Jérôme Schmid1, Christophe Chênes2, Sylvain Chagué3, Pierre Hoffmeyer4, Panayiotis Christofilopoulos4, Massimiliano Bernardoni5, Caecilia Charbonnier3. 1. Geneva School of Health (HEdS), University of Applied Sciences of Western Switzerland (HES-SO), Av. de Champel 47, 1206, Geneva, Switzerland. jerome.schmid@hesge.ch. 2. Geneva School of Health (HEdS), University of Applied Sciences of Western Switzerland (HES-SO), Av. de Champel 47, 1206, Geneva, Switzerland. 3. Medical Research Department, Artanim Foundation, Geneva, Switzerland. 4. Orthopedics and Trauma Service, University Hospitals of Geneva, Geneva, Switzerland. 5. Medacta International SA, Lugano, Switzerland.
Abstract
PURPOSE: Total hip arthroplasty (THA) aims to restore patient mobility by providing a pain-free and stable artificial joint. A successful THA depends on the planning and its execution during surgery. Both tasks rely on the experience of the surgeon to understand the complex biomechanical behavior of the hip. We investigate the hypothesis that a computer-assisted solution for THA effectively supports the preparation and execution of the planning. METHODS: We devised MyHip as a computer-assisted framework for THA. The framework provides pre-operative planning based on medical imaging and optical motion capture to optimally select and position the implant. The planning considers the morphology and range of motion of the patient's hip to reduce the risk of impingements and joint instability. The framework also provides intra-operative support based on patient-specific surgical guides. We performed a post-operative analysis on three patients who underwent THA. Based on post-operative radiological images, we reconstructed a patient-specific model of the prosthetic hip to compare planned and effective positioning of the implants. RESULTS: When the guides were used, we measured non-significant variations of planned executions such as bone cutting. Moreover, patients' hip motions were acquired and used in a dynamic simulation of the prosthetic hip. Conflicts prone to implant failure, such as impingements or subluxations, were not detected. CONCLUSIONS: The results show that MyHip provides a promising computer assistance for THA. The results of the dynamic simulation highlighted the quality of the surgery and especially of its planning. The planning was properly executed since non-significant variations were detected during the radiological analysis.
PURPOSE:Total hip arthroplasty (THA) aims to restore patient mobility by providing a pain-free and stable artificial joint. A successful THA depends on the planning and its execution during surgery. Both tasks rely on the experience of the surgeon to understand the complex biomechanical behavior of the hip. We investigate the hypothesis that a computer-assisted solution for THA effectively supports the preparation and execution of the planning. METHODS: We devised MyHip as a computer-assisted framework for THA. The framework provides pre-operative planning based on medical imaging and optical motion capture to optimally select and position the implant. The planning considers the morphology and range of motion of the patient's hip to reduce the risk of impingements and joint instability. The framework also provides intra-operative support based on patient-specific surgical guides. We performed a post-operative analysis on three patients who underwent THA. Based on post-operative radiological images, we reconstructed a patient-specific model of the prosthetic hip to compare planned and effective positioning of the implants. RESULTS: When the guides were used, we measured non-significant variations of planned executions such as bone cutting. Moreover, patients' hip motions were acquired and used in a dynamic simulation of the prosthetic hip. Conflicts prone to implant failure, such as impingements or subluxations, were not detected. CONCLUSIONS: The results show that MyHip provides a promising computer assistance for THA. The results of the dynamic simulation highlighted the quality of the surgery and especially of its planning. The planning was properly executed since non-significant variations were detected during the radiological analysis.
Entities:
Keywords:
Guiding blocks; Impingements and joint instability; Joint kinematics; Medical imaging; Pre-operative planning; Total hip arthroplasty
Authors: Ryan M Nunley; Bradley S Ellison; Jinjun Zhu; Erin L Ruh; Stephen M Howell; Robert L Barrack Journal: Clin Orthop Relat Res Date: 2011-12-20 Impact factor: 4.176
Authors: Arnab Palit; Richard King; Zoe Hart; Yolanda Gu; James Pierrepont; Mark T Elliott; Mark A Williams Journal: Ann Biomed Eng Date: 2020-01-22 Impact factor: 3.934