for Hip Osteotomy Experiment with a cadaver specimen to evaluate 1 feasibility of BB implantation and 2 visibility on Xray images Team Members Michael Van Maele amp Jesse Hamilton ID: 1048400
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1. X-ray Image Based Navigation for Hip OsteotomyExperiment with a cadaver specimen to evaluate(1) feasibility of BB implantation and (2) visibility on X-ray imagesTeam Members: Michael Van Maele & Jesse HamiltonMentors: Dr. Mehran Armand, Dr. Yoshito Otake, & Ryan MurphyDate: April 10, 2012Location: International Center for Orthopaedic Advancement, Bayview Campus, Johns Hopkins University
2. SummaryDate: April 10, 2012Time: 11:30AM – 1:30 PMPlace: International Center for Orthopaedic Advancement, Bayview Medical Center, Alpha Center Materials/DevicesCadaver specimen (extracted femur)C-arm (make/model: ***?)Beads (McMaster-Carr, stainless steel)Super glue (Loctite Ultra Gel Control)Drill with small diameter bitForceps, scissors, scalpelFemur with different size BBs attached with super glue
3. MethodsCleared overlying tissue using scissors and scalpel to expose boneDrilled three very shallow burrs in distal end of femur (closely spaced, ~1-2 cm apart)Applied super glue to burrsPlaced BB in each burr using forcepsGenerously applied super glue over the BBsRepeated steps 1-5 for four different size BBs, using three BBs of each size.Let glue dry for at least 10 minutes.Acquired two C-arm images at different view angles. Attempted to dislodge BBs from bone byHitting bone against handStriking bone with malletPicking BBs off with forcepsEvaluated images forBB visibility (image contrast between BBs and surrounding bone/tissue)Ability to distinguish between BB sizes
4. MethodsburrAfter step 1Step 2Distal end of femurStep 5Step 8b
5. ResultsX-ray shot #1X-ray shot #2X-ray setting: **kVp, **mAX-ray setting: **kVp, **mAfemurtable~**cm (approximate distance)~**cmC-arm setupWhat was the C-arm setup? What were the x-ray settings?
6. Results (Zoom In)123456789101112123456789101112BB IDSize No.Diameter (mm)1, 2, 33?? (largest)4, 5, 65?? (2nd largest)7, 8, 96?? (2nd smallest)10, 11, 128?? (smallest)
7. Discussion – BB FixationNo BBs dislodged after hitting bone against hand and striking bone with mallet Similar to mock surgical conditionsCould pick off BBs with forcepsNot similar to mock surgical conditions Conclusion: We predict that our method should hold BBs in place during a cadaver surgery.
8. BBs visible on x-ray. Good image contrast versus background tissue.Radial symmetry algorithm could automatically distinguish between large and small BBs.Conclusion: Should be possible to use different size BBs as confidence and fragment points.Discussion – Image AnalysisLarge BBsSmall BBsMin radius61Max radius102Factor0.50.35ROI Radius200200Controls detection sensitivity (higher value fewer BBs detected)