title: Electrical Bioimpedance-Controlled Surgical Instrumentation.
abstract: A bioimpedance-controlled concept for bone cement milling during revision total hip replacement is presented. Normally, the surgeon manually removes bone cement using a hammer and chisel. However, this procedure is relatively rough and unintended harm may occur to tissue at any time. The proposed bioimpedance-controlled surgical instrumentation improves this process because, for example, most risks associated with bone cement removal are avoided. The electrical bioimpedance measurements enable online process-control by using the milling head as both a cutting tool and measurement electrode at the same time. Furthermore, a novel integrated surgical milling tool is introduced, which allows acquisition of electrical bioimpedance data for online control; these data are used as a process variable. Process identification is based on finite element method simulation and on experimental studies with a rapid control prototyping system. The control loop design includes the identified process model, the characterization of noise as being normally distributed and the filtering, which is necessary for sufficient accuracy ( ±0.5 mm). Also, in a comparative study, noise suppression is investigated in silico with a moving average filter and a Kalman filter. Finally, performance analysis shows that the bioimpedance-controlled surgical instrumentation may also performs effectively at a higher feed rate (e.g., 5 mm/s).
authors.forename: Christian
authors.initials: C
authors.lastname: Brendle
authors.forename: Benjamin
authors.initials: B
authors.lastname: Rein
authors.forename: Annegret
authors.initials: A
authors.lastname: Niesche
authors.forename: Alexander
authors.initials: A
authors.lastname: Korff
authors.forename: Klaus
authors.initials: K
authors.lastname: Radermacher
authors.forename: Berno
authors.initials: B
authors.lastname: Misgeld
authors.forename: Steffen
authors.initials: S
authors.lastname: Leonhardt
mesh_terms: D019644:Arthroplasty, Replacement, Hip / Q000295:instrumentation*; D001843:Bone Cements; D017097:Electric Impedance; D004867:Equipment Design; D005269:Femur / Q000601:surgery; D006801:Humans; D008954:Models, Biological; D012815:Signal Processing, Computer-Assisted / Q000295:instrumentation*; D013525:Surgical Instruments
chemical_list: D001843:Bone Cements