Multi-Body 3D-2D Registration for Robot-Assisted Joint Reduction: Preclinical Evaluation in the Ankle Syndesmosis.
Multi-Body 3D-2D Registration for Robot-Assisted Joint Reduction: Preclinical Evaluation in the Ankle Syndesmosis.
复制标题
机器人辅助关节复位的多体 3D-2D 配准：踝关节联合的临床前评估。
DOI：
10.1117/12.2654481
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发表时间：
2023
期刊：
影响因子：
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通讯作者：
Uneri,A
中科院分区：
文献类型：
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作者：
Vijayan,RC;Venkataraman,K;Wei,J;Sheth,NM;Shafiq,B;Siewerdsen,JH;Zbijewski,W;Li,G;Cleary,K;Uneri,A
目的现有的提高下胫腓关节复位准确性的方法存在工作流程挑战、高辐射暴露以及缺乏准确性和精确性，导致手术结果不佳。为了解决这些限制，我们提出了一种使用术中成像进行机器人辅助关节复位的方法，将脱位的腓骨与相对于胫骨的目标姿势对齐。方法该方法(1)通过连接到其末端执行器的定制板适配器的3D-2D配准来定位机器人，(2)使用多体3D-2D配准来定位胫骨和腓骨，以及(3)驱动机器人根据目标计划来复位脱位的腓骨。定制机器人适配器设计用于直接与腓骨板连接，同时呈现射线照相特征以帮助配准。在尸体脚踝标本上评估了配准精度，并通过操纵尸体脚踝中脱位的腓骨来评估机器人引导的可行性。结果使用标准 AP 和榫眼射线照相视图，测量机器人适配器和脚踝骨的配准误差小于 1 毫米和 1°。在尸体标本上进行的实验显示，与预期路径的偏差高达 4 毫米，使用术中成像和 3D-2D 配准引导的校正措施将偏差减少到 <2 毫米。结论临床前研究表明，在腓骨操作过程中会发生显着的机器人弯曲和胫骨运动，从而促使使用所提出的方法动态校正机器人轨迹。通过使用定制设计中嵌入的基准点实现了准确的机器人配准。未来的工作将评估目前正在建设中的定制射线可透机器人设计的方法，并在其他尸体标本上验证该解决方案。
PurposeExisting methods to improve the accuracy of tibiofibular joint reduction present workflow challenges, high radiation exposure, and a lack of accuracy and precision, leading to poor surgical outcomes. To address these limitations, we propose a method to perform robot-assisted joint reduction using intraoperative imaging to align the dislocated fibula to a target pose relative to the tibia.MethodsThe approach (1) localizes the robot via 3D-2D registration of a custom plate adapter attached to its end effector, (2) localizes the tibia and fibula using multi-body 3D-2D registration, and (3) drives the robot to reduce the dislocated fibula according to the target plan. The custom robot adapter was designed to interface directly with the fibular plate while presenting radiographic features to aid registration. Registration accuracy was evaluated on a cadaveric ankle specimen, and the feasibility of robotic guidance was assessed by manipulating a dislocated fibula in a cadaver ankle.ResultsUsing standard AP and mortise radiographic views registration errors were measured to be less than 1 mm and 1° for the robot adapter and the ankle bones. Experiments in a cadaveric specimen revealed up to 4 mm deviations from the intended path, which was reduced to <2 mm using corrective actions guided by intraoperative imaging and 3D-2D registration.ConclusionsPreclinical studies suggest that significant robot flex and tibial motion occur during fibula manipulation, motivating the use of the proposed method to dynamically correct the robot trajectory. Accurate robot registration was achieved via the use of fiducials embedded within the custom design. Future work will evaluate the approach on a custom radiolucent robot design currently under construction and verify the solution on additional cadaveric specimens.