Topography matching for osteochondral graft transplantation

项目摘要/摘要 拟议项目的总体目标是翻译用于骨软骨的地形匹配算法 将同种异体移植应用于临床。膝盖局灶性软骨缺陷症很常见，是一种 在年轻、活跃的人群中，这是疼痛和发病率的重要来源。同种异体骨软骨移植成功 移植取决于移植物的一致性、准备、大小和固定。不规范的地方 供区和受区之间的软骨厚度可能会导致异常应力和受损 功能。对骨和软骨表面形态的评估和了解在移植中也是有用的。 骨软骨移植手术方式的选择。然而，对地形的评价 使用传统的CT和/或MR成像可能既麻烦又昂贵。更新的成像技术是 正在兴起，包括3D扫描和快速智能手机扫描。通过这种方法获得的3D图像是 简单、快速、廉价，我们的试点研究支持将其用作CT扫描的替代方案，并可能 在手术和同种异体移植准备中使用。嫁接地形匹配的精确实现 移植需要适当的器械。我们已经证明了新的3D的准确性和有效性 使用3D打印设备的患者专用器械系统用于全肩关节置换和我们的 提出的同种异体移植程序的技术将分享相同的工作原理。这个 提议的项目将利用这些新技术来将地形匹配技术转化为 骨软骨移植从硅胶移植到临床实践。骨软骨移植的解剖形态匹配 使用3D计算机模型计划的移植将在身体标本上实施并得到验证 将硅胶移植模型与实物移植模型进行比较，作为金标准(目标1)。 使用智能手机的新3D成像技术的准确性，这将是临床上的一项关键技术 将通过与激光扫描作为黄金标准(目标2)进行比较来验证设置。精确地形 在拟议的项目中建立的移植物移植匹配可以改善局灶性疾病的治疗结果 通过增加移植物的稳定性和减少软骨来治疗年轻患者的膝关节软骨缺陷 移植物和周围/对侧软骨的退化，进而降低了未来骨关节炎的风险 开始了。该项目所获得的技术和知识也可应用于其他外科手术。 涉及到三维曲面几何评价。

Project Summary/Abstract The overall goal of the proposed project is to translate topography matching algorithms for osteochondral allograft transplantation to clinical practice. Focal chondral defects of the knee are prevalent and are a significant source of pain and morbidity in the young, active population. Successful osteochondral allograft transplantation is dependent on the congruity, preparation, size, and fixation of the graft. Irregularities in cartilage thickness between the donor and recipient site may lead to abnormal stresses and compromised function. Evaluation and understanding of osseous and chondral surface topography can be also useful in graft selection during surgical procedures in osteochondral graft transplantation. However, evaluation of topography can be cumbersome and expensive with conventional CT and/or MR imaging. Newer imaging technologies are emerging, including 3D scanning with a quick smartphone scan. 3D image acquisition through this method is simple, fast, and inexpensive and our pilot study supports its use as an alternative to CT scanning and could be used during surgery and allograft preparation. Accurate implementation of the topographic matching for graft transplantation requires appropriate instrumentation. We have demonstrated accuracy and efficacy of novel 3D patient-specific instrumentation systems using 3D printed devices for total shoulder arthroplasty and our proposed techniques for allograft transplantation procedures will share the same working principles. The proposed project will utilize these novel technologies in order to translate the topography matching technique for osteochondral transplantation from in silico to clinical practice. Topography matching for osteochondral graft transplantation planned using 3D computer models will be implemented on cadaveric specimens and validated by comparing in silico transplanted model with the real cadaveric transplanted model as a gold standard (Aim 1). Accuracy of the new 3D imaging technique using the smartphone, which will be a key technique in a clinical setting, will be validated by comparing with laser scanning as a gold standard (Aim 2). Accurate topography matching of graft transplantation established in the proposed project can improve treatment outcomes for focal chondral defects of the knee in young patients through increased stability of the graft and decreased cartilage degeneration in the graft and surrounding/opposing cartilage, in turn, reducing the risk for future osteoarthritis onset. The technique and knowledge obtained by the project can also be applied to other surgical procedures involving 3D surface geometry evaluation.