In recent years, computer assisted surgery （CAS） systems become more and more common in clinical practices, but few specific design criteria have been proposed for human-computer interface （HCI） in GAS systems. Th...In recent years, computer assisted surgery （CAS） systems become more and more common in clinical practices, but few specific design criteria have been proposed for human-computer interface （HCI） in GAS systems. This paper tried to give universal criteria of HCI design for CAS systems through introduction of demonstration application, which is total knee replacement （TKR） with a nonimage-based navigation system. A typical computer assisted process can be divided into four phases： the preoperative planning phase, the intraoperative registration phase, the intraoperative navigation phase and finally the postoperative assessment phase. The interface design for four steps is described respectively in the demonstration application. These criteria this paper summarized can be useful to software developers to achieve reliable and effective interfaces for new CAS systems more easily.展开更多
Background:The traditional manual orthopaedic technology heavily relies on a surgeon's experience,so it certainly increases the instability of the surgery.Therefore,computer assisted orthopaedic surgery(CAOS) is b...Background:The traditional manual orthopaedic technology heavily relies on a surgeon's experience,so it certainly increases the instability of the surgery.Therefore,computer assisted orthopaedic surgery(CAOS) is becoming a hot research topic for its high accuracy and stability.We developed a new CAOS system WATO,which is mainly designed for total knee replacement(TKR).Methods:WATO system provides the interactive software for a surgeon's preoperative planning.Based on its two infrared cameras,infrared markers and infrared probe,WATO system gives a simple surgical positioning procedure of femur and tibia without additional surgery for the placement of fiducial markers.According to the reference alignment axis from positioning procedure,a surgeon can move the robot of WATO system to do accurate bone resection.Safety checking is also considered in WATO system.Results:Extensive experiments were conducted on phantoms and cadaver bones to verify the accuracy and stability of WATO system.Experimental results showed that TKR using WATO system had better performance compared with traditional and navigated TKR.Conclusion:WATO system shows its superiority in TKR,and has a broad application prospect in the future.We will develop its new functions for other orthopaedic surgery such as total hip replacement(THR).Current disadvantages such as bigger skin incision have to be resolved in the future.展开更多
An automatic markerless knee tracking and registration algorithm has been proposed in the literature to avoid the marker insertion required by conventional computer-assisted knee surgery,resulting in a shorter and les...An automatic markerless knee tracking and registration algorithm has been proposed in the literature to avoid the marker insertion required by conventional computer-assisted knee surgery,resulting in a shorter and less invasive surgical workflow.However,such an algorithm considers intact femur geometry only.The bone surface modification is inevitable due to intra-operative intervention.The mismatched correspondences will degrade the reliability of registered target pose.To solve this problem,this work proposed a supervised deep neural network to automatically restore the surface of processed bone.The network was trained on a synthetic dataset that consists of real depth captures of a model leg and simulated realistic femur cutting.According to the evaluation on both synthetic data and real-time captures,the registration quality can be effectively improved by surface reconstruction.The improvement in tracking accuracy is only evident over test data,indicating the need for future enhancement of the dataset and network.展开更多
Background Severe valgus deformity often has bone defect and laxity of the medial ligamentous, and total knee arthroplasty in severe valgus knee is, in most cases, more challenging for surgeons. The usefulness of a co...Background Severe valgus deformity often has bone defect and laxity of the medial ligamentous, and total knee arthroplasty in severe valgus knee is, in most cases, more challenging for surgeons. The usefulness of a computer assisted navigation system in reestablishing the mechanical axis has been well established. Hence, the interest for surgeons is how the navigation system makes the procedure of total knee arthroplasty with severe valgus knee easier. Methods From June 2006 to March 2008 in Department of Joint Surgery, Shanghai Sixth People＇s Hospital, 6 patients （7 knees） with severe valgus knee underwent total knee arthroplasty using the Stryker Navigation system, which is an active wireless and imageless system. All the patients were followed up for 12 to 18 months after surgery. The X-ray radiographs for whole limbs were obtained on all patients to determine preoperative and postoperative alignments. Results A primary, posterior stabilized prosthesis was utilized in all cases. The average preoperative overall mechanical axis of the seven knees was 19.6°±4.6° of valgus （range 16°to 29°）, and the average postoperative mechanical axis was 0.4°±0.7° （range 0.8° varus to 1.4° valgus ）. Conclusions The navigation system is a very effective and useful tool for accurate intraoperative restoration of alignment in the face of significant deformity with valgus knee. To prevent component malposition, we did not reduce the knee before solidification of bone cement but controlled alignment using the navigation system up to implantation of the final component.展开更多
Objective： To evaluate the clinical feasibility and effect of the computer-assisted auto-frame navigation system for distal locking of tibial intramedullary nails. Methods： The hardware components of the system inc...Objective： To evaluate the clinical feasibility and effect of the computer-assisted auto-frame navigation system for distal locking of tibial intramedullary nails. Methods： The hardware components of the system included a PC computer with a monitor, auto mechanical stereotactical locating cubic frame, foot holder and localization operative apparatus. Special navigation software can be used for registration of X-ray fluoroscopic images and real-time controlling navigation of tools. Twenty-one cases of dose tibial and fibular fractures were treated with dosed intramedullary nailing, 6 of which involved in middle third, 12 in middle and lower third, 3 in lower third. C-arm alignment and registration time, fluoroscopic time and drilling time involved in the locking procedure were recorded. The size of unreamed or reamed tibial nails ranged from 8/300-11/330. Results： All distal holes except 1 were locked successfully. In 9 of 41 locked holes （21.95 % ）, the drill bit touched the canal of locking hole without damage of the nail and clinical consequences. The fluoroscopy time per pair of screws was 2.23 s± 0.31s. Conclusions： The computer-assisted auto-frame navigation system for distal locking is well designed, easy to operate and do not need additional instrmnents during the procedure. The developed system enables the physician to precisely navigate surgical instruments throughout the anatomy using just a few computer-calibrated radiographic images. The total time of x-ray exposure per procedure can be significantly reduced.展开更多
Total knee arthroplasty （TKA） is an effective treatment for severe knee arthritis. However, TKA is more challenging when that arthritis is associated with femoral deformity that has resulted in irregularity of the c...Total knee arthroplasty （TKA） is an effective treatment for severe knee arthritis. However, TKA is more challenging when that arthritis is associated with femoral deformity that has resulted in irregularity of the canal and variation in anatomic landmarks. In such cases, it is difficult to restore the mechanical alignment of the lower limb using intramedullary instruments.展开更多
Objective To evaluate the advantages of image guided system in transnasal endoscopic surgery Methods Transnasal endoscopic surgery was performed with the aid of an image guided system in 28 patients, supported wi...Objective To evaluate the advantages of image guided system in transnasal endoscopic surgery Methods Transnasal endoscopic surgery was performed with the aid of an image guided system in 28 patients, supported with histopathologic diagnoses of chronic sinusitis with/without nasal polyps (10 cases), juvenile nasopharyngeal angiofibroma (4 cases), pituitary adenoma (6 cases), ethmoidal ossifying fibroma (3 cases), nasopharyngeal mixed tumor (2 cases), nasal leiomyoma (1 case), fungal sinusitis (1 case) and inverted nasal papilloma (1 case) Results For all the patients, the time periods from initialization to surgery ranged from 15 to 30 minutes (a mean of 26 minutes) The calibration coefficient ranged from 1 3 to 2 0 Accuracy of localization fell within 1 mm Compared with traditional endoscopic surgery, operation times were not noticeably different No complications occurred Conclusions The image guided system was able to identify borders and critical anatomical structures in real time, especially of those with distorted anatomical markers It provided a powerful means for a safer and less invasive endoscopic sinus surgery展开更多
基金the National High Technology Research and Development Program (863) of China(No. 2006AA02A137)
文摘In recent years, computer assisted surgery （CAS） systems become more and more common in clinical practices, but few specific design criteria have been proposed for human-computer interface （HCI） in GAS systems. This paper tried to give universal criteria of HCI design for CAS systems through introduction of demonstration application, which is total knee replacement （TKR） with a nonimage-based navigation system. A typical computer assisted process can be divided into four phases： the preoperative planning phase, the intraoperative registration phase, the intraoperative navigation phase and finally the postoperative assessment phase. The interface design for four steps is described respectively in the demonstration application. These criteria this paper summarized can be useful to software developers to achieve reliable and effective interfaces for new CAS systems more easily.
文摘Background:The traditional manual orthopaedic technology heavily relies on a surgeon's experience,so it certainly increases the instability of the surgery.Therefore,computer assisted orthopaedic surgery(CAOS) is becoming a hot research topic for its high accuracy and stability.We developed a new CAOS system WATO,which is mainly designed for total knee replacement(TKR).Methods:WATO system provides the interactive software for a surgeon's preoperative planning.Based on its two infrared cameras,infrared markers and infrared probe,WATO system gives a simple surgical positioning procedure of femur and tibia without additional surgery for the placement of fiducial markers.According to the reference alignment axis from positioning procedure,a surgeon can move the robot of WATO system to do accurate bone resection.Safety checking is also considered in WATO system.Results:Extensive experiments were conducted on phantoms and cadaver bones to verify the accuracy and stability of WATO system.Experimental results showed that TKR using WATO system had better performance compared with traditional and navigated TKR.Conclusion:WATO system shows its superiority in TKR,and has a broad application prospect in the future.We will develop its new functions for other orthopaedic surgery such as total hip replacement(THR).Current disadvantages such as bigger skin incision have to be resolved in the future.
文摘An automatic markerless knee tracking and registration algorithm has been proposed in the literature to avoid the marker insertion required by conventional computer-assisted knee surgery,resulting in a shorter and less invasive surgical workflow.However,such an algorithm considers intact femur geometry only.The bone surface modification is inevitable due to intra-operative intervention.The mismatched correspondences will degrade the reliability of registered target pose.To solve this problem,this work proposed a supervised deep neural network to automatically restore the surface of processed bone.The network was trained on a synthetic dataset that consists of real depth captures of a model leg and simulated realistic femur cutting.According to the evaluation on both synthetic data and real-time captures,the registration quality can be effectively improved by surface reconstruction.The improvement in tracking accuracy is only evident over test data,indicating the need for future enhancement of the dataset and network.
文摘Background Severe valgus deformity often has bone defect and laxity of the medial ligamentous, and total knee arthroplasty in severe valgus knee is, in most cases, more challenging for surgeons. The usefulness of a computer assisted navigation system in reestablishing the mechanical axis has been well established. Hence, the interest for surgeons is how the navigation system makes the procedure of total knee arthroplasty with severe valgus knee easier. Methods From June 2006 to March 2008 in Department of Joint Surgery, Shanghai Sixth People＇s Hospital, 6 patients （7 knees） with severe valgus knee underwent total knee arthroplasty using the Stryker Navigation system, which is an active wireless and imageless system. All the patients were followed up for 12 to 18 months after surgery. The X-ray radiographs for whole limbs were obtained on all patients to determine preoperative and postoperative alignments. Results A primary, posterior stabilized prosthesis was utilized in all cases. The average preoperative overall mechanical axis of the seven knees was 19.6°±4.6° of valgus （range 16°to 29°）, and the average postoperative mechanical axis was 0.4°±0.7° （range 0.8° varus to 1.4° valgus ）. Conclusions The navigation system is a very effective and useful tool for accurate intraoperative restoration of alignment in the face of significant deformity with valgus knee. To prevent component malposition, we did not reduce the knee before solidification of bone cement but controlled alignment using the navigation system up to implantation of the final component.
基金This study was supported by Chinese National High Technology Development Programs (2002AA-4201100)
文摘Objective： To evaluate the clinical feasibility and effect of the computer-assisted auto-frame navigation system for distal locking of tibial intramedullary nails. Methods： The hardware components of the system included a PC computer with a monitor, auto mechanical stereotactical locating cubic frame, foot holder and localization operative apparatus. Special navigation software can be used for registration of X-ray fluoroscopic images and real-time controlling navigation of tools. Twenty-one cases of dose tibial and fibular fractures were treated with dosed intramedullary nailing, 6 of which involved in middle third, 12 in middle and lower third, 3 in lower third. C-arm alignment and registration time, fluoroscopic time and drilling time involved in the locking procedure were recorded. The size of unreamed or reamed tibial nails ranged from 8/300-11/330. Results： All distal holes except 1 were locked successfully. In 9 of 41 locked holes （21.95 % ）, the drill bit touched the canal of locking hole without damage of the nail and clinical consequences. The fluoroscopy time per pair of screws was 2.23 s± 0.31s. Conclusions： The computer-assisted auto-frame navigation system for distal locking is well designed, easy to operate and do not need additional instrmnents during the procedure. The developed system enables the physician to precisely navigate surgical instruments throughout the anatomy using just a few computer-calibrated radiographic images. The total time of x-ray exposure per procedure can be significantly reduced.
文摘Total knee arthroplasty （TKA） is an effective treatment for severe knee arthritis. However, TKA is more challenging when that arthritis is associated with femoral deformity that has resulted in irregularity of the canal and variation in anatomic landmarks. In such cases, it is difficult to restore the mechanical alignment of the lower limb using intramedullary instruments.
文摘Objective To evaluate the advantages of image guided system in transnasal endoscopic surgery Methods Transnasal endoscopic surgery was performed with the aid of an image guided system in 28 patients, supported with histopathologic diagnoses of chronic sinusitis with/without nasal polyps (10 cases), juvenile nasopharyngeal angiofibroma (4 cases), pituitary adenoma (6 cases), ethmoidal ossifying fibroma (3 cases), nasopharyngeal mixed tumor (2 cases), nasal leiomyoma (1 case), fungal sinusitis (1 case) and inverted nasal papilloma (1 case) Results For all the patients, the time periods from initialization to surgery ranged from 15 to 30 minutes (a mean of 26 minutes) The calibration coefficient ranged from 1 3 to 2 0 Accuracy of localization fell within 1 mm Compared with traditional endoscopic surgery, operation times were not noticeably different No complications occurred Conclusions The image guided system was able to identify borders and critical anatomical structures in real time, especially of those with distorted anatomical markers It provided a powerful means for a safer and less invasive endoscopic sinus surgery
