Development of a Force-Based Ream Vector Measurement System For Glenoid Reaming Simulation

Glenoid reaming is a technically challenging step during total shoulder arthroplasty surgery that may be improved through frequent practice and exposure to simulation training. At our institution, a vibration haptic glenoid reaming simulator is being developed that simulates the vibrations felt during glenoid reaming. This thesis presents the development of a force-based reamer vector measurement system that allows the simulator to measure the user’s net applied force and reamer angle of approach. This capability allows for the simulation of eccentric reaming maneuvers commonly used to adjust the glenoid orientation. The system error was characterized and evaluated using a robot to operate a surgical reaming tool. Finally, a study was performed that assessed the ability of surgeons to correct glenoid retroversion while using the haptic vibration simulator. Overall, the surgeons were able to correct glenoid orientation within 1 degree of the target orientation, according to the simulator’s reaming vector measurement system

A bone reaming system using micromachined pressure sensor.

Ho, Wai-to Antony.Thesis (M.Phil.)--Chinese University of Hong Kong, 2001.Includes bibliographical references (leaves 100-102).Abstracts in English and Chinese.Abstract --- p.IAcknowledgement --- p.IIITable of Content --- p.IVList of Figures --- p.VIList of Tables --- p.XList of Charts --- p.XIChapter CHAPTER 1: --- INTRODUCTION --- p.1Chapter 1.1 --- Biomedical sensing --- p.1Chapter 1.2 --- Bone Fracture --- p.2Chapter 1.3 --- Bone Fracture Treatment --- p.3Chapter 1.4 --- Objectives --- p.4Chapter CHAPTER 2: --- LITERATURE SURVEY --- p.5Chapter 2.1 --- Bone Structure --- p.5Chapter 2.2 --- Biomechanics in Bone Fracture --- p.10Chapter 2.3 --- Mathematical Model on Bending and Fracture --- p.11Chapter 2.4 --- Intramedullary nailing --- p.12Chapter 2.5 --- Reaming technique for intramedullary nailing --- p.14Chapter 2.6 --- More on reaming technique --- p.16Chapter 2.7 --- Existing pressure-monitoring system of reaming operation --- p.18Chapter 2.8 --- Biomedical sensation --- p.19Chapter CHAPTER 3: --- SYSTEM DESIGN: RE-ENGINEERING OF A BONE REAMING SYSTEM --- p.23Chapter 3.1 --- Mechanical Design-Bone Reaming Guide Rod --- p.23Chapter 3.2 --- Guide Rod --- p.24Chapter 3.2.1 --- Guide Rod: Head --- p.25Chapter 3.2.2 --- Guide Rod: Rod Body --- p.32Chapter 3.2.3 --- Guide Rod: Tail --- p.41Chapter 3.3 --- Connection System --- p.43Chapter 3.3.1 --- Connection System: Components --- p.44Chapter 3.3.2 --- Connection System: Connection Mechanism --- p.50Chapter 3.3.3 --- Connection System: Disconnection Mechanism --- p.53Chapter 3.4 --- Signal Transmission Mechanism --- p.54Chapter 3.5 --- Plastic Case --- p.57Chapter 3.6 --- Selection of Microsensor --- p.59Chapter CHAPTER 4: --- SIGNAL CONDITIONING & PROCESSING --- p.62Chapter 4.1 --- Signal Conditioning and Processing --- p.62Chapter 4.2 --- Voltage Regulation --- p.62Chapter 4.3 --- Instrumentation Amplification --- p.64Chapter 4.4 --- Noise Filtering --- p.66Chapter 4.5 --- Signal Processing Software --- p.66Chapter CHAPTER 5: --- EXPERIMENTAL SETUP --- p.68Chapter 5.1 --- Experiments --- p.68Chapter 5.2 --- MEMS Pressure Sensor --- p.68Chapter 5.3 --- Voltage Regulation Experiment --- p.70Chapter 5.4 --- Noise Filtering Experiment --- p.70Chapter 5.5 --- Rotating Bearing Signal Transmission System --- p.74Chapter 5.6 --- Guide Rod System Calibration Experiment --- p.76Chapter 5.6.1 --- Calibration Experiment-Stationary --- p.79Chapter 5.6.2 --- Calibration Experiment-Dynamic --- p.79Chapter CHAPTER 6: --- EXPERIMENTAL RESULTS --- p.80Chapter 6.1 --- Results --- p.80Chapter 6.2 --- MEMS Pressure Sensor --- p.80Chapter 6.3 --- Voltage Regulation Experiment --- p.81Chapter 6.4 --- Noise Filtering Experiment --- p.82Chapter 6.5 --- Rotating Bearing Signal Transmission System --- p.83Chapter 6.5.1 --- Non-rotating experiment --- p.83Chapter 6.5.2 --- Rotating experiment --- p.84Chapter 6.5.2.1 --- Rotating experiment -Unprocessed --- p.84Chapter 6.5.2.2 --- Rotating experiment -Noise Filtering --- p.86Chapter 6.6 --- Guide Rod System Calibration Experiment --- p.89Chapter 6.6.1 --- Calibration experiment-Stationary System Calibration --- p.89Chapter 6.6.2 --- Rotating experiment-Rotating Speed Calibration --- p.91Chapter 6.6.2.1 --- Influence of rotation motion on fluidic pressure --- p.91Chapter 6.6.2.2 --- Calibration Experiment --- p.94Chapter CHAPTER 7: --- CONCLUSION --- p.98Chapter CHAPTER 8: --- REFERENCE --- p.100Appendix --- p.10

Machine learning and interactive real-time simulation for training on relevant total hip replacement skills.

Virtual Reality simulators have proven to be an excellent tool in the medical sector to help trainees mastering surgical abilities by providing them with unlimited training opportunities. Total Hip Replacement (THR) is a procedure that can benefit significantly from VR/AR training, given its non-reversible nature. From all the different steps required while performing a THR, doctors agree that a correct fitting of the acetabular component of the implant has the highest relevance to ensure successful outcomes. Acetabular reaming is the step during which the acetabulum is resurfaced and prepared to receive the acetabular implant. The success of this step is directly related to the success of fitting the acetabular component. Therefore, this thesis will focus on developing digital tools that can be used to assist the training of acetabular reaming. Devices such as navigation systems and robotic arms have proven to improve the final accuracy of the procedure. However, surgeons must learn to adapt their instrument movements to be recognised by infrared cameras. When surgeons are initially introduced to these systems, surgical times can be extended up to 20 minutes, maximising surgical risks. Training opportunities are sparse, given the high investment required to purchase these devices. As a cheaper alternative, we developed an Augmented Reality (AR) alternative for training on the calibration of imageless navigation systems (INS). At the time, there were no alternative simulators that using head-mounted displays to train users into the steps to calibrate such systems. Our simulator replicates the presence of an infrared camera and its interaction with the reflecting markers located on the surgical tools. A group of 6 hip surgeons were invited to test the simulator. All of them expressed their satisfaction with the ease of use and attractiveness of the simulator as well as the similarity of interaction with the real procedure. The study confirmed that our simulator represents a cheaper and faster option to train multiple surgeons simultaneously in the use of Imageless Navigation Systems (INS) than learning exclusively on the surgical theatre. Current reviews on simulators for orthopaedic surgical procedures lack objective metrics of assessment given a standard set of design requirements. Instead, most of them rely exclusively on the level of interaction and functionality provided. We propose a comparative assessment rubric based on three different evaluation criteria. Namely immersion, interaction fidelity, and applied learning theories. After our assessment, we found that none of the simulators available for THR provides an accurate interactive representation of resurfacing procedures such as acetabular reaming based on force inputs exerted by the user. This feature is indispensable for an orthopaedics simulator, given that hand-eye coordination skills are essential skills to be trained before performing non-reversible bone removal on real patients. Based on the findings of our comparative assessment, we decided to develop a model to simulate the physically-based deformation expected during traditional acetabular reaming, given the user’s interaction with a volumetric mesh. Current interactive deformation methods on high-resolution meshes are based on geometrical collision detection and do not consider the contribution of the materials’ physical properties. By ignoring the effect of the material mechanics and the force exerted by the user, they become inadequate for training on hand- eye coordination skills transferable to the surgical theatre. Volumetric meshes are preferred in surgical simulation to geometric ones, given that they are able to represent the internal evolution of deformable solids resulting from cutting and shearing operations. Existing numerical methods for representing linear and corotational FEM cuts can only maintain interactive framerates at a low resolution of the mesh. Therefore, we decided to train a machine-learning model to learn the continuum mechanic laws relevant to acetabular reaming and predict deformations at interactive framerates. To the best of our knowledge, no research has been done previously on training a machine learning model on non-elastic FEM data to achieve results at interactive framerates. As training data, we used the results from XFEM simulations precomputed over 5000 frames for plastic deformations on tetrahedral meshes with 20406 elements each. We selected XFEM simulation as the physically-based deformation ground-truth given its accuracy and fast convergence to represent cuts, discontinuities and large strain rates. Our machine learning-based interactive model was trained following the Graph Neural Networks (GNN) blocks. GNNs were selected to learn on tetrahedral meshes as other supervised-learning architectures like the Multilayer perceptron (MLP), and Convolutional neural networks (CNN) are unable to learn the relationships between entities with an arbitrary number of neighbours. The learned simulator identifies the elements to be removed on each frame and describes the accumulated stress evolution in the whole machined piece. Using data generated from the results of XFEM allowed us to embed the effects of non-linearities in our interactive simulations without extra processing time. The trained model executed the prediction task using our tetrahedral mesh and unseen reamer orientations faster per frame than the time required to generate the training FEM dataset. Given an unseen orientation of the reamer, the trained GN model updates the value of accumulated stress on each of the 20406 tetrahedral elements that constitute our mesh during the prediction task. Once this value is updated, the tetrahedrons to be removed from the mesh are identified using a threshold condition. After using each single-frame output as input for the following prediction repeatedly for up to 60 iterations, our model can maintain an accuracy of up to 90.8% in identifying the status of each element given their value of accumulated stress. Finally, we demonstrate how the developed estimator can be easily connected to any game engine and included in developing a fully functional hip arthroplasty simulator

From Concept to Market: Surgical Robot Development

Surgical robotics and supporting technologies have really become a prime example of modern applied information technology infiltrating our everyday lives. The development of these systems spans across four decades, and only the last few years brought the market value and saw the rising customer base imagined already by the early developers. This chapter guides through the historical development of the most important systems, and provide references and lessons learnt for current engineers facing similar challenges. A special emphasis is put on system validation, assessment and clearance, as the most commonly cited barrier hindering the wider deployment of a system

Experimental Analysis of Parameters Influencing the Bone Burring Process

The experimental quantification of the bone removal characteristics associated with bone burring represents a desirable outcome mainly for the selection of optimal parameters. An experimental apparatus was developed that allowed for concurrent measurement of three outputs associated with the bone removal process (cutting force, vibration, and temperature) as a function of various burring-specific parameters. Initial process trends were established on a uniform sawbone analog through use of a fully balanced multivariate statistical analysis. A smaller set of optimal and suboptimal parameters were further validated using a porcine femur. From the parameters tested, an optimal tool configuration, to avoid high temperature and high vibration, was found to be a 6 mm sphere burr at a rotational speed of 15,000 rpm, feed rate of 2 mm/s and a path overlap of 50%. This set of parameters also provided flexibility in tool depth/orientation angle relative to the bone without sacrificing optimal process outcomes

Medical Robotics

The first generation of surgical robots are already being installed in a number of operating rooms around the world. Robotics is being introduced to medicine because it allows for unprecedented control and precision of surgical instruments in minimally invasive procedures. So far, robots have been used to position an endoscope, perform gallbladder surgery and correct gastroesophogeal reflux and heartburn. The ultimate goal of the robotic surgery field is to design a robot that can be used to perform closed-chest, beating-heart surgery. The use of robotics in surgery will expand over the next decades without any doubt. Minimally Invasive Surgery (MIS) is a revolutionary approach in surgery. In MIS, the operation is performed with instruments and viewing equipment inserted into the body through small incisions created by the surgeon, in contrast to open surgery with large incisions. This minimizes surgical trauma and damage to healthy tissue, resulting in shorter patient recovery time. The aim of this book is to provide an overview of the state-of-art, to present new ideas, original results and practical experiences in this expanding area. Nevertheless, many chapters in the book concern advanced research on this growing area. The book provides critical analysis of clinical trials, assessment of the benefits and risks of the application of these technologies. This book is certainly a small sample of the research activity on Medical Robotics going on around the globe as you read it, but it surely covers a good deal of what has been done in the field recently, and as such it works as a valuable source for researchers interested in the involved subjects, whether they are currently “medical roboticists” or not

Development of Optimal Total Hip Joint Replacement

Total hip replacement (THR) is a surgical process in which the hip joint is replaced by a hip prosthesis. It is one of the most popular and cost effective surgery. In particular in 2014, 83,125 primary procedures were recorded. Some of these operations need to be carried out again for different reasons after sometime. These are called revision (replacement of the prosthesis) procedures. Important studies and statistics suggest that the number of THR procedures is projected to increase by almost 175% by 2030. Aseptic loosening appears to be the most significant cause of failure in THR. Aseptic loosening might lead to revision surgery and in turn can be avoided by enhancing the stability and durability of the hip replacement. Primary stability attained after surgery is a determinant issue for the long-term stability of cementless hip arthroplasty. Primary stability is the level of relative micromotion between the femur and the prosthesis induced via the physiological joint forces following the surgery. The hip prosthesis is also exposed to dynamic loadings and activities of daily living, which can induce the stress distribution on the prosthesis of the hip joint model and affect the durability of the implant. The aim of this study is to develop an optimal total hip replacement (THR) implant with new and improved design features to achieve stability and durability. The micromotion between bone and implant interface and the stress distribution on the prosthesis and femur assembly has been reviewed and investigated. The laboratory testing were carried out on the femur including the compression, torsion and Brinell hardness testing. A compression testing using strain gauge technique done on the hip implant. Finite element analysis software used to simulate all compression and torsion testing assuming the same boundary and loading conditions and subsequently the computational results were compared with the earlier experimental data to verify the experiments and models used. 7 The comparative micromotion studies and findings of other researchers were used beside the clinical follow-up reports on success or failure rates of related hip designs, to justify the best solutions for design factors. In this computational approach researchers usually use finite element methodology to calculate micromotion of elements, sometimes known as migration. The elements exceeding the threshold limit would simulate the migration and subsequently eliminated from the assembly. This procedure recurs until reaching the convergence that derives a stable mechanical equilibrium. One of the restrictions of micromotion analysis was the inability to divide the final results into axial and rotational components. Therefore it would have been inappropriate to eventually conclude the best femoral stem, without considering the sustaining torsional loadings. Another limitation was that the micromotion analysis would not reflect the stress distribution on the hip prosthesis and consequently would ignore the potential high stress concentration that is associated with post operative pain as well as low durability and long-term stability. For these reasons stress analysis was carried out under dynamic loadings of nine different activities to examine the von Mises stress, shear stress and principal stress distribution of a cementless hip implant. In each activity realistic boundary and loading conditions of a complete assembly of femur and hip implant were investigated which includes defining of many variables including different geometry, material properties, boundary conditions, forces and moments of varying magnitude and orientation over specific time intervals. The critical points and areas that were developed in the entire 3D model were evaluated and explained. The finite element analysis which verified by experimental testing and hold the clinical relevance were used to decide the best optimal hip stem design amongst different presented design concepts. This was accompanied and improved with further stress analysis of different design factors to get the final optimal model. High offset stem option is a unique feature that helps tightening the abductor and boosts the hip implant stability with the ability to adjust neck and offset. It gives a surgeon more options to fix the most accurate offset and do the operation more effectively. The final optimal design and its advantages were presented in the last chapter

Mining Technologies Innovative Development

The present book covers the main challenges, important for future prospects of subsoils extraction as a public effective and profitable business, as well as technologically advanced industry. In the near future, the mining industry must overcome the problems of structural changes in raw materials demand and raise the productivity up to the level of high-tech industries to maintain the profits. This means the formation of a comprehensive and integral response to such challenges as the need for innovative modernization of mining equipment and an increase in its reliability, the widespread introduction of Industry 4.0 technologies in the activities of mining enterprises, the transition to "green mining" and the improvement of labor safety and avoidance of man-made accidents. The answer to these challenges is impossible without involving a wide range of scientific community in the publication of research results and exchange of views and ideas. To solve the problem, this book combines the works of researchers from the world's leading centers of mining science on the development of mining machines and mechanical systems, surface and underground geotechnology, mineral processing, digital systems in mining, mine ventilation and labor protection, and geo-ecology. A special place among them is given to post-mining technologies research

Personalized Hip and Knee Joint Replacement

This open access book describes and illustrates the surgical techniques, implants, and technologies used for the purpose of personalized implantation of hip and knee components. This new and flourishing treatment philosophy offers important benefits over conventional systematic techniques, including component positioning appropriate to individual anatomy, improved surgical reproducibility and prosthetic performance, and a reduction in complications. The techniques described in the book aim to reproduce patients’ native anatomy and physiological joint laxity, thereby improving the prosthetic hip/knee kinematics and functional outcomes in the quest of the forgotten joint. They include kinematically aligned total knee/total hip arthroplasty, partial knee replacement, and hip resurfacing. The relevance of available and emerging technological tools for these personalized approaches is also explained, with coverage of, for example, robotics, computer-assisted surgery, and augmented reality. Contributions from surgeons who are considered world leaders in diverse fields of this novel surgical philosophy make this open access book will invaluable to a wide readership, from trainees at all levels to consultants practicing lower limb surger