Abstract
Femoroacetabular impingement (FAI) before or after Periacetabular Osteotomy (PAO) is surprisingly frequent and surgeons need to be aware of the risk preoperatively and be able to avoid it intra-operatively. In this paper we present a novel computer assisted planning and navigation system for PAO with impingement analysis and range of motion (ROM) optimization. Our system starts with a fully automatic detection of the acetabular rim, which allows for quantifying the acetabular morphology with parameters such as acetabular version, inclination and femoral head coverage ratio for a computer assisted diagnosis and planning. The planned situation was optimized with impingement simulation by balancing acetabuar coverage with ROM. Intra-operatively navigation was conducted until the optimized planning situation was achieved. Our experimental results demonstrated: 1) The fully automated acetabular rim detection was validated with accuracy 1.1 ±0.7mm; 2) The optimized PAO planning improved ROM significantly compared to that without ROM optimization; 3) By comparing the pre-operatively planned situation and the intra-operatively achieved situation, sub-degree accuracy was achieved for all directions.
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Ganz, R., Klaue, K., Vinh, T., Mast, J.: A New Periacetabular Osteotomy for the Treatment of Hip Dysplasia. Technique and Preliminary Results. Clin. Orthop. 232, 26–36 (1988)
Crockaress Jr., J., Trousdale, R.T., Cabanela, M.E., Berry, D.J.: Early Experience and Results with the Periacetabular Osteotomy. The Mayo Clinic experience. Clin. Orthop. 363, 45–53 (1999)
Rodriguez, A.C., Buckley, J.M., Diab, M., Burch, S.: An Evaluation of the Accuracy of Computer Assisted Surgery in Preoperatively Three Dimensionally Planned Periacetabular Osteotomies. In: 56th Annual Meeting of the Orthopaedic Research Society (2009)
Jager, M., Westhoff, B., Wild, A., Krauspe, R.: Computer-assisted Periacetabular Triple Osteotomy for Treatment of Dysplasia of the Hip. Z Orthop Ihre Grenzgeb 142, 51–59 (2004)
Langlotz, F., Bachler, R., Berlemann, U., Nolte, L.P., Ganz, R.: Computer Assistance for Pelvic Osteotomies. Clin. Orthop. 354, 92–102 (1998)
Armand, M., Lepisto, J.V.S., Merkle, A.C., Tallroth, K., Liu, X., Taylor, R.H., Wenz, J.: Computer-aided Orthopedic Surgery with Near-real-time Biomechanical Feedback. Johns Hopkins APL Technical Digest 25, 242–252 (2004)
Ziebarth, K., Balakumar, J., Domayer, S., Kim, Y.J., Millis, M.B.: Bernese Periacetabular Osteotomy in Males: Is There An Increased Risk of Femoroacetabular Impingement (FAI) after Bernese Periacetabular Osteotomy? Clin. Orthop. 469, 447–453 (2011)
Zheng, G., Marx, A., Langlotz, U., Widmer, K.H., Buttaro, M., Nolte, L.P.: A Hybrid CT–free Navigation System for Total Hip Arthroplasty. Computer Aided Surgery 7, 129–145 (2002)
Murphy, S.B., Simon, S.R., Kijewski, P.K., Wilkinson, R.H., Griscom, N.T.: Femoral Anteversion. J. Bone Joint Surg. Am. 69, 1169–1176 (1987)
Puls, M., Ecker, T.M., Steppacher, S.D., Tannast, M., Siebenrock, K.A., Kowal, J.H.: Automated Detection of the Acetabular Rim Using Three-dimensional Models of the Pelvis. Comput. Biol. Med. 41, 285–291 (2011)
Murray, D.W.: The Definition and Measurement of Acetabular Orientation. J. Bone Joint Surg. Br. 75(B), 228–232 (1993)
Wiberg, G.: The Anatomy and Roentgenographic Appearance of A Normal Hip Joint. Acta Chir. Scand. Suppl. 83, 7–38 (1939)
Murphy, S.B., Ganz, R., Muller, M.E.: The Prognosis in Untreated Dysplasia of the Hip. A Study of Radiographic Factors that Predict the Outcome. J. Bone Joint Surg. Am. 77, 985–989 (1995)
Tannast, M., Kubiak-Langer, M., Langlotz, F., Puls, M., Murphy, S.B., Siebenrock, K.A.: Noninvasive Three-dimensional Assessment of Femoroacetabular Impingement. J. Orthop. Res. 25, 122–131 (2007)
Gottschalk, S., Lin, M.C., Manocha, D.: Obbtree: A Hierachical Structure for Rapid Interference Detection. In: Rushmeier, H. (ed.) Proceedings of SIGGRAPH 1996, pp. 1169–1176. Addison Wesley (1996)
Thornberry, R.L., Hogan, A.J.: The Combined Use of Simulation and Navigation to Demonstrate Hip kinematics. J. Bone Joint Surg. Am. 91, 144–152 (2009)
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Liu, L., Ecker, T., Schumann, S., Siebenrock, K., Nolte, L., Zheng, G. (2014). Computer Assisted Planning and Navigation of Periacetabular Osteotomy with Range of Motion Optimization. In: Golland, P., Hata, N., Barillot, C., Hornegger, J., Howe, R. (eds) Medical Image Computing and Computer-Assisted Intervention – MICCAI 2014. MICCAI 2014. Lecture Notes in Computer Science, vol 8674. Springer, Cham. https://doi.org/10.1007/978-3-319-10470-6_80
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DOI: https://doi.org/10.1007/978-3-319-10470-6_80
Publisher Name: Springer, Cham
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