Liu Li, Ecker Timo, Schumann Steffen, Siebenrock Klaus, Nolte Lutz, Zheng Guoyan
Med Image Comput Comput Assist Interv. 2014;17(Pt 2):643-50. doi: 10.1007/978-3-319-10470-6_80.
Femoroacetabular impingement (FAI) before or after Periacetabular Osteotomy (PAO) is surprisingly frequent and surgeons need to be aware of the risk preoperatively and be able to avoid it intraoperatively. In this paper we present a novel computer assisted planning and navigation system for PAO with impingement analysis and range of motion (ROM) optimization. Our system starts with a fully automatic detection of the acetabular rim, which allows for quantifying the acetabular morphology with parameters such as acetabular version, inclination and femoral head coverage ratio for a computer assisted diagnosis and planning. The planned situation was optimized with impingement simulation by balancing acetabuar coverage with ROM. Intra-operatively navigation was conducted until the optimized planning situation was achieved. Our experimental results demonstrated: 1) The fully automated acetabular rim detection was validated with accuracy 1.1 ± 0.7mm; 2) The optimized PAO planning improved ROM significantly compared to that without ROM optimization; 3) By comparing the pre-operatively planned situation and the intra-operatively achieved situation, sub-degree accuracy was achieved for all directions.
髋臼周围截骨术(PAO)前后出现股骨髋臼撞击症(FAI)的情况出奇地频繁,外科医生需要在术前了解这种风险,并能够在术中避免它。在本文中,我们提出了一种用于PAO的新型计算机辅助规划和导航系统,该系统具有撞击分析和活动范围(ROM)优化功能。我们的系统首先对髋臼边缘进行全自动检测,这使得能够通过髋臼旋转、倾斜度和股骨头覆盖率等参数对髋臼形态进行量化,以用于计算机辅助诊断和规划。通过平衡髋臼覆盖度和ROM,利用撞击模拟对规划情况进行优化。术中进行导航,直到达到优化后的规划情况。我们的实验结果表明:1)全自动髋臼边缘检测的验证精度为1.1±0.7毫米;2)与未进行ROM优化的情况相比,优化后的PAO规划显著改善了ROM;3)通过比较术前规划情况和术中实际情况,所有方向均实现了亚度精度。
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