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International Journal of Computer Assisted Radiology and Surgery

Numerical optimization of alignment reproducibility for customizable surgical guides

Thomas Kroes, Edward R. Valstar, and Elmar Eisemann

Left full exposure, pins can be deployed anywhere on the bone/cartilage. Right limited exposure. The orthopedic surgeon paints the areas on the bone that are deemed accessible during surgery, thus limiting where pins can be deployed

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Computer-assisted orthopedic surgery aims at minimizing invasiveness, postoperative pain, and morbidity with computer-assisted preoperative planning and intra-operative guidance techniques, of which camera-based navigation and patient-specific templates (PST) are the most common. PSTs are one-time templates that guide the surgeon initially in cutting slits or drilling holes. This method can be extended to reusable and customizable surgical guides (CSG), which can be adapted to the patients' bone. Determining the right set of CSG input parameters by hand is a challenging task, given the vast amount of input parameter combinations and the complex physical interaction between the PST/CSG and the bone. This paper introduces a novel algorithm to solve the problem of choosing the right set of input parameters. Our approach predicts how well a CSG instance is able to reproduce the planned alignment based on a physical simulation and uses a genetic optimization algorithm to determine optimal configurations. We validate our technique with a prototype of a pin-based CSG and nine rapid prototyped distal femora.

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Citation

Thomas Kroes, Edward R. Valstar, and Elmar Eisemann, Numerical optimization of alignment reproducibility for customizable surgical guides, International Journal of Computer Assisted Radiology and Surgery, 10, pp. 1567–1578, 2015.

BibTex 

@article{bib:kroes:2015,
    author       = { Kroes, Thomas and Valstar, Edward R. and Eisemann, Elmar },    
    title        = { Numerical optimization of alignment reproducibility for customizable surgical guides },
    journal      = { International Journal of Computer Assisted Radiology and Surgery },
    volume       = { 10 },
    year         = { 2015 },
    pages        = { 1567--1578 },
    doi          = { 10.1007/s11548-015-1171-8 },
    dblp         = { journals/cars/KroesVE15 },
    url          = { https://publications.graphics.tudelft.nl/papers/263 },
}