Computer-Assisted Ankle Joint Arthroplasty Using Bio-engineered Autografts

Bio-engineered cartilage has made substantial progress over the last years. Preciously few cases, however, are known where patients were actually able to benefit from these developments. In orthopaedic surgery, there are two major obstacles between in-vitro cartilage engineering and its clinical application: successful integration of an autologuous graft into a joint and the high cost of individually manufactured implants. Computer Assisted Surgery techniques can potentially address both issues at once by simplifying the therapy, allowing pre-fabrication of bone grafts according to a shape model, individual operation planning based on CT images and providing optimal accuracy during the intervention. A pilot study was conducted for the ankle joint, comprising a simplified rotational symmetric bone surface model, a dedicated planning software and a complete cycle of treatment on one cadaveric human foot. The outcome was analysed using CT and MRI images; the post-operative CT was further segmented and registered with the implant shape to prove the feasibility of computer assisted arthroplasty using bio-engineered autografts.

[1]  A I Caplan,et al.  Principles of cartilage repair and regeneration. , 1997, Clinical orthopaedics and related research.

[2]  R. Horch,et al.  Biological Matrices and Tissue Reconstruction , 1998, Springer Berlin Heidelberg.

[3]  Arnold I. Caplan,et al.  Overview: Principles of Cartilage Repair and Regeneration , 1997 .

[4]  Colin Studholme,et al.  An overlap invariant entropy measure of 3D medical image alignment , 1999, Pattern Recognit..

[5]  Martin Styner,et al.  Statistical shape models for segmentation and structural analysis , 2002, Proceedings IEEE International Symposium on Biomedical Imaging.

[6]  B. Oakes,et al.  Orthopaedic tissue engineering: from laboratory to the clinic , 2004, The Medical journal of Australia.

[7]  C. Klemt,et al.  Tissue Engineered Cartilage with Cultured Chondrocytes and a Collagen Sponge Matrix , 1998 .

[8]  R. Ganz,et al.  Computer-Assisted Orthopedic Surgery (Caos) , 1999 .

[9]  N. Sugano Computer-assisted orthopedic surgery , 2003, Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association.

[10]  W. Landis,et al.  The potential of tissue engineering in orthopedics. , 2005, The Orthopedic clinics of North America.

[11]  A. Lynn,et al.  Repair of defects in articular joints. Prospects for material-based solutions in tissue engineering. , 2004, The Journal of bone and joint surgery. British volume.