Development and validation of a navigational guidance system for acetabular implant placement
During the past year our group has been developing HipNav, a system which helps surgeons determine optimal, patient-specific acetabular implant placement and accurately achieve the desired implant placement during surgery. HipNav includes three components: a pre-operative planner, a range of motion simulator, and an intra-operative tracking and guidance system. The goals of the current HipNav system are to: 1) reduce dislocations following total hip replacement surgery due to acetabular malposition; 2) determine and potentially increase the “safe” range of motion; 3) reduce wear debris resulting from impingement of the implant's femoral neck with the acetabular rim; and 4) track in real-time the position of the pelvis and acetabulum during surgery.
The original implementation of the HipNav system was a proof-of-concept prototype which was useful for demonstrating the efficacy of this technology in-vitro. As the HipNav system progressed towards a clinical implementation, our efforts focussed on several practical development and validation issues. This paper describes our experience transforming HipNav from a proof-of-concept prototype into a robust clinical system, with emphasis on technical development and validation. Despite the highly applied nature of this endeavor, many fundamental research issues exist. The benefits of tightly coupling fundamental research together with applied development in our work are discussed.
Keywordscomputer-assisted surgery total hip replacement navigational guidance system validation
Unable to display preview. Download preview PDF.
- M. Blackwell, et al., Design and evaluation of 3-d pre-operative planning software: Application to acetabular implant alignment. RI tech report CMU-RI-TR-96-44, Carnegie Mellon, Pittsburgh, Dec 1996.Google Scholar
- E. Cuchet, et al., Registration in neurosurgery and neuroradiotherapy applications. In Proc. 2nd Int'l Symp. MRCAS, pp. 31–38, Baltimore, Nov 1995.Google Scholar
- A.M. DiGioia, et al., HipNav: pre-operative planning and intra-operative navigational guidance for acetabular implant placement in total hip replacement surgery. In Proc CAOS Symp., Bern, Nov. 1995.Google Scholar
- B. Geiger. Three-dimensional modeling of human organs and its application to diagnosis and surgical planning. PhD thesis, Ecole des Mines de Paris, April 1993.Google Scholar
- C. J. Henri, et al., Registration of 3-d surface data for intra-operative guidance and visualization in frameless stereotactic neurosurgery. In N. Ayache, ed., Proc. 1st Int'l CVRMed, pp. 47–56, Nice, France, April 1995. Springer-Verlag.Google Scholar
- B. K. P. Horn. Closed-form solution of absolute orientation using unit quaternions. Journal of the Optical Society of America A, 4(4):629–642, April 1987.Google Scholar
- B. Jaramaz, et al., Simulation of implant impingement and dislocation in total hip replacement. In Computer Assisted Radiology 96, Paris, June 1996.Google Scholar
- B. Jaramaz, et al., Range of motion after total hip arthroplasty: Experimental verification of the analytical simulator. In Proc 1st Joint CVRMed /MRCAS, Grenoble, March 1997.Google Scholar
- D.E. McCollum, M.D. and W.J. Gray, M.D. Dislocation after total hip arthroplasty. Clinical Orthopaedics, 261:159–170, 1990.Google Scholar
- B.F. Morrey, editor. Reconstructive Surgery of the Joints, pages 1247–1260. Churchill Livingston, 1996.Google Scholar
- L. P. Nolte, et al., A novel approach to computer assisted spine surgery. In Proc. 1st Int'l Symp. MRCAS, pp. 323–328, Pittsburgh, PA, September 1994.Google Scholar
- D. A. Simon and T. Kanade. Geometric constraint analysis and synthesis: Methods for improving shape-based registration accuracy. In Proc. 1st Joint CVRMed/MRCAS, Grenoble, March 1997.Google Scholar
- D. A. Simon, et al., Accuracy validation in image-guided orthopaedic surgery. In Proc. 2nd Int'l Symp. MRCAS, Baltimore, Nov. 1995.Google Scholar