TY - JOUR
T1 - Computer-integrated revision total hip replacement surgery
T2 - Concept and preliminary results
AU - Taylor, Russell H.
AU - Joskowicz, Leo
AU - Williamson, Bill
AU - Guéiec, André
AU - Kalvin, Alan
AU - Kazanzides, Peter
AU - Van Vorhis, Robert
AU - Yao, Jianhua
AU - Kumar, Rajesh
AU - Bzostek, Andrew
AU - Sahay, Alind
AU - Börner, Martin
AU - Lahmer, Armin
N1 - Funding Information:
Janez Funda, Steve Gomory, Gabriel Taubin, Roger Kane, Lisa Brown, Joe McCarthy MD, Roderick Turner MD and Bela Musits participated in the early stages of this project. This project is partially funded by the US Department of Commerce under the National Institute of Standards’ Advanced Technology Program (NIST/ATP) Cooperative Agreement Number 94-01-228. The Johns Hopkins University members of our team also gratefully acknowledge generous donation of computing equipment and software to Johns Hopkins by Intel Corporation and Microsoft Corporation. We thank the anonymous reviewers for suggestions that helped improve the presentation of the paper.
PY - 1999
Y1 - 1999
N2 - This paper describes an ongoing project to develop a computer-integrated system to assist surgeons in revision total hip replacement (RTHR) surgery. In RTHR surgery, a failing orthopedic hip implant, typically cemented, is replaced with a new one by removing the old implant, removing the cement and fitting a new implant into an enlarged canal broached in the femur. RTHR surgery is a difficult procedure fraught with technical challenges and a high incidence of complications. The goals of the computer-based system are the significant reduction of cement removal labor and time, the elimination of cortical wall penetration and femur fracture, the improved positioning and lit of the new implant resulting from precise, high-quality canal milling and the reduction of bone sacrificed to lit the new implant. Our starting points are the ROBODOC(R) system for primary hip replacement surgery and the manual RTHR surgical protocol. We first discuss the main difficulties of computer-integrated RTHR surgery and identify key issues and possible solutions. We then describe possible system architectures and protocols for preoperative planning and intraoperative execution. We present a summary of methods and preliminary results in CT image metal artifact removal, interactive cement cut-volume definition and cement machining, anatomy-based registration using fluoroscopic X-ray images and clinical trials using an extended RTHR version of ROBODOC. We conclude with a summary of lessons learned and a discussion of current and future work.
AB - This paper describes an ongoing project to develop a computer-integrated system to assist surgeons in revision total hip replacement (RTHR) surgery. In RTHR surgery, a failing orthopedic hip implant, typically cemented, is replaced with a new one by removing the old implant, removing the cement and fitting a new implant into an enlarged canal broached in the femur. RTHR surgery is a difficult procedure fraught with technical challenges and a high incidence of complications. The goals of the computer-based system are the significant reduction of cement removal labor and time, the elimination of cortical wall penetration and femur fracture, the improved positioning and lit of the new implant resulting from precise, high-quality canal milling and the reduction of bone sacrificed to lit the new implant. Our starting points are the ROBODOC(R) system for primary hip replacement surgery and the manual RTHR surgical protocol. We first discuss the main difficulties of computer-integrated RTHR surgery and identify key issues and possible solutions. We then describe possible system architectures and protocols for preoperative planning and intraoperative execution. We present a summary of methods and preliminary results in CT image metal artifact removal, interactive cement cut-volume definition and cement machining, anatomy-based registration using fluoroscopic X-ray images and clinical trials using an extended RTHR version of ROBODOC. We conclude with a summary of lessons learned and a discussion of current and future work.
KW - Computer-assisted surgery
KW - Image-based registration
KW - Orthopedics, revision total hip replacement
KW - ROBODOC and ORTHODOC systems
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U2 - 10.1016/S1361-8415(99)80026-7
DO - 10.1016/S1361-8415(99)80026-7
M3 - Article
C2 - 10710298
AN - SCOPUS:0033182557
VL - 3
SP - 301
EP - 319
JO - Medical Image Analysis
JF - Medical Image Analysis
SN - 1361-8415
IS - 3
ER -