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）：对于骨质流失可能会在多大程度上损害力量并增加骨折风险进行了大量研究。据报道，患有骨质疏松症的老年患者髋部骨折后的死亡率高达30%。有人认为，股骨增强是降低高度骨质疏松髋部骨折风险的有效对策。这项技术对于那些跌倒风险高以及如果持续跌倒则死亡和发病风险最高的患者尤其有价值。对股骨增强进行的后续临床案例研究表明，成功的结果需要详细的规划、生物力学分析和对增强过程的精确控制，以避免由于增强而产生高应力区域。我们的长期目标是开发一种技术，使外科医生能够精确确定骨质疏松的程度和骨折风险水平，根据计算机机械分析获得优化的手术计划，通过术中生物力学反馈进行快速微创髋关节增强术，以及最终在一次患者就诊中验证结果。在在这个项目中，我们将开发一个用于规划股骨近端增强的手术试验台并证明其可行性。为了实现这一目标，我们提出两个目标： 1. 股骨成形术的最佳规划：我们建议开发一种新颖的框架，涉及应用于骨质疏松股骨患者特异性 CT 扫描的计算扩散模型。该模型将适用于使用来自患者特异性 CT 和另一个计算模型的输入来预测骨水泥注射的最佳模式和策略的普遍问题，以评估和降低骨折风险。 2. 术前规划策略的验证：我们将进行一系列受控无损尸体测试，以验证我们的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股骨进行一系列破坏性尸体测试，以验证规划框架以相对较低的增强材料注射量强化骨骼的能力。该项目开发的技术可能会带来一种急需的替代治疗方法，对于因骨质疏松症而面临骨折风险的患者来说可能至关重要，并证明将基于生物力学的规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.