title: Computer assisted planning and navigation of periacetabular osteotomy with range of motion optimization.
abstract: Femoroacetabular impingement (FAI) before or after Periacetabular Osteotomy (PAO) is surprisingly frequent and surgeons need to be aware of the risk preoperatively and be able to avoid it intraoperatively. In this paper we present a novel computer assisted planning and navigation system for PAO with impingement analysis and range of motion (ROM) optimization. Our system starts with a fully automatic detection of the acetabular rim, which allows for quantifying the acetabular morphology with parameters such as acetabular version, inclination and femoral head coverage ratio for a computer assisted diagnosis and planning. The planned situation was optimized with impingement simulation by balancing acetabuar coverage with ROM. Intra-operatively navigation was conducted until the optimized planning situation was achieved. Our experimental results demonstrated: 1) The fully automated acetabular rim detection was validated with accuracy 1.1 ± 0.7mm; 2) The optimized PAO planning improved ROM significantly compared to that without ROM optimization; 3) By comparing the pre-operatively planned situation and the intra-operatively achieved situation, sub-degree accuracy was achieved for all directions.
authors.forename: Li
authors.initials: L
authors.lastname: Liu
authors.forename: Timo
authors.initials: T
authors.lastname: Ecker
authors.forename: Steffen
authors.initials: S
authors.lastname: Schumann
authors.forename: Klaus
authors.initials: K
authors.lastname: Siebenrock
authors.forename: Lutz
authors.initials: L
authors.lastname: Nolte
authors.forename: Guoyan
authors.initials: G
authors.lastname: Zheng
mesh_terms: D000077:Acetabulum / Q000000981:diagnostic imaging* / Q000601:surgery*; D000465:Algorithms; D057925:Femoracetabular Impingement / Q000000981:diagnostic imaging* / Q000601:surgery*; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods; D010027:Osteotomy / Q000379:methods*; D010363:Pattern Recognition, Automated / Q000379:methods; D011300:Preoperative Care / Q000379:methods; D011856:Radiographic Image Enhancement / Q000379:methods; D011857:Radiographic Image Interpretation, Computer-Assisted / Q000379:methods; D016059:Range of Motion, Articular; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D025321:Surgery, Computer-Assisted / Q000379:methods*; D014057:Tomography, X-Ray Computed / Q000379:methods*; D016896:Treatment Outcome