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%的患者需要后续手术来纠正髋关节植入物的错误放置。加拿大滑铁卢的Intellijoint Surgical公司开发了一种实时导航系统，用于外科医生监测这些植入物的精确位置。迄今为止，该系统已在5000多例手术中使用，但它不能告诉外科医生植入物的位置和方向，以最大限度地降低髋关节脱位的风险。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，以确定髋关节置换术中植入物的最佳位置和方向。我们将重点关注手术后出现高脱位风险的坐姿-站立运动，并开发预测模拟，包括脊柱柔韧性、骨盆前/后倾、关节反作用力和受试者特定数据的影响。在文献中没有包括这些重要影响的坐姿-站立模型。通过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，从而最大限度地降低髋关节脱位的风险。由此产生的算法可以由Intelljoint商业化，为他们目前的导航产品提供术前规划能力。最终结果将是这家加拿大公司获得更大的市场份额，以及更高的髋关节置换手术成功率，提高加拿大患者的生活质量，并降低我国的医疗保健费用。

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.