Intelligent Orthopaedics: Artificial Intelligence and Smart Image-guided Technology for Orthopaedics

353 Pages·2018·9.77 MB·English

by  Guoyan Zheng

Advances in Experimental Medicine and Biology 1093
Guoyan Zheng · Wei Tian · Xiahai Zhuang
Editors
Intelligent
Orthopaedics
Artifi cial Intelligence and Smart Image-
guided Technology for Orthopaedics
Advances in Experimental Medicine
and Biology
Volume1093
EditorialBoard
IRUNR.COHEN,TheWeizmannInstituteofScience,Rehovot,Israel
ABELLAJTHA,N.S.KlineInstituteforPsychiatricResearch,Orangeburg,
NY,USA
JOHND.LAMBRIS,UniversityofPennsylvania,Philadelphia,PA,USA
RODOLFOPAOLETTI,UniversityofMilan,Milan,Italy
NIMAREZAEI,TehranUniversityofMedicalSciences,Children’sMedical
CenterHospital,Tehran,Iran
Moreinformationaboutthisseriesathttp://www.springer.com/series/5584
Guoyan Zheng • Wei Tian (cid:129) Xiahai Zhuang
Editors
Intelligent Orthopaedics
Artificial Intelligence and Smart
Image-guided Technology for
Orthopaedics
123
Editor
GuoyanZheng WeiTian
UniversityofBern BeijingJishuitanHospital
Bern,Switzerland PekingUniversity
Beijing,Beijing,China
XiahaiZhuang
FudanUniversity
Shanghai,China
ISSN0065-2598 ISSN2214-8019 (electronic)
AdvancesinExperimentalMedicineandBiology
ISBN978-981-13-1395-0 ISBN978-981-13-1396-7 (eBook)
https://doi.org/10.1007/978-981-13-1396-7
LibraryofCongressControlNumber:2018958708
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Contents
1 Computer-Aided Orthopaedic Surgery: State-of-the-Art
andFuturePerspectives .................................. 1
GuoyanZhengandLutz-P.Nolte
2 Computer-AidedOrthopedicSurgery:IncrementalShift
orParadigmChange?.................................... 21
LeoJoskowiczandEricJ.Hazan
3 CAMISSConceptandItsClinicalApplication .............. 31
WeiTian,YajunLiu,MingxingFan,JingweiZhao,PeihaoJin,
andChengZeng
4 SurgicalNavigationinOrthopedics:WorkflowandSystem
Review ................................................. 47
ChidozieH.Ewurum,YingyingGuo,SeangPagnha,ZhaoFeng,
andXiongbiaoLuo
5 Multi-object Model-Based Multi-atlas Segmentation
Constrained Grid Cut for Automatic Segmentation of
LumbarVertebraefromCTImages ....................... 65
Weimin Yu, Wenyong Liu, Liwen Tan, Shaoxiang Zhang,
andGuoyanZheng
6 Deep Learning-Based Automatic Segmentation of the
ProximalFemurfromMRImages ......................... 73
GuodongZengandGuoyanZheng
7 MuscleSegmentationforOrthopedicInterventions.......... 81
NaokiKamiya
8 3X-Knee:ANovelTechnologyfor3DPreoperativePlanning
andPostoperativeEvaluationofTKABasedon2DX-Rays... 93
Guoyan Zheng, Alper Alcoltekin, Benedikt Thelen,
andLutz-P.Nolte
9 Atlas-Based3DIntensityVolumeReconstructionfrom2D
LongLegStandingX-Rays:ApplicationtoHardandSoft
TissuesinLowerExtremity ............................... 105
WeiminYuandGuoyanZheng
10 3DUltrasoundforOrthopedicInterventions................ 113
IlkerHacihaliloglu
v
vi Contents
11 A Novel Ultrasound-Based Lower Extremity Motion
TrackingSystem ........................................ 131
KenanNiu,VictorSluiter,JasperHomminga,AndréSprengers,
andNicoVerdonschot
12 Computer-AssistedPlanning,Simulation,andNavigation
SystemforPeriacetabularOsteotomy ..................... 143
LiLiu,KlausSiebenrock,Lutz-P.Nolte,andGuoyanZheng
13 Biomechanical Optimization-Based Planning
ofPeriacetabularOsteotomy ............................. 157
LiLiu,KlausSiebenrock,Lutz-P.Nolte,andGuoyanZheng
14 Biomechanical Guidance System for Periacetabular
Osteotomy.............................................. 169
MehranArmand,RobertGrupp,RyanMurphy,RachelHegman,
Robert Armiger, Russell Taylor, Benjamin McArthur,
andJyriLepisto
15 Gravity-Assisted Navigation System for Total
HipArthroplasty........................................ 181
GuoyanZheng
16 3DVisualizationandAugmentedRealityforOrthopedics.... 193
Longfei Ma, Zhencheng Fan, Guochen Ning, Xinran Zhang,
andHongenLiao
17 IntelligentHMIinOrthopedicNavigation ................. 207
GuangzhiWang,LiangLi,ShuweiXing,andHuiDing
18 Patient-SpecificSurgicalGuidanceSystemforIntelligent
Orthopaedics ........................................... 225
ManuelaKunzandJohnF.Rudan
19 Intelligent Control for Human-Robot Cooperation
inOrthopedicsSurgery .................................. 245
Shaolong Kuang, Yucun Tang, Andi Lin, Shumei Yu,
andLiningSun
20 Multilevel Fuzzy Control Based on Force Information
inRobot-AssistedDecompressiveLaminectomy ............ 263
Xiaozhi Qi, Yu Sun, Xiaohang Ma, Ying Hu, Jianwei Zhang,
andWeiTian
21 Potential Risk of Intelligent Technologies in Clinical
Orthopedics ............................................ 281
YajunLiu
22 ClinicalApplicationofNavigationintheSurgicalTreatment
ofaPelvicRingInjuryandAcetabularFracture............ 289
Masaki Takao, Hidetoshi Hamada, Takashi Sakai,
andNobuhikoSugano
Contents vii
23 Patient-SpecificSurgicalGuideforTotalHipArthroplasty ... 307
TakashiSakai
24 ComputerNavigationinOrthopaedicTumourSurgery ...... 315
Kwok-Chuen Wong, Xiaohui Niu, Hairong Xu, Yuan Li,
andShekharKumta
25 Sensor-Based Soft Tissue Balancing in Total
KneeArthroplasty....................................... 327
JimmyChow,TsunYeeLaw,andMartinRoche
26 Implant Orientation Measurement After THA Using
theEOSX-RayImageAcquisitionSystem.................. 335
KunihikoTokunaga,MasashiOkamoto,andKenji Watanabe
27 3DPrintinginSpineSurgery.............................. 345
Hong Cai, Zhongjun Liu, Feng Wei, Miao Yu, Nanfang Xu,
andZiheLi
1
Computer-Aided Orthopaedic
Surgery: State-of-the-Art and Future
Perspectives
GuoyanZheng andLutz-P.Nolte
Abstract Keywords
Introduced more than two decades ago, Computer-aidedorthopaedicsurgery
computer-aided orthopaedic surgery (CAOS) (CAOS)·Smartinstrumentation·Medical
has emerged as a new and independent robotics·Artificialintelligence·Machine
area, due to the importance of treatment learning·Deeplearning·Bigdataanalytics·
of musculoskeletal diseases in orthopaedics Intelligentorthopaedics
and traumatology, increasing availability of
different imaging modalities and advances in
analytics and navigation tools. The aim of
this chapter is to present the basic elements
1.1 Introduction
of CAOS devices and to review state-of-the-
art examples of different imaging modalities
The human musculoskeletal system is an organ
used to create the virtual representations,
systemthatincludesthebonesoftheskeletonand
of different position tracking devices for
the cartilages, ligaments, and other connective
navigation systems, of different surgical
tissuesthatbindtissuesandorganstogether.The
robots, of different methods for registration
mainfunctionsofthissystemaretoprovideform,
and referencing, and of CAOS modules that
support, stability, and movement to the body.
have been realized for different surgical pro-
Bones,besidessupportingtheweightofthebody,
cedures. Future perspectives will be outlined.
work together with muscles to maintain body
It is expected that the recent advancement
positionandtoproducecontrolled,precisemove-
on smart instrumentation, medical robotics,
ments. Musculoskeletal disease is among the
artificial intelligence, machine learning, and
mostcommoncausesofseverelong-termdisabil-
deeplearningtechniques,incombinationwith
ity and practical pain in industrialized societies
big data analytics, may lead to smart CAOS
[1].Theimpactandimportanceofmusculoskele-
systems and intelligent orthopaedics in the
tal diseases are critical not only for individual
nearfuture.
health and mobility but also for social function-
G.Zheng((cid:2))·L.-P.Nolte ing and productivity and economic growth on a
InstituteforSurgicalTechnologyandBiomechanics, largerscale,reflectedbytheproclamationofthe
UniversityofBern,Bern,Switzerland BoneandJointDecade2000–2010[1].
e-mail:[email protected]
©SpringerNatureSingaporePteLtd.2018 1
G.Zhengetal.(eds.),IntelligentOrthopaedics,AdvancesinExperimentalMedicine
andBiology1093,https://doi.org/10.1007/978-981-13-1396-7_1
2 G.ZhengandL.-P.Nolte
Both traumatology and orthopaedic surgery breviation, which is the target of the treatment),
aim at the treatment of musculoskeletal tissues. a virtual object (VO in abbreviation, which is
Surgical steps such as the placement of an im- the virtual representation in the planning and
plant component, the reduction and fixation of navigation computer), and a so-called navigator
a fracture, ligament reconstruction, osteotomy, thatlinksbothobjects.Forreasonsofsimplicity,
tumour resection, and the cutting or drilling of theterm“CAOSsystem”willbeusedwithinthis
boneshouldideallybecarriedoutaspreciselyas article to refer to both navigation systems and
possible.Notonlywilloptimalprecisionimprove roboticdevices.
the post-operative outcome of the treatment, but The central element of each CAOS system is
it will also minimize the risk factors for intra- the navigator. It is a device that establishes a
and post-operative complications. To this end, global, three-dimensional (3-D) coordinate sys-
a large number of pure mechanical guides have tem (COS) in which the target is to be treated
beendevelopedforvariousclinicalapplications. and the current location and orientation of the
The pure mechanical guides, though easy to use utilized end effectors (EE) are mathematically
andeasytohandle,donotrespecttheindividual described. End effectors are usually passive sur-
patient’s morphology. Thus, their general ben- gical instruments but can also be semi-active or
efit has been questioned (see for example [2]). active devices. One of the main functions of
Additionally, surgeons often encounter the chal- the navigator is to enable the transmission of
lenge of limited visibility of the surgical situs, positionalinformationbetweentheendeffectors,
which makes it difficult to achieve the intended theTOandtheVO.Forroboticdevices,therobot
procedure as accurately as desired. Moreover, itself plays the role of the navigator, while for
the recent trend towards increased minimally surgical navigation a position tracking device is
invasive surgery makes it more and more im- used.
portant to gain feedback about surgical actions For the purpose of establishment of a CAOS
that take place subcutaneously. Just as a Global system through coactions of these three entities,
Positioning System (GPS)-based car navigation three key procedural requirements have to be
providesvisualinstructiontoadriverbydisplay- fulfilled. The first is the calibration of the end
ingthelocationofthecaronamap,acomputer- effectors, which means to describe the end ef-
aided orthopaedic surgery (CAOS) module al- fectors’ geometry and shape in the coordinate
lowsthesurgeontogetreal-timefeedbackabout system of the navigator. For this purpose, it is
theperformedsurgicalactionsusinginformation requiredtoestablishphysicallyalocalcoordinate
conveyed through a virtual scene of the situs system at the end effectors. When an optical
presented on a display device [3, 4]. Parallel to tracker is used, this is done via rigid attach-
theCAOSmoduletopotentiallyimprovesurgical mentofthreeormoreopticalmarkersontoeach
outcome is the employment of surgical robots end effector. The second is registration, which
that actively or semi-actively participate in the aims to provide a geometrical transformation
surgery[5]. between the TO and the VO in order to display
Introducedmorethantwodecadesago[3–5], the end effect’s localization with respect to the
CAOS has emerged as a new and independent virtual representation, just like the display of
areaandstandsforapproachesthatusecomputer- the location of a car in a map in a GPS-based
enabled tracking systems or robotic devices to navigation system. The geometrical transforma-
improve visibility to the surgical field and in- tion could be rigid or non-rigid. In literature,
crease application accuracy in a variety of sur- a wide variety of registration concepts and as-
gical procedures. Although CAOS modules use sociated algorithms exist (see the next section
numeroustechnicalmethodstorealizeindividual for more details). The third key ingredient to a
aspects of a procedure, their basic conceptual CAOSsystemisreferencing,whichisnecessary
designisverysimilar.Theyallinvolvethreema- to compensate for possible motion of the navi-
jor components: a therapeutic object (TO in ab- gator and/or the TO during the surgical actions