Our objective is to develop novel image-guided, less-invasive techniques for hip revision surgery. From September 2005 to December 2006 approximately 51300 revision Total Hip Arthroplasties (THAs) were performed in the United States with an average cost of $54500 per each revision surgery. The number of both primary and revision hip arthroplasty is projected to almost double between 2005 and 2030. Some of the goals of THA revision surgery are to eliminate the particle debris, remove all osteolytic lesions from the bone and other tissues, and replace the articulating polyethylene liner. The less-invasive approach attempts to preserve acetabular and femoral components of the THA, as long as they are firmly fixed to the bone, and only replaces the acetabular polyethylene liner. In the less-invasive approach, lesions are accessed through existing screw holes of the well-fixed metal acetabular component. Here, a major challenge for the surgeon is determining that the lesion is fully debrided and that the lesion is fully bone grafted. One study suggests that, on average, less than 50% of the lesion is actually grafted due to difficulty in accessing the areas o osteolysis behind the acetabular component. Standard surgical instruments are unable to access the cavities deep behind the component (sometimes extending all the way to the sacro-iliac joint). Because direct visual inspection and access to the areas requiring debridment is not always possible, many times surgeons have to completely remove THA components because they cannot otherwise clean the osteolytic lesions. Component removal increases risk of fracture and pelvic dissociation, and makes for remarkably long (i.e. 4-6 months after surgery) recovery and bed-rest periods in elderly patients. With less-invasive approaches patients may start normal weight bearing immediately after the surgery. This procedure, therefore, would highly benefit from the use of less-invasive approaches and highly dexterous (robotically-assisted) instruments to access these very difficult to reach areas within the body. To our knowledge, robotically-assisted, less-invasive revision techniques for treatment of osteolytic bone are not developed. In particular, the design of the appropriate tools and dexterous manipulators for the treatment and removal of the osteolytic lesions poses unique challenges because of the requirements for both structural strength and flexibility. We propose to develop a prototype surgical workstation for preoperative planning, and real-time intraoperative monitoring, navigation, and updating of plans during the revision surgery.

Agency
National Institute of Health (NIH)
Institute
National Institute of Biomedical Imaging and Bioengineering (NIBIB)
Type
Research Project (R01)
Project #
5R01EB016703-03
Application #
8879138
Study Section
Bioengineering, Technology and Surgical Sciences Study Section (BTSS)
Program Officer
Krosnick, Steven
Project Start
2013-09-30
Project End
2017-06-30
Budget Start
2015-07-01
Budget End
2016-06-30
Support Year
3
Fiscal Year
2015
Total Cost
$406,982
Indirect Cost
$132,549
Name
Johns Hopkins University
Department
Orthopedics
Type
Schools of Medicine
DUNS #
001910777
City
Baltimore
State
MD
Country
United States
Zip Code
21205
Fotouhi, Javad; Fuerst, Bernhard; Johnson, Alex et al. (2017) Pose-aware C-arm for automatic re-initialization of interventional 2D/3D image registration. Int J Comput Assist Radiol Surg 12:1221-1230
Gao, Anzhu; Murphy, Ryan J; Liu, Hao et al. (2017) Mechanical Model of Dexterous Continuum Manipulators with Compliant Joints and Tendon/External Force Interactions. IEEE ASME Trans Mechatron 22:465-475
Wilkening, Paul; Alambeigi, Farshid; Murphy, Ryan J et al. (2017) Development and Experimental Evaluation of Concurrent Control of a Robotic Arm and Continuum Manipulator for Osteolytic Lesion Treatment. IEEE Robot Autom Lett 2:1625-1631
Alambeigi, Farshid; Wang, Y; Murphy, Ryan J et al. (2016) Toward robot-assisted hard osteolytic lesion treatment using a continuum manipulator. Conf Proc IEEE Eng Med Biol Soc 2016:5103-5106
Murphy, Ryan J; Armand, Mehran (2015) Estimating the configuration of a continuum dexterous manipulator with variable curvature bending using partial shape-sensing. Conf Proc IEEE Eng Med Biol Soc 2015:5268-71
Liu, Hao; Farvardin, Amirhossein; Pedram, Sahba Aghajani et al. (2015) Large Deflection Shape Sensing of a Continuum Manipulator for Minimally-Invasive Surgery. IEEE Int Conf Robot Autom 2015:201-206
Moses, Matthew S; Murphy, Ryan J; Kutzer, Michael D M et al. (2015) Modeling Cable and Guide Channel Interaction in a High-Strength Cable-Driven Continuum Manipulator. IEEE ASME Trans Mechatron 20:2876-2889
Liu, Hao; Farvardin, Amirhossein; Grupp, Robert et al. (2015) Shape Tracking of a Dexterous Continuum Manipulator Utilizing Two Large Deflection Shape Sensors. IEEE Sens J 15:5494-5503
Xin Kang; Armand, Mehran; Otake, Yoshito et al. (2014) Robustness and accuracy of feature-based single image 2-D-3-D registration without correspondences for image-guided intervention. IEEE Trans Biomed Eng 61:149-61
Alambeigi, Farshid; Murphy, Ryan J; Basafa, Ehsan et al. (2014) Control of the coupled motion of a 6 DoF robotic arm and a continuum manipulator for the treatment of pelvis osteolysis. Conf Proc IEEE Eng Med Biol Soc 2014:6521-5

Showing the most recent 10 out of 11 publications