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Fiducial-Free 2D/3D Registration for Robot-Assisted Femoroplasty
Cong Gao1, Amirhossein Farvardin2, Robert B Grupp1
1Department of Computer Science, Johns Hopkins University, Baltimore, MD, USA 21211.
IEEE Transactions on Medical Robotics and Bionics
|March 25, 2021
Summary
This study introduces a fiducial-free navigation system for robot-assisted femoroplasty, a procedure to prevent hip fractures. The system accurately guides instruments using fluoroscopic images, showing promise for elderly patients at risk of osteoporotic fractures.
Area of Science:
- Orthopedic surgery
- Medical robotics
- Medical imaging
Background:
- Osteoporotic hip fractures pose a significant risk to the elderly.
- Femoroplasty is a potential preventative therapy.
- Existing navigation systems require external fiducials, complicating the procedure.
Purpose of the Study:
- To develop and evaluate a fiducial-free 2D/3D registration pipeline for robot-assisted femoroplasty.
- To enable accurate intraoperative guidance using only fluoroscopic images.
Main Methods:
- A novel fiducial-free 2D/3D registration pipeline was developed.
- The system uses intraoperative fluoroscopic images from multiple views.
- Performance was validated through comprehensive simulations and cadaveric studies.
Main Results:
- Simulations showed high accuracy for injection entry point (1.26±0.74 mm) and direction (0.63±0.21°, 0.17±0.19°).
- Cadaver studies achieved a mean error of 2.64 ± 1.10 mm for the entry point.
- Biomechanical analysis confirmed sufficient accuracy, with a 40.7% increase in yield load even with deviation.
Conclusions:
- The fiducial-less 2D/3D registration pipeline is accurate and reliable for guiding robot-assisted femoroplasty.
- This method offers a less invasive and potentially more efficient approach to preventing osteoporotic hip fractures.
