodology score, and risk of bias for the randomized controlled studies was assessed using the Cochrane Collaboration tool. Results: Seventeen studies were found, encompassing 367 patients. The mean patient age was 35.1 years. Bone marrow was the most common source of stem cells utilized. Mesenchymal stem cell therapy consistently demonstrated good short- to medium-term outcomes in the studies reviewed with no serious adverse events being recorded. There was significant heterogeneity in cell harvesting and preparation as well as in the reporting of outcomes. Conclusion: Mesenchymal stem cells demonstrated a clinically relevant improvement in outcomes in patients with osteochondral defects of the knee. More research is needed to establish an optimal treatment protocol, long-term outcomes, and superiority over other therapies. Registration: CRD42020179391 (PROSPERO).

scholarly journals Transconjunctival excision of an orbital conjunctival cyst using computer‐assisted 3‐D surgical planning in a dog

2021 ◽  
Vol 9 (7) ◽  
Author(s):  
Jessica B. Burn ◽  
András M. Komáromy ◽  
Dodd G. Sledge ◽  
Rebecca Smedley ◽  
Sarah E. Coe ◽  
...  
Keyword(s):  
Surgical Planning ◽  
Computer Assisted ◽  
Conjunctival Cyst
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