Image-Guided Workstation and Tools for Bone Defects
Image-Guided Workstation and Tools for Bone Defects
批准号:
10460547
负责人:
MEHRAN ARMAND
金额:
$45.78万
依托单位:
依托单位国家:
美国
项目类别:
财政年份:
2013
资助国家:
美国
项目状态:
已结题
起止时间:
2013-09-30 至 2024-05-31
关键词:
AddressAgeAnimalsAreaAsianAvascular Necrosis of Femur HeadBiomechanicsBlood CirculationBone DiseasesBone SubstitutesBone TransplantationBone necrosisCadaverCartilageCessation of lifeComputer softwareCountryDebridementDefectDevelopmentDevicesDiseaseExcisionGoalsHeadHemorrhageHip region structureHybridsImageIncidenceIntraoperative MonitoringLesionMagnetic Resonance ImagingNeckNecrosisOperative Surgical ProceduresOrthopedic SurgeryOrthopedicsOsteoporosisOsteotomyOutcomePatient imagingPatientsPelvisPerformancePhasePositioning AttributeProceduresResearchRobotRoboticsSeriesShapesSiteStimulusStructureSurfaceSurgeonSystemTechniquesTechnologyTestingTimeUnderweightUnited StatesUpdateVascular blood supplyWeight-Bearing stateWorkacetabulumadvanced diseasebasebiomechanical testbonebone fracture repaircalcium phosphatedesigndexterityflexibilityfollow-upfoothip replacement arthroplastyimage guidedimprovedinstrumentminimally invasivenext generationnovelnovel therapeutic interventionoperationpain reliefpelvis fracturepreventprocedure safetyprototypereal time monitoringreconstructionrepairedrestorationrobot assistancesensorsubstantia spongiosasuccesstool
中文摘要
总结
英文摘要
Summary
Our long range goal is to develop an image-guided workstation that uses a novel Continuum Dexterous
Manipulator (CDM) and tools to enable next generation of minimally- and less-invasive procedures allowing
access to regions not currently accessible with conventional surgical tools in orthopaedic surgery. The system
and devices will enable treatment of bone defects such as femoroacetabular impingement, metastatic bone
disease, severe osteoporosis in areas including the pelvis/acetabulum, femoral neck, peri- and sub-
trochanteric regions, as well as the shin and foot, and finally traumatic fracture repair. The near-term focus of
this application is the core decompression for the treatment of Avascular Necrosis (AVN) of the femoral head
and reduction of pelvis fracture. We propose the development of an image-guided prototype robot-assisted
surgical system for planning, real-time intraoperative monitoring, navigation, and updating of the plans.
In the United States, avascular necrosis (AVN, also known as osteonecrosis) of the femoral head occurs in
10000-20000 of patients per year between the ages of 20-50 years old. The incidence of the AVN is even
higher in Middle Eastern and Asian countries. AVN occurs due to the loss of blood supply to the bone, leading
to the spontaneous death of the trabecular bone, which in turn may cause microfractures in the trabecular
bone. Depending on the amount of femoral head involved, collapse of the articular surface will occur as the
disease advances. Once collapse of the femoral head occurs in these patients, the disease course rarely
regresses. Total Hip Arthroplasty (THA) will be the primary surgery of choice and will provide pain relief to
those AVN patients. However, because of the young age of the AVN patients, THA is not the most desirable
choice. Core decompression is a conventional techniques used for the treatment of the AVN prior to the
collapse of the femoral head. Typically in core decompression the lesion area (death bone) is removed by
drilling and debriding. After debriding the bone graft will be inserted and/or bioresorbable material such as
calcium phosphates will be injected into the core to fill the void and provide stability.
The long-term success of core decompression is dependent on many parameters that may be out of the
control of surgeons given the existing tools and techniques. Some of the issues that the current conventional
techniques for core decompression does not answer are: 1) complete debriding of the death bone requires
significant increase in dexterity of the debriding tools, currently not available to the surgeons; 2) While it is ideal
to completely remove the death bone, the extent of the bone removal may be limited by the stability
requirements of the femoral head to prevent its collapse underweight bearing conditions. Biomechanical
analysis of the stability of the structure, therefore, must be important part of the planning. Further, the
successful implementation of the plan will require robot-assisted, image-guided navigation technology that, to
our knowledge, is currently not available to the surgeons.
To our knowledge, tools for biomechanical planning to maintain the stability of the hip after the surgery and
robotic platforms for minimally-invasive treatment of osteonecrosis are not developed. In particular, the design
of the manipulators for the full debriding of the AVN poses unique challenges because of the opposing
requirements for structural strength and flexibility. We propose to develop and test a prototype robot-assisted
surgical workstation for minimally-invasive treatment of the AVN. The workstation, during the planning phase,
will highlight the site of the lesion in MRI images of the patient and create an optimized surgical plan. During
the procedure, the surgeon will use a Continuum dexterous manipulator (CDM) in conjunction with a
positioning robot and various tools to remove the death bone and perform structural augmentation. Our goal is
to demonstrate that the proposed system can significantly improve the treatment of the AVN and the stability of
the hip, therefore, reducing the need for multiple follow-up surgeries and/or THA surgeries at early ages.
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DOI:
10.1007/s10439-018-2074-y
发表时间:
2018-10
期刊:
Annals of biomedical engineering
影响因子:
3.8
作者:
[Alambeigi F, Wang Z, Liu YH, Taylor RH, Armand M]
通讯作者:
Armand M
DOI:
10.1109/lra.2017.2678543
发表时间:
2017-07
期刊:
IEEE robotics and automation letters
影响因子:
5.2
作者:
[Wilkening P, Alambeigi F, Murphy RJ, Taylor RH, Armand M]
通讯作者:
Armand M
DOI:
10.1109/embc.2014.6945122
发表时间:
2014
期刊:
Annual International Conference of the IEEE Engineering in Medicine and Biology Society. IEEE Engineering in Medicine and Biology Society. Annual International Conference
影响因子:
--
作者:
[Alambeigi F, Murphy RJ, Basafa E, Taylor RH, Armand M]
通讯作者:
Armand M
DOI:
10.1109/tro.2021.3091283
发表时间:
2022-04
期刊:
IEEE TRANSACTIONS ON ROBOTICS
影响因子:
7.8
作者:
[Sefati, Shahriar, Hegeman, Rachel, Iordachita, Iulian, Taylor, Russell H., Armand, Mehran]
通讯作者:
Armand, Mehran
DOI:
10.1109/tmech.2015.2396894
发表时间:
2015-12
期刊:
IEEE/ASME transactions on mechatronics : a joint publication of the IEEE Industrial Electronics Society and the ASME Dynamic Systems and Control Division
影响因子:
--
作者:
[Moses MS, Murphy RJ, Kutzer MD, Armand M]
通讯作者:
Armand M
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