Development of an Intra-operative Tracking System using the Intellijoint Surgical System for Shoulder Implant Surgery******

肩关节成形术为关节疾病患者用植入物取代关节。植入物放置不当会导致假体过早磨损和松动--这是翻修手术的常见原因。然而，植入物的准确放置是一个挑战，因为这些部件的可靠定位和定向由于有限的手术暴露而变得复杂。为了提高髋关节和膝关节重建植入物放置的准确性，基于工程的导航系统已经建立得很好，但还没有完全开发和优化用于肩部的导航系统。**该项目的目标是开发一种用于肩部置换手术的最先进的导航系统。我们正在与IntelliJoint Surgical(滑铁卢，安大略省)合作，他们拥有一套成熟的单一微型光学摄像系统，目前正广泛用于髋关节的临床应用。我们建议将该系统改造为用于肩部。我们的第一个也是主要的项目将专注于成功将肩部植入物导航到目标位置所需的算法、工具和程序的设计和开发。这将以智能联合平台为基础，但进行了适当的修改。我们的第二项研究将使用安装在肩部模拟器中的身体标本来验证我们的新系统，以评估放置的准确性。本实验将把这种导航方法与目前使用的传统技术进行比较。**我们相信，平移和旋转的放置精度将低于1毫米，并且将比目前的传统放置至少提高10倍。这项拟议研究的成功完成将对IntelliJoint Surgical具有重要意义，因为它将扩大他们的产品组合到肩膀。此外，这些进展极有可能带来更好的植入物性能，减少植入物的松动和磨损，从而改善加拿大患者的生活质量。************

Shoulder Arthroplasty replaces the joint with implants for patients suffering from joint disease. Improper placement of the implants can lead to premature prosthetic wear and loosening- a common cause of revision surgery. However, accurate placement of implants is a challenge as reliable positioning and orientation of these components is complicated by the limited surgical exposure. Engineering-based navigation systems to improve the accuracy of implant placement for hip and knee reconstruction have become well established, but have yet to be fully developed and optimized for the shoulder.** The objective of this project is to develop a state-of-the art navigation system for shoulder replacement surgery. We are partnering with Intellijoint Surgical (Waterloo, ON) who have a well-established single mini-optical camera system currently in widespread clinical use for the hip. We propose to adapt this system for use in the shoulder. Our first and main project will be to focus on the design and development of the algorithms, tooling, and procedures required for the successful navigation of shoulder implants to the target positions. This will be based on the Intellijoint platform but suitably modified. Our second study will be to verify our new system using cadaver specimens mounted in our shoulder simulator to assess accuracy of placement. This experiment will compare this navigated approach with the traditional technique currently employed. ** We are confident that the accuracy of placement will be less than 1-mm in translation and 1-degree in rotation and will represent a minimum of a 10-fold improvement over current traditional placement. The successful completion of the proposed research would be significant for Intellijoint Surgical as it would broaden their product portfolio to the shoulder. Moreover, it is highly likely that these advances will lead to better implant performance with a reduction of loosening and wear of the implants, thus improving the quality of life for patients in Canada. ************