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International Journal of Computer Assisted Radiology and Surgery

, Volume 10, Issue 10, pp 1567–1578

First Online: 11 April 2015Received: 16 June 2014Accepted: 09 March 2015

Abstract

PurposeComputer-assisted orthopedic surgery aims at minimizing invasiveness, postoperative pain, and morbidity with computer-assisted preoperative planning and intra-operative guidance techniques, of which camera-based navigation and patient-specific templates PST are the most common. PSTs are one-time templates that guide the surgeon initially in cutting slits or drilling holes. This method can be extended to reusable and customizable surgical guides CSG, which can be adapted to the patients’ bone. Determining the right set of CSG input parameters by hand is a challenging task, given the vast amount of input parameter combinations and the complex physical interaction between the PST-CSG and the bone.

MethodsThis paper introduces a novel algorithm to solve the problem of choosing the right set of input parameters. Our approach predicts how well a CSG instance is able to reproduce the planned alignment based on a physical simulation and uses a genetic optimization algorithm to determine optimal configurations. We validate our technique with a prototype of a pin-based CSG and nine rapid prototyped distal femora.

ResultsThe proposed optimization technique has been compared to manual optimization by experts, as well as participants with domain experience. Using the optimization technique, the alignment errors remained within practical boundaries of 1.2 mm translation and \0.9^\circ \ rotation error. In all cases, the proposed method outperformed manual optimization.

ConclusionsManually optimizing CSG parameters turns out to be a counterintuitive task. Even after training, subjects with and without anatomical background fail in choosing appropriate CSG configurations. Our optimization algorithm ensures that the CSG is configured correctly, and we could demonstrate that the intended alignment of the CSG is accurately reproduced on all tested bone geometries.

KeywordsKnee replacement surgery Physical simulation Customizable surgical guide Surgical navigation device Genetic optimization  Download fulltext PDF



Author: Thomas Kroes - Edward Valstar - Elmar Eisemann

Source: https://link.springer.com/







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