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Biomechanical Guidance System for Periacetabular Osteotomy

  • Mehran Armand
  • Robert Grupp
  • Ryan Murphy
  • Rachel Hegman
  • Robert Armiger
  • Russell Taylor
  • Benjamin McArthur
  • Jyri Lepisto
Chapter
Part of the Advances in Experimental Medicine and Biology book series (AEMB, volume 1093)

Abstract

This chapter presents a biomechanical guidance navigation system for performing periacetabular osteotomy (PAO) to treat developmental dysplasia of the hip. The main motivation of the biomechanical guidance system (BGS) is to plan and track the osteotomized fragment in real time during PAO while simplifying this challenging procedure. The BGS computes the three-dimensional position of the osteotomized fragment in terms of conventional anatomical angles and simulates biomechanical states of the joint. This chapter describes the BGS structure and its application using two different navigation approaches including optical tracking of the fragment and x-ray-based navigation. Both cadaver studies and preliminary clinical studies showed that the biomechanical planning is consistent with traditional PAO planning techniques and that the additional information provided by accurate 3D positioning of the fragment does not adversely impact the surgery.

Keywords

Developmental dysplasia of the hip (DDH) Periacetabular osteotomy (PAO) Biomechanical guidance system X-ray-based navigation 

Notes

Acknowledgments

The human subject research and cadaver studies were approved by Johns Hopkins Medicine JHM IRB NA_00001257 and JHM IRB1 #05-09-02-01.The study was supported by grant number R01 EB60389 and R21 EB020113 from the National Institute for Biomedical Imaging and Bioengineering (NIH/NIBIB) and two JHU/APL graduate student scholarships.

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Copyright information

© Springer Nature Singapore Pte Ltd. 2018

Authors and Affiliations

  • Mehran Armand
    • 1
    • 2
    • 3
  • Robert Grupp
    • 4
  • Ryan Murphy
    • 1
  • Rachel Hegman
    • 1
    • 4
  • Robert Armiger
    • 1
  • Russell Taylor
    • 4
  • Benjamin McArthur
    • 5
  • Jyri Lepisto
    • 6
  1. 1.Johns Hopkins University Applied Physics laboratoryLaurelUSA
  2. 2.Department of Mechanical EngineeringJohns Hopkins UniversityBaltimoreUSA
  3. 3.Department of Orthopaedic SurgeryJohns Hopkins UniversityBaltimoreUSA
  4. 4.Department of Computer ScienceJohns Hopkins UniversityBaltimoreUSA
  5. 5.Dell Medical School at the University of TexasAustinUSA
  6. 6.Orton Orthopaedic HospitalHelsinkiFinland

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