SVIBOR - Project code: 3-01-009

MINISTRY OF SCIENCE AND TECHNOLOGY

Strossmayerov trg 4, HR - 10000 ZAGREB
tel.: +385 1 459 44 44, fax: +385 1 459 44 69
E-mail: ured@znanost.hr

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Project code: 3-01-009


COMPUTER-ASSISTED PREOPERATIVE PLANNING IN ORTHOPAEDIC SURGERY


Main researcher: BILIĆ, RANKO (17644)


Assistants
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
Communication
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


  1. Name of institution: ODJEL ZA TRAUMATOLOGIJU, KLINIKA ZA KIRURGIJU, KLINIČKA BOLNICA SESTRE MILOSRDNICE
    Type of institution: International organization
    City: 10000 - Zagreb, Croatia
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