Computer Assisted Surgery and Current Trends in Orthopaedics Research and Total Joint Replacements

Amirouche, Farid
June 2008
AIP Conference Proceedings;6/12/2008, Vol. 1019 Issue 1, p579
Academic Journal
Musculoskeletal research has brought about revolutionary changes in our ability to perform high precision surgery in joint replacement procedures. Recent advances in computer assisted surgery as well better materials have lead to reduced wear and greatly enhanced the quality of life of patients. The new surgical techniques to reduce the size of the incision and damage to underlying structures have been the primary advance toward this goal. These new techniques are known as MIS or Minimally Invasive Surgery. Total hip and knee Arthoplasties are at all time high reaching 1.2 million surgeries per year in the USA. Primary joint failures are usually due to osteoarthristis, rheumatoid arthritis, osteocronis and other inflammatory arthritis conditions. The methods for THR and TKA are critical to initial stability and longevity of the prostheses. This research aims at understanding the fundamental mechanics of the joint Arthoplasty and providing an insight into current challenges in patient specific fitting, fixing, and stability. Both experimental and analytical work will be presented. We will examine Cementless total hip arthroplasty success in the last 10 years and how computer assisted navigation is playing in the follow up studies. Cementless total hip arthroplasty attains permanent fixation by the ingrowth of bone into a porous coated surface. Loosening of an ingrown total hip arthroplasty occurs as a result of osteolysis of the periprosthetic bone and degradation of the bone prosthetic interface. The osteolytic process occurs as a result of polyethylene wear particles produced by the metal polyethylene articulation of the prosthesis. The total hip arthroplasty is a congruent joint and the submicron wear particles produced are phagocytized by macrophages initiating an inflammatory cascade. This cascade produces cytokines ultimately implicated in osteolysis. Resulting bone loss both on the acetabular and femoral sides eventually leads to component instability. As patients are living longer and total hip arthroplasty is performed in younger patients the risks of osteolysis associated with cumulative wear is increased. Computer-assisted surgery is based on sensing feedback; vision and imaging that help surgeons align the patient's joints during total knee or hip replacement with a degree of accuracy not possible with the naked eye. For the first time, the computer feedback is essential for ligament balancing and longevity of the implants. The computers navigation systems also help surgeons to use smaller incisions instead of the traditional larger openings. Small-incision surgery offers the potential for faster recovery, less bleeding and less pain for patients. The development of SESCAN imaging technique to create a patient based model of a 3D joint will be presented to show the effective solution of complex geometry of joints.


Related Articles

  • Expertise in Orthopedic Navigation. D'Ambrosia, Robert D. // Orthopedics;Oct2005 Supplement, Vol. 28, ps1215 

    The article discusses reports on orthopedics published within the issue, including one on the use of the OrthoPilot navigation systems for surgery of the anterior cruciate ligament (ACL), total knee arthroplasty (TKA) and total hip arthroplasty (THA).

  • Navigated Long-Bone Fracture Reduction. Kahler, David M. // Journal of Bone & Joint Surgery, American Volume;Feb2009 Supplement 1, Vol. 91-A Issue S1, p102 

    The first computer-assisted orthopaedic trauma procedures were limited to navigated drill-guide applications, in which the computer was used to predict the trajectory of the drill guide relative to stored radiographic images. By 2003, software for fracture reduction was commercially available....

  • Musculoskeletal radiology. Jonsson, K. // Acta Radiologica;May2005, Vol. 46 Issue 3, p220 

    The article presents the author's views on musculoskeletal radiology. According to the author, although examinations of the skeleton and chest constitute a majority of the examinations in a radiology department it is looked down on. The author reveals that in the everyday work, musculoskeletal...

  • A multipurpose image-guided orthopaedic surgical system. Phillips, R.; Mohsen, A. M. M. A.; Viant, W. J.; Griffiths, J. G.; Ozanian, T.; Cain, T. J.; Sherman, K. P.; Karpinski, M. R.; Howell, F. R. // Journal of Telemedicine & Telecare;Mar1996 Supplement 1, Vol. 2, p111 

    The article offers information on computer-assisted orthopedic surgery, which assists the orthopedic surgeon in performing the basic orthopedic principle (BOP) through the integration of a smart image intensifier, trajectory tactician and an intelligent drill guide. The BOP places an object at a...

  • Application of a computerised navigation technique to assist arthroscopic anterior cruciate ligament reconstruction. Zhu, Weimin; Lu, Wei; Han, Yun; Hui, Shi; Ou, Yangkan; Peng, Liangquan; Fen, Wenzhe; Wang, Daping; Zhang, Linlin; Zeng, Yanjun // International Orthopaedics;Feb2013, Vol. 37 Issue 2, p233 

    Purpose: Based on biomechanical cadaver studies, anatomical double-bundle reconstruction of the anterior cruciate ligament (ACL) was introduced to achieve better stability in the knee, particularly in respect of rotatory loads. Previously, the success of ACL reconstruction was believed to be...

  • Reference markers in computer aided orthopaedic surgery: rotational stability testings and clinical implications. Kendoff, Daniel; Gardner, Michael J.; Krettek, Christian; H├╝fner, Tobias; Citak, Musa // Archives of Orthopaedic & Trauma Surgery;Jun2008, Vol. 128 Issue 6, p633 

    Navigation procedures rely on the stability of the reference arrays (RA) fixed to the bony anatomy. The risk of inadvertent collision and unnoticed movements of the RA may occur, and limb movements might also provocate collisions. Consequently, relevant measurements failures during the navigated...

  • OrthoPilot Total Hip Arthroplasty Workflow and Surgery. Kiefer, Hartmuth; Othman, Aneis // Orthopedics;Oct2005 Supplement, Vol. 28, ps1221 

    To analyze the workflow and navigation principles of the OrthoPilot total hip arthroplasty (THA) Version 2.0 (B. Braun-Aesculap, Tuttlingen, Germany), a consecutive series of 60 patients was used to compare the navigated intraoperative data and postoperative measurements of stem and cup...

  • Results with Navigated Bicontact Total Hip Arthroplasty. Lazovic, Djordje; Kaib, Neils // Orthopedics;Oct2005 Supplement, Vol. 28, ps1227 

    The position of the cup is crucial for the overall quality of a total hip arthroplasty. A malpositioning of the cup leads to increased risk of dislocation, wear, and revision. The position of the stem influences leg length and may cause impingement and dislocation. These faults may increase with...

  • Navigated Unicompartmental Knee Replacement. Jenny, Jean-Yves // Orthopedics;Oct2005 Supplement, Vol. 28, ps1263 

    The author developed a non-image-guided navigation system for unicompartmental knee replacement that can be used with conventional surgery or minimally invasive surgery. The author performed a radiological analysis of the accuracy of implantation for unicompartmental knee replacement with...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics