Preoperative Planning of Femoroplasty

股骨成形术的术前计划

基本信息

批准号：
8697012
负责人：
MEHRAN ARMAND
金额：
$ 18.84万
依托单位：
JOHNS HOPKINS UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2013
资助国家：
美国
起止时间：
2013-07-05 至 2017-06-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8697012
关键词：
Admission activity Age Area Beds Biomechanics Bone Cements Bone Density Cadaver Case Study Clinical Computer Simulation Consensus Contralateral Defect Deterioration Development Diagnostic Diffusion Disease Distal Effectiveness Evaluation Feedback Femur Fracture Generations Geometry Goals Hip Fractures Hip region structure Hospitals Individual Injection of therapeutic agent Lead Life Measures Mechanics Medical Methodology Modeling Morbidity - disease rate Nursing Homes Operative Surgical Procedures Osteoporosis Outcome Patients Pattern Pelvis Physicians Population Prevention Preventive Procedures Radial Reporting Research Risk Risk Factors Series Stress Surgeon Techniques Technology Testing Therapeutic Therapeutic Intervention Time United States National Institutes of Health Validation Visit Woman X-Ray Computed Tomography alternative treatment base bone bone loss clinical practice computerized falls high risk human old age (65+)humerus men minimally invasive mortality novel older patient osteoporosis with pathological fracture osteosarcoma prevent prophylactic public health relevance

项目摘要

DESCRIPTION (provided by applicant): There is a wealth of research on the extent to which bone loss may impair strength and increase the risk of fracture. The rate of mortality after hip fracture in elderly patients with osteoporosis is reported to be as high as 30%. It is suggested that augmentation of the femur is an effective countermeasure to reduce the risk of fracture in highly osteoporotic hips. This technique would be especially valuable for those patients at high risk of falls and the highest risk of mortality and morbidity if they were to sustain a fall. The fw clinical case studies that have been performed on augmentation of the femur suggest that a successful outcome requires detailed planning, biomechanical analysis, and precise control of the augmentation procedure to avoid generation of areas of high stress due to augmentation. Our long term goal is to develop a technology that enables the surgeon to precisely determine the extent of osteoporosis and fracture risk level, obtain an optimized surgical plan based on computerized mechanical analysis, perform a rapid and minimally invasive hip augmentation with intraoperative biomechanical feedback, and finally verify the outcome in one patient visit. In this project, we will develop a surgical test bed for planning proximal femur augmentation and demonstrate its feasibility. Towards this goal, we propose two aims: 1. Optimal planning of the femoroplasty: We propose to develop a novel framework involving a computational diffusion model applied to patient-specific CT scans of the osteoporotic femora. The model will be suitable for the ubiquitous problem of predicting an optimal pattern and strategy for cement injection using input from both patient-specific CT and another computational model for assessment and reduction of the fracture risk. 2. Validation of the preoperative planning strategy: We will perform a series of controlled nondestructive cadaver tests to verify the accuracy of our model in predicting the diffusion geometry of the augmentation material. We will also perform a series of destructive cadaver tests on osteoporotic femora to verify the abiliy of the planning framework to strengthen the bone with a relatively low injection volume of the augmentation material. The technology developed in this project may lead to a highly needed alternative treatment that may be pivotal for patients at the risk of bone fracture due to osteoporosis as well as demonstrating the importance of incorporating biomechanics-based planning in end-to-end surgical treatment.

描述（由申请人提供）：关于骨质流失可能会损害强度并增加骨折的风险的程度，有很多研究。据报道，骨质疏松症老年患者的髋部骨折后死亡率高达30％。建议增强股骨是降低高度骨质疏松臀部骨折风险的有效对策。对于那些跌倒高风险的患者，如果他们要维持跌倒，这项技术将特别有价值。在股骨增强方面进行的FW临床案例研究表明，成功的结果需要详细的计划，生物力学分析以及对增强程序的精确控制，以避免由于增强而产生高压力的领域。我们的长期目标是开发一项技术，使外科医生能够精确确定骨质疏松症和断裂风险水平的程度，获得基于计算机化机械分析的优化手术计划，并通过术中生物力学反馈进行快速且微创的髋部增强，并在一次患者访问中验证结果。在这个项目，我们将开发一个外科手术测试床，以计划股骨近端增强，并证明其可行性。为了实现这一目标，我们提出了两个目的：1。股骨成形术的最佳计划：我们建议开发一个新型框架，涉及用于骨质疏松股骨的患者特异性CT扫描的计算扩散模型。该模型将适用于使用患者特异性CT的输入和另一个评估和减少断裂风险的计算模型来预测水泥注射的最佳模式和策略的无处不在问题。 2。验证术前计划策略：我们将执行一系列受控的无损尸体测试，以验证模型在预测增强材料的扩散几何形状方面的准确性。我们还将对骨质疏松性股骨进行一系列破坏性的尸体测试，以验证计划框架的效果，以使用相对较低的增强材料注入量来增强骨骼。该项目中开发的技术可能会导致急需的替代治疗方法，这对于因骨质疏松症引起的骨折风险的患者可能是关键的，并且证明了将基于生物力学的计划纳入端到端手术治疗的重要性。

项目成果

期刊论文数量（10）

专著数量（0）

科研奖励数量（0）

会议论文数量（0）

专利数量（0）

Intraoperative image-based multiview 2D/3D registration for image-guided orthopaedic surgery: incorporation of fiducial-based C-arm tracking and GPU-acceleration.

DOI：
10.1109/tmi.2011.2176555
发表时间：
2012-04
期刊：
IEEE transactions on medical imaging
影响因子：
10.6
作者：
Otake Y;Armand M;Armiger RS;Kutzer MD;Basafa E;Kazanzides P;Taylor RH
通讯作者：
Taylor RH

A Surgical Robotic System for Osteoporotic Hip Augmentation: System Development and Experimental Evaluation.

用于骨质疏松髋关节增强的手术机器人系统：系统开发和实验评估。

DOI：
10.1109/tmrb.2023.3241589
发表时间：
2023
期刊：
IEEE transactions on medical robotics and bionics
影响因子：
0
作者：
Bakhtiarinejad,Mahsan;Gao,Cong;Farvardin,Amirhossein;Zhu,Gang;Wang,Yu;Oni,JuliusK;Taylor,RussellH;Armand,Mehran
通讯作者：
Armand,Mehran

A Particle Model for Prediction of Cement Infiltration of Cancellous Bone in Osteoporotic Bone Augmentation.