| EPSRC Reference: |
EP/C014960/1 |
| Title: |
Computer assisted surgery: Radiation free, expedited design of disposable patient specific templates for total knee replacement |
| Principal Investigator: |
Seedhom, Dr BB |
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| Department: |
School of Medicine |
| Organisation: |
University of Leeds |
| Scheme: |
Standard Research (Pre-FEC) |
| Starts: |
23 May 2005 |
Ends: |
22 December 2006 |
Value (£): |
101,875
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Summary on Grant Application Form |
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Success of knee replacement operation depends on accurate placement of the artificial joint components in the patient's knee. In the operating theatre surgeons use sets of tool kits that consist of 'jigs and fixtures' / guides to aid them in making bone cuts to prepare the joint for the implantation process of the artificial components. The tool kit usually consists of 100 or so components, which are quite costly to make and costly to sterilize for reuse between operations. The guides also have been designed for the average geometry of each knee size and so they do not fit perfectly on the bones - there is a bit of play which might result in errors when making the bone cuts. This project is about using the images of patients' knee bones which can be stored in the computer and allow the three dimensional shapes of the bones to be displayed on a computer screen, and where the surgeon and bioengineer can do a mock operation on these bone models. This process, so called pre-operative planning is like some kind of a computer game. In this planning it is possible to call on the computer screen, from an electronic library the of right size of the artificial components, fit them on the bones; adjust the bone cuts and the position of the implant in the joint as it can never be done in the theatre. Once the optimal position of the implant is agreed, the bone cuts are also determined and on the basis of these a customised pair of guides are designed (one for each bone). Each of these guides will fit in one way only on the bone for which it is designed. It will have thin slits and holes for saw blades and drill bits to make the required bone cuts to receive the artificial component. The designs of these templates can be sent via the email to a manufacturing site to be produced overnight using a very cheap production method called rapid prototyping (RP). The RP refers a class of technologies that can automatically construct physical models from computer aided design data. Unlike traditional manufacturing techniques, in which material is removed from a block of material in a subtractive process, the RP is an additive process that melts plastic powder to create a solid object.Surgeons have tried these templates on both real and plastic knee bones and have been impressed by the accuracy of selection and placement of the correct artificial knee in the joint. Using the customised templates they were able to achieve the cuts as was planned on the computer. The short time to perform surgery, small number of tools (two to be precise), the ability of surgeon to operate without an assistance (a luxury not available in other types of surgical techniques) coupled with fact that no computers are taken into the operating theatre have been overwhelmingly welcomed by surgeons who were informed of the technique.While this technique has been proven in the laboratory there are two issues that need to be addressed before it can be tested directly in patients;1. The technology that we have used to obtain bone images, computer tomography (CT) scanning, while it provides good definition of joint geometry it exposes patient to X-ray radiation. It is preferable to have as few exposures to X-rays as possible and so it was necessary to find an alternative means of obtaining data from which it would be possible to reconstruct the 3-D geometries of the knee bones, which did not use X-rays. Magnetic Resonance Imaging (MRI) presents as a safe alternative. The first objective of our proposal is therefore to explore and demonstrate that MRI will be as good a source of information as is CT for the reconstruction 3-D geometries of the knee bones.2. At present the time it takes to complete pre-surgical planning and jig design is quite long / about 5 hours. The second objective is to reduce this to a minimum by the automation of as many of the steps in both activities as possible. This will require writing and validating appropriate software to achieve
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Key Findings |
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This information can now be found on Gateway to Research (GtR) http://gtr.rcuk.ac.uk
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Potential use in non-academic contexts |
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This information can now be found on Gateway to Research (GtR) http://gtr.rcuk.ac.uk
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Impacts |
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| Description |
This information can now be found on Gateway to Research (GtR) http://gtr.rcuk.ac.uk |
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Sectors submitted by the Researcher |
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This information can now be found on Gateway to Research (GtR) http://gtr.rcuk.ac.uk
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| Further Information: |
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| Organisation Website: |
http://www.leeds.ac.uk |