X-Ray Image-based Biomechanical Guidance for Hip Surgery

基于 X 射线图像的髋关节手术生物力学指导

• 批准号: 9055681
• 负责人: MEHRAN ARMAND
• 金额: $ 18.14万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-05-01 至 2019-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9055681
• 关键词: Affect; Anterior; Atlases; Auditory; Biomechanics; Cadaver; Cartilage; Clinical; Clinical Research; Degenerative polyarthritis; Diagnostic radiologic examination; Dysplasia; Ensure; Exposure to; Feedback; Fluoroscope; Fluoroscopy; Goals; Head; Health; Hip region structure; Image; Incidence; Ionizing radiation; Joints; Knee; Learning; Measurement; Methodology; Monitor; Navigation System; Operating Rooms; Operative Surgical Procedures; Optics; Osteotomy; Outcome; Pain; Patients; Pelvis; Physical activity; Process; Protocols documentation; Radiation; Research; Surgeon; System; Techniques; Testing; Time; Total Hip Replacement; United States; Update; Visual; Walking; X-Ray Computed Tomography; acetabulum; base; chronic pain; hip surgery; imaging modality; improved; improved outcome; joint destruction; pressure; prevent; subluxation; theories; three-dimensional modeling; tool; young adult

 DESCRIPTION (provided by applicant): Acetabular dysplasia (a shallow hip socket) is a significant cause of osteoarthritis in young adults. The affected patients are usually unable to walk long distances, suffer from chronic pain, and usually limp. The major goals of osteotomy surgery are to 1) reduce patient pain and maintain his/her ability to perform normal daily physical activities, and 2) slow down or prevent the process of joint degeneration by reorienting the acetabulum to contain the femoral head and, therefore, reduce joint subluxation. In theory, both of these goals can be achieved by improving the contact pressure distribution on the acetabulum. Furthermore, one can hypothesize that reducing the maximum contact pressure of the acetabular cartilage will help to slow or prevent additional joint degeneration and reduce the incidence of osteoarthritis in dysplastic hips. PAO is inherently a challenging surgery performed only by a handful of surgeons in the United States. The few existing PAO navigation systems use optical system to track tools, and do not provide real-time tracking of the osteotomized fragment, 3D measurement of the realignment angles, and the osteotomy lines. Furthermore, surgeons use fluoroscopy to verify the joint realignment in the anterior-posterior plane only, limiting abilities to quantify the realignment of the joint in three-dimensional space. Our goal i to develop and evaluate a fluoroscopic guided system that performs three dimensional, real- time, intra-operative biomechanical analysis and fragment tracking to help surgeons improve the outcome of the periacetabular osteotomy (PAO). While the focus here is PAO surgery, applications of this research can be extended to other types of hip osteotomies, knee osteotomies, joint osteotomies, total hip replacement, and hip resurfacing techniques.

 描述（由申请人提供）：髋臼发育不良（浅髋窝）是年轻人骨关节炎的重要原因。受影响的患者通常无法长距离行走，患有慢性疼痛，并且通常跛行。截骨手术的主要目标是：1）减轻患者疼痛，保持患者进行正常日常体力活动的能力; 2）通过重新定向髋臼以容纳股骨头，减缓或预防关节退行性变的过程，从而减少关节半脱位。理论上，这两个目标都可以通过改善髋臼上的接触压力分布来实现。此外，可以假设，减少髋臼软骨的最大接触压力将有助于减缓或防止额外的关节退行性变，并减少发育不良髋关节中骨关节炎的发生率。 PAO本质上是一种具有挑战性的手术，仅由美国少数外科医生进行。现有的少数PAO导航系统使用光学系统来跟踪工具，并且不提供截骨碎片的实时跟踪、重新对准角度的3D测量和截骨线。此外，外科医生仅使用荧光镜检查来验证前后平面中的关节重新对准，限制了在三维空间中量化关节重新对准的能力。 我们的目标是开发和评估一种X线透视引导系统，该系统可执行三维、真实的、术中生物力学分析和碎片跟踪，以帮助外科医生改善髋臼周围截骨术（PAO）的结果。虽然这里的重点是PAO手术，但这项研究的应用可以扩展到其他类型的髋关节截骨术、膝关节截骨术、关节截骨术、全髋关节置换术和髋关节表面置换术。

项目成果

Fiducial-Free 2D/3D Registration for Robot-Assisted Femoroplasty.

• DOI: 10.1109/tmrb.2020.3012460
• 发表时间: 2020-08
• 期刊: IEEE transactions on medical robotics and bionics
• 作者: Gao C;Farvardin A;Grupp RB;Bakhtiarinejad M;Ma L;Thies M;Unberath M;Taylor RH;Armand M
• 通讯作者: Armand M

Estimation of attachment regions of hip muscles in CT image using muscle attachment probabilistic atlas constructed from measurements in eight cadavers.

使用根据八具尸体的测量结果构建的肌肉附着概率图集来估计 CT 图像中臀部肌肉的附着区域。

• DOI: 10.1007/s11548-016-1519-8
• 发表时间: 2017
• 期刊: International journal of computer assisted radiology and surgery
• 影响因子: 3
• 作者: Fukuda,Norio;Otake,Yoshito;Takao,Masaki;Yokota,Futoshi;Ogawa,Takeshi;Uemura,Keisuke;Nakaya,Ryota;Tamura,Kazunori;Grupp,RobertB;Farvardin,Amirhossein;Armand,Mehran;Sugano,Nobuhiko;Sato,Yoshinobu
• 通讯作者: Sato,Yoshinobu

Generalizing Spatial Transformers to Projective Geometry with Applications to 2D/3D Registration.

• DOI: 10.1007/978-3-030-59716-0_32
• 发表时间: 2020-10
• 期刊: Medical image computing and computer-assisted intervention : MICCAI ... International Conference on Medical Image Computing and Computer-Assisted Intervention
• 作者: Gao C;Liu X;Gu W;Killeen B;Armand M;Taylor R;Unberath M
• 通讯作者: Unberath M