title: Fluoroscopy-based 3-D reconstruction of femoral bone cement: a new approach for revision total hip replacement.
abstract: In revision total hip replacement the removal of the distal femoral bone cement can be a time consuming and risky operation due to the difficulty in determining the three-dimensional (3-D) boundary of the cement. We present a new approach to reconstruct the bone cement volume by using just a small number of calibrated multiplanar X-ray images. The modular system design allows the surgeon to react intraoperatively to problems arising during the individual situation. When encountering problems during conventional cement removal, the system can be used on demand to acquire a few calibrated X-ray images. After a semi-automatic segmentation and 3-D reconstruction of the cement with a deformable model, the system guides the surgeon through a free-hand navigated or robot-assisted cement removal. The experimental evaluation using plastic test implants cemented into anatomic specimen of human femoral bone has shown the potential of this method with a maximal error of 1.2 mm (0.5 mm RMS) for the distal cement based on just 4-5 multiplanar X-ray images. A first test of the complete system, comparing the 3-D-reconstruction with a computed tompgraphy data set, confirmed these results with a mean error about 1 mm.
authors.affiliation: Helmholtz-Institute of Biomedical Technologies, D-52074 Aachen, Germany. fuente@hia.rwthaachen.de
authors.forename: Matías
authors.initials: M
authors.lastname: de la Fuente
authors.forename: Jörg A K
authors.initials: JA
authors.lastname: Ohnsorge
authors.forename: Erik
authors.initials: E
authors.lastname: Schkommodau
authors.forename: Stefanie
authors.initials: S
authors.lastname: Jetzki
authors.forename: Dieter C
authors.initials: DC
authors.lastname: Wirtz
authors.forename: Klaus
authors.initials: K
authors.lastname: Radermacher
mesh_terms: D019644:Arthroplasty, Replacement, Hip / Q000379:methods*; D001843:Bone Cements; D002484:Cementation / Q000379:methods; D003646:Debridement / Q000379:methods*; D020878:Device Removal / Q000379:methods; D005269:Femur / Q000000981:diagnostic imaging* / Q000601:surgery*; D005471:Fluoroscopy / Q000295:instrumentation / Q000379:methods; D021621:Imaging, Three-Dimensional / Q000379:methods*; D007430:Intraoperative Care / Q000379:methods; D019047:Phantoms, Imaging; D011857:Radiographic Image Interpretation, Computer-Assisted / Q000379:methods; D012086:Reoperation / Q000379:methods; D012371:Robotics / Q000379:methods; D025321:Surgery, Computer-Assisted / Q000379:methods*; D016896:Treatment Outcome
chemical_list: D001843:Bone Cements