RESUMO
Recent advances in tissue-engineered cartilage open the door to new clinical treatments of joint lesions. Common to all therapies with in-vitro engineered autografts is the need for optimal fit of the construct, to allow screwless implantation and optimal integration into the live joint. Computer Assisted Surgery techniques are prime candidates to ensure the required accuracy while at the same time simplifying the procedure. A pilot study has been conducted aiming at assembling a new set of methods to support ankle joint arthroplasty using bio-engineered autografts. Computer assistance allows planning of the implant shape on a CT image, manufacturing the construct according to the plan and interoperatively navigating the surgical tools for implantation. A rotational symmetric model of the joint surface was used to avoid segmentation of the CT image; a new software was developed to determine the joint axis and make the implant shape parameterisable. A complete cycle of treatment from planning to operation was conducted on a human cadaveric foot, thus proving the feasibility of computer-assisted arthroplasty using bio-engineered autografts.
RESUMO
Recent advances in tissue-engineered cartilage open the door to new clinical treatments of joint lesions. Common to all therapies with in-vitro engineered autografts is the need for optimal fit of the construct, to allow screwless implantation and optimal integration into the live joint. Computer Assisted Surgery techniques are prime candidates to ensure the required accuracy while at the same time simplifying the procedure. A pilot study has been conducted aiming at assembling a new set of methods to support ankle joint arthroplasty using bio-engineered autografts. Computer assistance allows planning of the implant shape on a CT image, manufacturing the construct according to the plan and interoperatively navigating the surgical tools for implantation. A rotational symmetric model of the joint surface was used to avoid segmentation of the CT image; a new software was developed to determine the joint axis and make the implant shape parameterisable. A complete cycle of treatment from planning to operation was conducted on a human cadaveric foot, thus proving the feasibility of computer-assisted arthroplasty using bio-engineered autografts.
RESUMO
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.