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Statistical Shape Models
Patient-Specific Surgical Guides
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Medicine and Health Sciences
Orthopedics

Patient-Specific Modelling in Orthopedics: From Image to Surgery

Profile image of Lara VigneronLara Vigneron

2012, Lecture Notes in Computational Vision and Biomechanics

https://doi.org/10.1007/978-94-007-4270-3_6
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23 pages

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Abstract

In orthopedic surgery, to decide upon intervention and how it can be optimized, surgeons usually rely on subjective analysis of medical images of the patient, obtained from computed tomography, magnetic resonance imaging, ultrasound or other techniques. Recent advancements in computational performance, image analysis and in silico modeling techniques have started to revolutionize clinical practice through the development of quantitative tools, including patient-specific models aiming at improving clinical diagnosis and surgical treatment. Anatomical and surgical landmarks as well as features extraction can be automated allowing for the creation of general or patient-specific models based on statistical shape models. Preoperative virtual planning and rapid prototyping tools allow the implementation of customized surgical solutions in real clinical environments. In the present chapter we discuss the applications of some of these techniques in orthopedics and present new computer-aided tools that can take us from image analysis to customized surgical treatment.

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jpe.ftn.uns.ac.rs

Geometrically accurate and anatomically correct three-dimensional geometric model(s) of human bones (or bone sections) and implants are essential for successful preoperative planning in orthopedic surgery. Such models are often used in various software systems for the preparation and control of surgical interventions. In this paper, the process of models' creation and their usage in application for the preoperative planning in orthopedics are presented. Models are created by using reverse engineering techniques, CAD (CATIA) and 3D Content creation software (Blender). The application is web oriented, and developed with use of modern web technologies like HTML5 and WebGL. In relation to commercial and free software systems currently in use, this application has several advantages such as: implementation of adaptive geometrical models, the ability to work across multiple platforms, ease of installation and use, etc.

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The geometrical models of the human femur and its usage in application for preoperative planning in orthopedics
stojanka arsic, Miroslav Trajanovic

vihos.masfak.ni.ac.rs

In this paper two types of human femur geometrical models and method for its creation are presented. Created method is developed with respect to the morphological and anatomical properties of the human femur, and it enables forming of parametric polygonal mesh and decriptive XML models. The parametric mesh model is based on two parameters, acquired from medical imaging method (CT, X-ray). The first parameter is determined as distance between most prominent points on epicondyles -Df, and the second one as distance between line conecting the most prominent points of epicondyles and the center of the femoral head -FHA. The purpose of the polygonal mesh model is to improve the preparation of orthopedic surgeries and make it easier. The aim of XML model is to enable exchange of mesh model data between applications in network environment. The presented models are applied in the application for preoperative planning, developed by the authors. The Journal of Arthroscopic and Related Surgery Volume 26, Issue 7 , Pages 901-906

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Computer-aided patient specific quantitative preoperative planning in a clinical environment
Leo Joskowicz

2007

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Computer Assisted Orthopaedic Surgery With Image Based Individual Templates
Hans Staudte

Clinical Orthopaedics and Related Research, 1998

position of the customized contact faces of the template until the location of exact fit to the bone is found. No additional computerized equipment or time is needed during surgery. The feasibility of this approach has been shown in spine, hip, and knee surgery, and it has been applied clinically for pelvic repositioning 0steotomies in acetabular dysplasia therapy.

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Computer-Aided Surgery Planning for Lower Limb Osteotomy
Ana Presedo

Osteotomies around the knee address lower limb deformities that affect the leg posture and especially the knee joint. Knee arthritis is a very common age-related joint disease that can be treated with osteotomy, as an alternative to knee replacement by implants. The preoperative planning process is demanding and significantly determines the surgical out-come. The choice of the osteotomy type and the determination of parameters, like the correction angle, are crucial for long-term success. We present a software tool for preoperative 3D planning of femoral and tibial opening, closing and derotation osteotomies, thus a particularly wide range of interventions. Our tool is based on patient specific 3D bone models and allows the user to position cutting planes and to simulate cut and alignment of the bone.

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Patient-Specific Three-Dimensional Composite Bone Models for Teaching and Operation Planning
Vladislav Raikov

Journal of Digital Imaging, 2009

Background: Orthopedic trauma care relies on two-dimensional radiograms both before and during the operation. Understanding the three-dimensional nature of complex fractures on plain radiograms is challenging. Modern fluoroscopes can acquire three-dimensional volume datasets even during an operation, but the device limitations constrain the acquired volume to a cube of only 12-cm edge. However, viewing the surrounding intact structures is important to comprehend the fracture in its context. We suggest merging a fluoroscope’s volume scan into a generic bone model to form a composite full-length 3D bone model. Methods: Materials consisted of one cadaver bone and 20 three-dimensional surface models of human femora. Radiograms and computed tomography scans were taken before and after applying a controlled fracture to the bone. A 3D scan of the fracture was acquired using a mobile fluoroscope (Siemens Siremobil). The fracture was fitted into the generic bone models by rigid registration using a modified least-squares algorithm. Registration precision was determined and a clinical appraisal of the composite models obtained. Results: Twenty composite bone models were generated. Average registration precision was 2.0 mm (range 1.6 to 2.6). Average processing time on a laptop computer was 35 s (range 20 to 55). Comparing synthesized radiograms with the actual radiograms of the fractured bone yielded clinically satisfactory results. Conclusion: A three-dimensional full-length representation of a fractured bone can reliably be synthesized from a short scan of the patient’s fracture and a generic bone model. This patient-specific model can subsequently be used for teaching, surgical operation planning, and intraoperative visualization purposes.

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