Title
Computer-integrated revision total hip replacement surgery: concept and preliminary results
Abstract
This paper describes an ongoing project to develop a computer-integrated system to assist surgeons in revision total hip replacement (RTHR) surgery. In RTHR surgery, a failing orthopedic hip implant, typically cemented, is replaced with a new one by removing the old implant, removing the cement and fitting a new implant into an enlarged canal broached in the femur. RTHR surgery is a difficult procedure fraught with technical challenges and a high incidence of complications. The goals of the computer-based system are the significant reduction of cement removal labor and time, the elimination of cortical wall penetration and femur fracture, the improved positioning and fit of the new implant resulting from precise, high-quality canal milling and the reduction of bone sacrificed to fit the new implant. Our starting points are the ROBODOC(R) system for primary hip replacement surgery and the manual RTHR surgical protocol. We first discuss the main difficulties of computer-integrated RTHR surgery and identify key issues and possible solutions. We then describe possible system architectures and protocols for preoperative planning and intraoperative execution. We present a summary of methods and preliminary results in CT image metal artifact removal, interactive cement cut-volume definition and cement machining, anatomy-based registration using fluoroscopic X-ray images and clinical trials using an extended RTHR version of ROBODOC. We conclude with a summary of lessons learned and a discussion of current and future work.
Year
DOI
Venue
1999
10.1016/S1361-8415(99)80026-7
Medical Image Analysis
Keywords
Field
DocType
computer-assisted surgery,image-based registration,orthopedics,revision total hip replacement,ROBODOC(R) and ORTHODOC(R) systems
Revision total hip replacement,Implant,Femur,Orthopedic surgery,Computer-assisted surgery,Surgery,Hip implant,Mathematics
Journal
Volume
Issue
ISSN
3
3
1361-8415
Citations 
PageRank 
References 
25
3.00
10
Authors
13
Name
Order
Citations
PageRank
Russell H. Taylor11970438.00
Leo Joskowicz2656110.91
B Williamson315345.46
André Guéziec473396.14
A Kalvin5334.23
Peter Kazanzides658496.63
R Van Vorhis7364.73
Jianhua Yao81135110.49
Rajesh Kumar9283.50
Andrew Bzostek106824.14
Alind Sahay11253.00
Martin Börner12345.73
Armin Lahmer13345.73