A 3D computed tomography based tool for orthopedic surgery planning

The preparation of a plan is essential for a surgery to take place in the best way possible and also for shortening patient’s recovery times. In the orthopedic case, planning has an accentuated significance due to the close relation between the degree of success of the surgery and the patient recovering time. It is important that surgeons are provided with tools that help them in the planning task, in order to make it more reliable and less time consuming. In this paper, we present a 3D Computed Tomography based solution and its implementation as an OsiriX plugin for orthopedic surgery planning. With the developed plugin, the surgeon is able to manipulate a three-dimensional isosurface rendered from the selected imaging study (a CT scan). It is possible to add digital representations of physical implants (surgical templates), in order to evaluate the feasibility of a plan. These templates are STL files generated from CAD models. There is also the feature to extract new isosurfaces of different voxel values and slice the final 3D model according to a predefined plane, enabling a 2D analysis of the planned solution. Finally, we discuss how the proposed application assists the surgeon in the planning process in an alternative way, where it is possible to three-dimensionally analyze the impact of a surgical intervention on the patient.

[1]  Henry Fuchs,et al.  Optimal surface reconstruction from planar contours , 1977, CACM.

[2]  Jay D. Mabrey,et al.  SYMPOSIUM: ABJS CARL T. BRIGHTON WORKSHOP ON HEALTH INFORMATICS Virtual Reality in Orthopaedics , 2010 .

[3]  Nico Verdonschot,et al.  Digital versus analogue preoperative planning of total hip arthroplasties: a randomized clinical trial of 210 total hip arthroplasties. , 2007, The Journal of arthroplasty.

[4]  Alessandro Sarti,et al.  Facial soft tissue esthetic predictions: validation in craniomaxillofacial surgery with cone beam computed tomography data. , 2010, Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons.

[5]  J M Sikorski,et al.  Computer-assisted orthopaedic surgery: do we need CAOS? , 2003, The Journal of bone and joint surgery. British volume.

[6]  Yanling Hu,et al.  Computer-assisted virtual surgical procedure for acetabular fractures based on real CT data. , 2011, Injury.

[7]  Frederic Schuind,et al.  ASPECTS OF CURRENT MANAGEMENT Kienböck's disease , 2008 .

[8]  Christian Krettek,et al.  The use of a professional graphics editing program for the preoperative planning in deformity correction surgery: A technical note. , 2010, Injury.

[9]  Osman Ratib,et al.  OsiriX: An Open-Source Software for Navigating in Multidimensional DICOM Images , 2004, Journal of Digital Imaging.

[10]  William E. Lorensen,et al.  Marching cubes: A high resolution 3D surface construction algorithm , 1987, SIGGRAPH.

[11]  James Rose,et al.  Preoperative planning in orthopedic trauma: benefits and contemporary uses. , 2010, Orthopedics.

[12]  T. H.,et al.  The Journal of Bone and Joint Surgery , 2006 .

[13]  R H Wade,et al.  Pre-operative planning in orthopaedics: a study of surgeons' opinions. , 1998, Injury.

[14]  R. Lattanzi,et al.  Applications of 3D medical imaging in orthopaedic surgery:introducing the hip-op system , 2002, Proceedings. First International Symposium on 3D Data Processing Visualization and Transmission.

[15]  Andrew R. Hsu,et al.  Effect of training level on accuracy of digital templating in primary total hip and knee arthroplasty. , 2012, Orthopedics.

[16]  Musa Citak,et al.  Use of a virtual 3D software for planning of tibial plateau fracture reconstruction. , 2010, Injury.

[17]  A. Steen,et al.  3D Visualization of Pre-operative Planning for Orthopedic Surgery , 2013, SIGRAD.

[18]  Scott D. Roth,et al.  Ray casting for modeling solids , 1982, Comput. Graph. Image Process..

[19]  Hongjian Wang Three-Dimensional Medical CT Image Reconstruction , 2009, 2009 International Conference on Measuring Technology and Mechatronics Automation.

[20]  S. Dekel,et al.  Preoperative planning of total hip replacement using the TraumaCad™ system , 2010, Archives of Orthopaedic and Trauma Surgery.