Intraoperative Cross-Sectional Imaging for ACL Tunnel Alignment
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Solution Overview
Problem
Surgeons face challenges in correlating preoperative cross-sectional images with the actual anatomy during ACL reconstruction, making it difficult to accurately place tunnels for graft attachment.
Innovation Solution
A surgical controller registers a three-dimensional bone model with intraoperative video frames using an origin marker, such as a bone fiducial, to select and display cross-sectional images based on the instrument's position and orientation, overlaying the instrument's tip location and displaying a visual representation of the bone model.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Loss of information
If cross-sectional images are displayed during surgery, then the surgeon can reference preoperative plans, but it becomes difficult to correlate the images with actual anatomy
Solution Approach 1:
The system creates a three-dimensional model that replicates the anatomical structure from preoperative cross-sectional images. This digital copy can be visually correlated with actual anatomy during surgery through registration techniques, allowing surgeons to reference preoperative plans while maintaining accurate spatial correspondence with the patient's anatomy.
Solution Approach 2:
The system transforms two-dimensional cross-sectional images into a three-dimensional model, adding spatial dimensionality that enables better correlation with actual anatomy. This volumetric representation allows surgeons to navigate and correlate images across multiple planes (axial, sagittal, coronal) simultaneously, resolving the difficulty of matching 2D images with 3D anatomy.
2Loss of information
If multiple cross-sectional images are displayed, then comprehensive anatomical information is available, but the surgeon cannot quickly locate relevant images
Solution Approach 1:
The system provides real-time feedback by automatically updating the displayed cross-sectional images based on the current position and orientation of the surgical instrument. As the instrument moves, the system continuously correlates its location with the three-dimensional bone model and retrieves the corresponding anatomical slices, eliminating the need for manual image searching and providing immediate relevant information.
Solution Approach 2:
The system performs automatic image selection and display based on instrument position data. Rather than requiring the surgeon to manually navigate through image stacks, the system autonomously determines which cross-sectional images are relevant to the current surgical step and displays them, saving time and reducing cognitive load.
3Manufacturing precision
If tunnel placement is performed without real-time image correlation, then surgery proceeds quickly, but precision of tunnel placement is reduced
Solution Approach 1:
The system provides real-time feedback by continuously monitoring instrument position and correlating it with the three-dimensional bone model and cross-sectional images. This allows the surgeon to verify tunnel placement accuracy against the preoperative plan during the procedure itself, ensuring precision without requiring time-consuming postoperative adjustments or revisions.
Solution Approach 2:
The system enables preliminary planning of tunnel paths using three-dimensional modeling and cross-sectional image analysis before surgery. The preoperative plan is then integrated with intraoperative navigation, allowing the surgeon to follow the predetermined precise path while maintaining the ability to make adjustments based on real-time visual feedback from correlated anatomical images.
Data Source
AI summary
Some examples are directed to methods and related systems for intraoperatively selecting and displaying cross-sectional images.