Topography matching for osteochondral graft transplantation

项目总结/摘要 该项目的总体目标是将骨软骨病的地形匹配算法 同种异体移植的临床应用。膝关节的局灶性软骨缺损很普遍， 在年轻的活跃人群中是疼痛和发病的重要来源。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。的不规则性 供体和受体部位之间的软骨厚度可能导致异常应力和损害 功能评估和了解骨和软骨表面形貌也有助于移植 在骨软骨移植物移植手术过程中的选择。然而，地形评估 对于常规的CT和/或MR成像可能是麻烦和昂贵的。较新的成像技术 新兴的，包括3D扫描与快速智能手机扫描。通过该方法获取的3D图像， 简单，快速，廉价，我们的初步研究支持其作为CT扫描的替代品， 在手术和同种异体移植物准备过程中使用。精确实现移植物的地形匹配 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打印器械进行全肩关节置换术的患者专用器械系统，以及我们的 所提出的用于同种异体移植手术的技术将共享相同的工作原理。的 拟议的项目将利用这些新技术，以转化地形匹配技术， 骨软骨移植从计算机模拟到临床实践。骨软骨移植的局部匹配 使用3D计算机模型计划的移植将在尸体标本上实施并验证 以真实的尸体移植模型为金标准（Aim 1），通过计算机模拟移植模型进行比较。 使用智能手机的新3D成像技术的准确性，这将是临床应用的关键技术。 将通过与作为金标准的激光扫描进行比较来验证（目标2）。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肝硬化的治疗结果。 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损 移植物和周围/相对软骨的退化，反过来，降低未来骨关节炎的风险 发病该项目所获得的技术和知识也可以应用于其他外科手术 涉及3D表面几何形状评估。

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.