Patient-Specific Modelling in Orthopedics: From Image to Surgery
In orthopedic surgery, to decide upon intervention and how it can be optimized, surgeons usually rely on subjective analysis of medical images of the patient, obtained from computed tomography, magnetic resonance imaging, ultrasound or other techniques. R
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Abstract In orthopedic surgery, to decide upon intervention and how it can be optimized, surgeons usually rely on subjective analysis of medical images of the patient, obtained from computed tomography, magnetic resonance imaging, ultrasound or other techniques. Recent advancements in computational performance, image analysis and in silico modeling techniques have started to revolutionize clinical practice through the development of quantitative tools, including patient specific models aiming at improving clinical diagnosis and surgical treatment. Anatomical and surgical landmarks as well as features extraction can be automated allowing for the creation of general or patient specific models based on statistical shape models. Preoperative virtual planning and rapid prototyping tools allow the implementation of customized surgical solutions in real clinical environments. In the present chapter we discuss the applications of some of these techniques in orthopedics and present new computer-aided tools that can take us from image analysis to customized surgical treatment. Keywords Musculoskeletal modelling • Patient-specific models • Surgical planning
G.T. Gomes • C. Pattyn • E.A. Audenaert (*) Ghent University Hospital, Ghent, Belgium e-mail: [email protected] S. Van Cauter • M. De Beule IBiTech–bioMMeda, Ghent University, Ghent, Belgium L. Vigneron Orthopedic Department, Materialise NV, Leuven, Belgium D. Iacoviello and U. Andreaus (eds.), Biomedical Imaging and Computational Modeling 109 in Biomechanics, Lecture Notes in Computational Vision and Biomechanics 4, DOI 10.1007/978-94-007-4270-3_6, # Springer Science+Business Media Dordrecht 2013
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1 Virtual Anatomical Landmark Extraction 1.1
Anatomical Landmarks in Orthopedics
The identification of reference parameters or anatomical landmarks is a well-established technique in orthopedic surgery. Anatomical features are used for various applications. Many morphological parameters (e.g. distances, angles) are quantified based on landmarks (Paley 2002). These measurements can serve as a guideline for distinguishing dysplastic from normal morphologies (Delaunay et al. 1997). Also, many studies have shown that accurate prosthetic component positioning is a key factor for the success of joint replacement surgery and have presented recommendations for the orientation angles (Yoon et al. 2008). Joint kinematics is often described by the relative motion of joint coordinate systems that are attached to the bones. These joint coordinate systems can be defined based on anatomical features (Grood and Suntay 1983). Moreover, surgical navigation systems rely on landmarks. Image-based navigation requires patient-to-image registration and this process often relies on registration points that are determined on the image and have to be recognized during the operation (Nizard 2002). Image-free navigation systems use landmarks to create anatomical reference frames that relate the position and orientation of the reference frames that are attached to the p
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