An Inertial-based Navigation System via Direct Anterior Approach in Total Hip Arthroplasty Surgeries, with both system design and validity verification. Funded by Shenzhen People's Hospital. (Grant 100,000 CNY.)
Introduction
•With the aging of society, the number of people suffering from hip diseases has increased year by year.
•Total hip replacement (THA) surgery is an effective way to treat end-stage hip diseases and elderly hip fractures.
•THA can be performed using a variety of surgical approaches, such as the direct anterior approach (DAA), the anterolateral approach, the lateral approach, and the posterolateral approach (PLA) [1].
•DAA offers a quicker functional recovery and is less invasive with an earlier return to daily activities in older THA patients.
Difficulties
Most frequent complication of THA: Dislocation[1]
To avoid dislocation:
• The acetabular prosthesis should be implanted accurately.
• Two reference angles in radiographic definition, anteversion angle (RA) and inclination angle (RI).
• Safe zones of 5◦ to 25◦ for RA and 30◦ to 50◦ for RI is widely recognized in medical community[2].
Current Methods and Our Proposal
Surgeons use: Computed Tomography (CT)
• High cost
• Long operation time
• Radiation exposure
Researches tried:
Visual Aided System
• Complex image analysis -> power consumption and delay
• Remodeling of the operating room
We propose:
Methods
On-handle Module:
On-body Module:
Data Process and Transmission:
Visualization and Demos
Experimental Design
3-DoF of the system :
System Validation – Static Validation:
For each DoF:
Mounted on a robotic arm and rotate from 0-90 deg with step 5 deg
Root Mean Square Error (RMSE) of:
R_(Handle_Z) : 1.04 deg
R_(Handle_X) : 2.37 deg
R_(Body_Z) : 0.85 deg
System Validation – Dynamic Validation:
For each DoF:
Mounted on a robotic arm and rotate from 0-90 deg with different speeds
System Validation – Long-term drift:
Model Simulation
Discussion
1.Suffer from magnetic field
•Magnetometers measure the strength and direction of the magnetic field in the vicinity of the device.
•Therefore, they can be easily disturbed by other magnetic fields—such as those produced by nearby electronic devices, metal objects, or even electrical wiring in a building.
2. Only appliable for DAA
•Due to the relative fixability of patients’ pelvis along the X and Y axis, we used single-axis gyroscope to measure the rotation.
•Cannot be appliable to other surgeries and other approach of THA. Only appliable for DAA.
3. Influence on mounted position
•The mounting position of an Inertial Measurement Unit (IMU) can significantly influence its performance and the accuracy of its measurements.
•IMUs are sensitive to vibration and shock. If the IMU is mounted in a location that experiences high levels of vibration or shock, this can introduce noise into the sensor data and reduce the accuracy of the measurements.
Our contribution
• We proposed a hardware-software co-designed measurement system for THA surgeries via DAA.
• We verified the validity of the system and apply plastic pelvis model situation to restore the most real situation.
Reference
[1] Z. Jin, L. Wang, J. Qin, H. Hu, and Q. Wei, “Direct anterior approach versus posterolateral approach for total hip arthroplasty in the treatment of femoral neck fractures in elderly patients: a meta-analysis and systematic review,” Annals of Medicine, vol. 55, no. 1, pp. 1378–1392, Dec. 2023, doi: 10.1080/07853890.2023.2193424.
[2] M. B. Rasmussen, A. El-Galaly, L. Daugberg, P. T. Nielsen, and T. Jakobsen, “Projection of primary and revision hip arthroplasty surgery in Denmark from 2020 to 2050,” ActaO, vol. 93, pp. 849–853, Nov. 2022, doi: 10.2340/17453674.2022.5255.
[3] R. Biedermann, A. Tonin, M. Krismer, F. Rachbauer, G. Eibl, and B. Stöckl, “Reducing the risk of dislocation after total hip arthroplasty: THE EFFECT OF ORIENTATION OF THE ACETABULAR COMPONENT,” The Journal of Bone and Joint Surgery. British volume, vol. 87-B, no. 6, pp. 762–769, Jun. 2005, doi: 10.1302/0301-620X.87B6.14745.
[4] P. A. Banaszkiewicz, “Dislocations After Total Hip-Replacement Arthroplasties,” in Classic Papers in Orthopaedics, P. A. Banaszkiewicz and D. F. Kader, Eds., London: Springer London, 2014, pp. 113–115. doi: 10.1007/978-1-4471-5451-8_27.
