Development of new delivery systems for precise alignment in Total Hip Replacement (THR)
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USyd Access
Type
ThesisThesis type
Doctor of PhilosophyAuthor/s
Arulampalam, JevanAbstract
Assistive technologies are becoming more common in Total Hip Replacement (THR) procedures, improving surgeons' abilities to achieve target orientations. These systems can be large, absorbing limited space in the operating theatre, and add complexity to surgery. Furthermore, these ...
See moreAssistive technologies are becoming more common in Total Hip Replacement (THR) procedures, improving surgeons' abilities to achieve target orientations. These systems can be large, absorbing limited space in the operating theatre, and add complexity to surgery. Furthermore, these systems historically do not enable the surgeon to account for functional changes in pelvic position, with target component placements generally being defined from non-functional safe zones. In this thesis, we developed and investigated newer technologies of image registration and augmented reality, incorporating them into delivery systems for THR. Critically, the developed systems utilised information from patient-specific planning to increase their precision and address the gap between planning and delivering patient-specific safe zones. Two systems were developed to different stages of maturity. The first, an image-based navigation system incorporating Augmented Reality was validated in cadaver testing with surgeons, demonstrating its accuracy and usability. The second, is a 2D/3D image registration solution, that matches 3D pre-operative data to intra-operative fluoroscopy which was tested for accuracy in bench tests using representative images. Both systems showed promising accuracy results with mean absolute errors, compared to ground truth, within clinically acceptable limits. Both are viable alternatives for clinical settings, to assist in the delivery of preoperative target component alignments for THR. This body of work describes the development and testing of these systems and details the proposed application and use in THR surgery.
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See moreAssistive technologies are becoming more common in Total Hip Replacement (THR) procedures, improving surgeons' abilities to achieve target orientations. These systems can be large, absorbing limited space in the operating theatre, and add complexity to surgery. Furthermore, these systems historically do not enable the surgeon to account for functional changes in pelvic position, with target component placements generally being defined from non-functional safe zones. In this thesis, we developed and investigated newer technologies of image registration and augmented reality, incorporating them into delivery systems for THR. Critically, the developed systems utilised information from patient-specific planning to increase their precision and address the gap between planning and delivering patient-specific safe zones. Two systems were developed to different stages of maturity. The first, an image-based navigation system incorporating Augmented Reality was validated in cadaver testing with surgeons, demonstrating its accuracy and usability. The second, is a 2D/3D image registration solution, that matches 3D pre-operative data to intra-operative fluoroscopy which was tested for accuracy in bench tests using representative images. Both systems showed promising accuracy results with mean absolute errors, compared to ground truth, within clinically acceptable limits. Both are viable alternatives for clinical settings, to assist in the delivery of preoperative target component alignments for THR. This body of work describes the development and testing of these systems and details the proposed application and use in THR surgery.
See less
Date
2023Rights statement
The author retains copyright of this thesis. It may only be used for the purposes of research and study. It must not be used for any other purposes and may not be transmitted or shared with others without prior permission.Faculty/School
Faculty of Engineering, School of Aerospace Mechanical and Mechatronic EngineeringAwarding institution
The University of SydneyShare