Predictive dynamic simulation of human movement following hip replacement

2014-2015年间，加拿大有超过5万例髋关节置换手术；其中8.5%需要进行后续手术，以纠正髋关节植入物的错误放置。加拿大滑铁卢的IntelliJoint Surgical为外科医生开发了一种实时导航系统，以监控这些植入物的精确放置。到目前为止，该系统已经在5000多例手术中使用，但它无法告诉外科医生应该将植入物的位置和方向降至最低，从而将髋关节脱位的风险降至最低。 这项合作研究的目的是开发多体动力学模型和计算机模拟来确定髋关节置换手术中植入物的最佳位置和方向。我们将重点研究手术后存在高脱位风险的坐立运动，并开发包括脊柱柔韧性、骨盆向前/向后倾斜、关节反作用力和特定受试者数据的预测性模拟。在文献中没有包含这些重要影响的坐立模型。使用预测模拟和优化算法，我们可以确定髋关节植入物的位置和方向，从而将髋关节脱位的风险降至最低。 得到的算法可以由IntelJoin商业化，为他们目前的导航产品提供手术前规划能力。最终结果将是这家加拿大公司更大的市场份额，以及更高的髋关节置换手术成功率，加拿大患者更高的生活质量，以及我国医疗保健成本的降低。

Between 2014-2015 in Canada, there were over 50,000 hip replacement surgeries; of these, 8.5% required a subsequent surgery to correct for a faulty placement of the hip implants. Intellijoint Surgical of Waterloo, Canada, has developed a real-time navigation system for surgeons to monitor the precise placement of these implants. This system has been used in over 5000 surgeries to date, but it cannot tell the surgeon where the implants should be positioned and oriented to minimize a risk of a hip dislocation. The purpose of this collaborative research is to develop multibody dynamic models and computer simulations to determine the best position and orientation of implants in a hip replacement surgery. We will focus on sit-to-stand motions that present high dislocation risks following surgery, and develop predictive simulations that include the effects of spine flexibility, forward/backward tilting of the pelvis, joint reaction forces, and subject-specific data. There is no sit-to-stand model in the literature that includes these important effects. Using predictive simulations and optimization algorithms, we can then determine the position and orientation of the hip implants that minimize the risk of hip dislocation. The resulting algorithms can be commercialized by Intelljoint to provide pre-surgery planning capability to their current navigation product. The end result will be a greater market share for this Canadian company, as well as a higher success rate for hip replacement surgeries, greater quality of life for Canadian patients, and a reduction in health care costs in our country.