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A virtual environment for the modelling, simulation and manufacturing of orthopaedic devices
This thesis was submitted for the degree of Doctor of Philosophy and awarded by Brunel University.The objective of this work is to investigate whether the game physics based
modelling is accurate enough to be used in modelling the motion of the human body,
in particular musculoskeletal motion. Hitherto, the implementation of game physics
in the medical field focused only on anatomical representation for education and
training purposes. Introducing gaming platforms and physics engines into
orthopaedics applications will help to overcome several difficulties encountered in
the modelling of articular joints. Implementing a physics engine (PhysX), which is mainly designed for video games, handles intensive computations in optimized ways
at an interactive speed. In this study, the capabilities of the physics engine (PhysX)
and gaming platform for modelling and simulating articular joints are evaluated.
First, a preliminary validation is carried out for mechanical systems with analytical
solutions, before constructing the musculoskeletal model to evaluate the consistency of gaming platforms. The developed musculoskeletal model deals with the human joint as an unconstrained system with 6 DOF which is not available with other joint modeller. The model articulation is driven by contact surfaces and the stiffness of surrounding tissues. A number of contributions, such as contact modelling and
muscle wrapping, have been made in this research to overcome some existing
challenges in joint modelling. Using muscle segmentation, the proposed technique
effectively handles the problem of muscle wrapping, a major concern for many; thus
the shortest path and line of action are no longer problematic. Collision behaviour
has also shown a stable response for colliding as well as resting objects, provided that it is based on the principles of surface properties and the conservation of linear and angular momentums. The precision of collision detection and response are within an acceptable tolerance controllable by varying the mesh density. An image based analysis system is developed in this thesis, mainly in order to validate the
proposed physics based modelling solution. This minimally invasive method is based
on the analysis of marker positions located at bony positions with minimal skin
movement. The image based system overcomes several challenges associated with
the currently existing methods, such as inaccuracy, complication, impracticability
and cost. The analysis part of this research has considered the elbow joint as a case
study to investigate and validate the proposed physics based model. Beside the
interactive 3D simulation, the obtained results are validated by comparing them with
the image based system developed within the current research to investigate joint
kinematics and laxity and also with published material, MJM and results from
experiments performed at the Brunel Orthopaedic Research and Learning Centre.
The proposed modelling shows the advantageous speed, reliability and flexibility of the proposed model. It is shown that the gaming platform and physics engine provide a viable solution to human musculoskeletal modelling. Finally, this thesis considers an extended implementation of the proposed platform for testing and assessing the design of custom-made implants, to enhance joint performance. The developed simulation software is expected to give indicative results as well as testing different types of prosthetic implant. Design parameterization and sensitivity analysis for geometrical features are discussed. Thus, an integrated environment is proposed to link the real-time simulation software with a manufacturing environment so as to assist the production of patient specific implants by rapid manufacturing
Modelling and simulation of flexible instruments for minimally invasive surgical training in virtual reality
Improvements in quality and safety standards in surgical training, reduction in training hours and constant technological advances have challenged the traditional apprenticeship model to create a competent surgeon in a patient-safe way. As a result, pressure on training outside the operating room has increased. Interactive, computer based Virtual Reality (VR) simulators offer a safe, cost-effective, controllable and configurable training environment free from ethical and patient safety issues.
Two prototype, yet fully-functional VR simulator systems for minimally invasive procedures relying on flexible instruments were developed and validated. NOViSE is the first force-feedback enabled VR simulator for Natural Orifice Transluminal Endoscopic Surgery (NOTES) training supporting a flexible endoscope. VCSim3 is a VR simulator for cardiovascular interventions using catheters and guidewires. The underlying mathematical model of flexible instruments in both simulator prototypes is based on an established theoretical framework β the Cosserat Theory of Elastic Rods. The efficient implementation of the Cosserat Rod model allows for an accurate, real-time simulation of instruments at haptic-interactive rates on an off-the-shelf computer. The behaviour of the virtual tools and its computational performance was evaluated using quantitative and qualitative measures. The instruments exhibited near sub-millimetre accuracy compared to their real counterparts. The proposed GPU implementation further accelerated their simulation performance by approximately an order of magnitude.
The realism of the simulators was assessed by face, content and, in the case of NOViSE, construct validity studies. The results indicate good overall face and content validity of both simulators and of virtual instruments. NOViSE also demonstrated early signs of construct validity. VR simulation of flexible instruments in NOViSE and VCSim3 can contribute to surgical training and improve the educational experience without putting patients at risk, raising ethical issues or requiring expensive animal or cadaver facilities. Moreover, in the context of an innovative and experimental technique such as NOTES, NOViSE could potentially facilitate its development and contribute to its popularization by keeping practitioners up to date with this new minimally invasive technique.Open Acces