The objective of the proposed research is to advance and evaluate a real-time, intra-operative biomechanical guidance system (BGS) that may improve decision making during joint surgeries. The system will be used by the surgeon during periacetabular osteotomies (PAO). The BGS will interact with the surgeon during the operation and display the current biomechanical state of the joint. It will use the information from the imagery of the navigation system and display the joint orientation and contact pressure distribution in the hip joint as the joint alignment is modified intraoperatively. The proposed research will further enhance the BGS prototype technology by developing new cartilage segmentation and deformable registration techniques as well as novel tools and interfaces for surgeon-BGS interaction (Aim 1). The theoretical foundation of the BGS will be extended in order to model subluxation, joint incongruency in hip dysplasia, and nonlineaavers (Aim 4). Based on available conventional techniques, the minimum anatomical criteria for successful joint realignment during PAO surgery will be devised. The reliability of the system will be determined by testing whether the system continuously satisfies those criteria for joint realignment. The surgeon will use the biomechanical and virtual-radiographic feedback of the BGS to supplement the conventional PAO techniques in order to realign the anatomical angles of the dysplastic hip to that of the normal hip. In order to compare the clinical outcomes of the osteotomy with real-time BGS to osteotomy without BGS, annual clinical follow-ups will be performed and the clinical outcomes will be compared to the biomechanical and radiological outcomes (Aim 5). While the focus of this work will be on periacetabular osteotomy, applications of this research can be extended to other types of hip osteotomies, other joint osteotomies, and total joint replacement techniques. ????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????

Agency
National Institute of Health (NIH)
Institute
National Institute of Biomedical Imaging and Bioengineering (NIBIB)
Type
Research Project (R01)
Project #
3R01EB006839-03S1
Application #
7844240
Study Section
Biomedical Imaging Technology Study Section (BMIT)
Program Officer
Haller, John W
Project Start
2007-07-01
Project End
2009-10-31
Budget Start
2009-06-01
Budget End
2009-10-31
Support Year
3
Fiscal Year
2009
Total Cost
$12,547
Indirect Cost
Name
Johns Hopkins University
Department
Type
Organized Research Units
DUNS #
001910777
City
Baltimore
State
MD
Country
United States
Zip Code
21218
Gordon, Chad R; Murphy, Ryan J; Armand, Mehran et al. (2016) Discussion on: Usefulness of an Osteotomy Template for Skull Tumorectomy and Simultaneous Skull Reconstruction. J Craniofac Surg 27:1568-70
Murphy, Ryan J; Gordon, Chad R; Basafa, Ehsan et al. (2015) Computer-assisted, Le Fort-based, face-jaw-teeth transplantation: a pilot study on system feasiblity and translational assessment. Int J Comput Assist Radiol Surg 10:1117-26
Murphy, Ryan J; Armiger, Robert S; Lepistö, Jyri et al. (2015) Development of a biomechanical guidance system for periacetabular osteotomy. Int J Comput Assist Radiol Surg 10:497-508
Gordon, Chad R; Murphy, Ryan J; Coon, Devin et al. (2014) Preliminary development of a workstation for craniomaxillofacial surgical procedures: introducing a computer-assisted planning and execution system. J Craniofac Surg 25:273-83
Santiago, Gabriel F; Susarla, Srinivas M; Al Rakan, Mohammed et al. (2014) Establishing cephalometric landmarks for the translational study of Le Fort-based facial transplantation in Swine: enhanced applications using computer-assisted surgery and custom cutting guides. Plast Reconstr Surg 133:1138-51
Gordon, Chad R; Swanson, Edward W; Susarla, Srinivas M et al. (2013) Overcoming cross-gender differences and challenges in Le Fort-based, craniomaxillofacial transplantation with enhanced computer-assisted technology. Ann Plast Surg 71:421-8
Murphy, Ryan J; Subhawong, Ty K; Chhabra, Avneesh et al. (2011) A quantitative method to assess focal acetabular overcoverage resulting from pincer deformity using CT data. Clin Orthop Relat Res 469:2846-54
Armand, M; Armiger, R; Mendat, D et al. (2010) Computer-Assisted Orthopedic Surgery with Real-Time Biomechanics. Johns Hopkins APL Tech Dig 28:214-215
Armiger, Robert S; Armand, Mehran; Tallroth, Kaj et al. (2009) Three-dimensional mechanical evaluation of joint contact pressure in 12 periacetabular osteotomy patients with 10-year follow-up. Acta Orthop 80:155-61
Lepisto, Jyri; Armand, Mehran; Armiger, Robert S (2008) Periacetabular osteotomy in adult hip dysplasia - developing a computer aided real-time biomechanical guiding system (BGS). Suom Ortoped Traumatol 31:186-190

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