Bone Model Updating for Orthopedic Revision Surgery Planning
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Solution Overview
Problem
The challenge in orthopedic revision surgeries is the unpredictability of bone loss during the removal of an existing orthopedic prosthesis, which complicates the surgical planning and registration of 3D models with real-world bones, leading to potential errors and inaccuracies in surgical execution.
Innovation Solution
A surgical assistance system generates a pre-revision model of a bone based on pre-revision imaging data, identifies damaged and intact parts using intra-revision imaging data, and updates the model to exclude damaged areas, enabling a revised surgical plan and improved registration with the actual bone, facilitating accurate MR visualization and guidance.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Loss of time
If a pre-revision model of the bone is used for surgical planning, then the surgical plan can be prepared in advance, but the model becomes inaccurate due to unpredictable bone loss during prosthesis removal
Solution Approach 1:
The system transitions from a static pre-revision bone model to a dynamic intra-revision bone model that is continuously updated during surgery based on real imaging data. This allows the model to adapt to actual bone conditions as they change during prosthesis removal, maintaining accuracy while enabling ongoing surgical planning adjustments.
Solution Approach 2:
The system implements feedback by capturing intra-revision imaging data during surgery, comparing it with the pre-revision model, identifying damaged bone areas, and updating the model accordingly. This closed-loop feedback mechanism ensures the bone model reflects actual surgical conditions, resolving the accuracy issue while preserving advance preparation benefits.
2Ease of manufacture
If 3D models are registered with real-world bones using pre-revision data, then virtual objects can be positioned in advance, but registration errors occur due to bone loss and anatomical changes
Solution Approach 1:
The system performs preliminary registration using the pre-revision bone model to establish initial virtual object positions and surgical plans before surgery. This allows advance preparation while the model is still accurate, setting the stage for subsequent intra-revision updates without losing the benefits of pre-planning.
Solution Approach 2:
The registration process is made dynamic by continuously updating the bone model with intra-revision imaging data and re-registering virtual objects to the updated model. This ensures registration accuracy is maintained despite anatomical changes during surgery, while preserving the ease of advance plan creation.
3Loss of time
If the surgical plan is based on pre-revision imaging data, then planning can be completed before surgery, but the plan becomes obsolete due to unexpected bone damage during prosthesis removal
Solution Approach 1:
The surgical plan is transformed from a static document based on pre-revision data to a dynamic plan that is continuously updated using intra-revision bone models. This allows the plan to adapt to actual bone conditions discovered during surgery, maintaining both advance preparation efficiency and necessary flexibility.
Solution Approach 2:
The system implements feedback loops where intra-revision imaging data and identified bone damage are fed back into the surgical plan, automatically or manually updating it to reflect current surgical conditions. This resolves the conflict between advance planning efficiency and plan adaptability to unexpected findings.
Data Source
AI summary
A surgical assistance system may obtain a pre-revision model of a bone of a patient. The pre-revision model of the bone represents a pre-revision state of the bone after a prior orthopedic surgery on the bone. In this example, an orthopedic prosthesis was attached to the bone during the prior orthopedic surgery. Additionally, the surgical assistance system may obtain intra-revision imaging data of the bone. The intra-revision imaging data represents an intra-revision state of the bone during the orthopedic revision surgery after removal of the orthopedic prosthesis from the bone. The surgical assistance system may determine, based on the intra revision imaging data, damaged and intact parts of the bone. The surgical assistance system may then generate a second intra-revision model of the bone by modifying the pre-revision model of the bone to exclude damaged parts of the bone.