COMPUTER-ASSISTED PREOPERATIVE PLANNING IN ORTHOPAEDIC SURGERY
: BILIĆ, RANKO (17644) Assistants
SMILJANIĆ, BRANIMIR (94541)
ZDRAVKOVIĆ, VILIJAM (42403)
HAŠPL, MIROSLAV (161045)
SMERDELJ, MIROSLAV (146636)
Type of research: applied Duration from: 04/30/91. to 12/31/96. Papers on project (total): 16
Papers on project quoted in Current Contents: 2
Institution name: Medicinski fakultet, Zagreb (108) Department/Institute: Research Department - Department of Orthopaedic Surgery, Zagreb Medical School, University of Zagreb Address: Šalata 7 City: 10000 - Zagreb, Croatia
Phone: 385 (0)41 276-911
Fax: 385 (0)41 277-810
Summary: Computer application in the field of preoperative planning
inorthopaedics only just starts to evolve in the world. Publishedresults of
research and methods developed are of merely academicsignificance, and they
can rarely be practically utilised. Ourproject is based on the BIZCAD
method, which is developed in theDepartment of Orthopaedic Surgery of
Zagreb Medical School inZagreb. BIZCAD is the method of three-dimensional
planning ofcorrective osteotomy of the radius by using computer. In
thisproject, further possibilities are investigated forthree-dimensional
planning of corrective osteotomies inorthopaedic surgery. The research
continues in the direction ofsimulation on axisting models of surgically
treated patients, aswell as of evaluation of late results of operations
performed.The same procedure of research and development of the
BIZCADmethod will be used for the anatomic region of the hip.
Methoddevelopment includes basic biomechanical and anatomic
research.Evaluation of the results was done in two steps:
technicalevaluation after the first series of ten patients, and
evaluationof late results after thirty patients have been operated on.
Theproject, although medical, is of predominantly technicalcharacter. Thus,
it is less dependant on biological response tothe operation. During the
course of the project, it has beenestablished that no reliable method
existed for measuring radiuslength after fracture. The study was performed
which resulted infinding new method of measuring length of the malunited
radius.Further on, the BIZCAD method made it possible to determineexactly
the position and extent of postoperative resorption ofbony aotutransplant.
This indicated the possibilty and necessityof improving the technique of
osteosynthesis for correctiveosteotomies. Further application of computer
in preoperativeplanning of orthopaedic surgical procedures is for
additionalmethods of determing CCD and AT angles of the proximal femur,like
"sinus wave" method. Based on the results achieved by now,in treating
patients with malunited radius fractures by using theBIZCAD method, and
considering its advantages compared to otherconcurrent methods, it is
undoubtful that the use of the BIZCADmethod will in future be medically,
etically and economicallyacceptable worldwide.
Keywords: orthopaedic surgery, corrective osteotomy, computer, radius, hip, 3D approach, computer simulation of surgery, postoperative control.
Research goals: The main GOAL of the project is to improve, by the
use of computer, both diagnostic and therapeutical aspects of corrective
procedures in orthopaedics. Orthopaedics involve much more "technical"
elements than other medical specialties, and these can be successfully
controled by using computer. The goals of the project are: 1. Improvement
of the BIZCAD method for corrective osteotomy of the radius in the way of
optimising the bony autotransplant and its movements by means of multiple
simulations on several levels. 2. Determination of reliable method for
measuring radius length after fracture and malunion of the bone. 3.
Determination of the cause, position and extent of postoperative resorption
of the bony graft. 4. Determination of the significancy of the difference
between values for angles measured in two-dimensional system (projected
angles) and values for angles measured in three-dimensional system (real
angles), which is of importance in everyday clinical practice. 5. Research
on the application of the BIZCAD method for corrective osteotomies of the
hip. EXPECTED RESULTS of the project are both theoretical and practical.
Theoretically, new aspects of corrective osteotomies will be indicated
which could not be analysed in two-dimensional system. Practical
contribution will be achieved by utilisation of developed methods in
clinical practice, which is also the ultimate goal. Expected results for
region of the hip are merely the same as achievments in using the BIZCAD
method for the radius. That means that we expect the following
contributions: 1. Corrective osteotomies will be planned in three
dimensions, which will give new diagnostic parameters and better input data
for the very surgery. 2. Ideal biomechanical relationships in the hip joint
will be preserved or restored during corrective operation. 3. We shall be
able to determine the origin of eventual bad results and complications,
because variations in planning procedure will now be under control. 4. The
overall success of patient treatment by corrective osteotomies will be
greater. 5. Postoperative control of the results will be objective and
detailed. For corrective osteotomies of the radius contributions are
expected which go even further than already numbered (which are also
already achieved). By multiple simulations of surgical procedures we shall
be able to establish the idealised location of the fracture and in this way
to facilitate the procedure and decrease necessary size of the bony graft.
We expect that many interesting new issues will be raised during the course
of the project, which is also particular contribution.
COOPERATION - INSTITUTIONS
Name of institution
: ODJEL ZA TRAUMATOLOGIJU, KLINIKA ZA
KIRURGIJU, KLINIČKA BOLNICA SESTRE MILOSRDNICE Type of institution: International organization City: 10000 - Zagreb, Croatia Other information about the project.