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Biomechanical behavior of the three-dimensionally printed surgical plates for mandibular defect reconstruction: a finite element analysis. 三维打印手术板用于下颌缺损重建的生物力学行为:有限元分析。
IF 2.1 4区 医学 Q3 SURGERY Pub Date : 2023-12-01 Epub Date: 2023-11-27 DOI: 10.1080/24699322.2023.2286181
Chao-Fei Wang, Shuo Liu, Lei-Hao Hu, Yao Yu, Xin Peng, Wen-Bo Zhang

The aim of the study was to investigate the biomechanical behavior of three-dimensionally (3D)-printed surgical plates used for mandibular defect reconstruction, compare them with conventional surgical plates, and provide experimental evidence for their clinical application. Three-dimensional models were created for the normal mandible and for mandibular body defects reconstructed using free fibula and deep circumflex iliac artery flaps. Three-dimensional finite element models of reconstructed mandibles fixed using 3D-printed and conventional surgical plates were established. Vertical occlusal forces were applied to the remaining teeth and the displacement and Von Mises stress distributions were studied using finite element analysis. The normal and reconstructed mandibles had similar biomechanical behaviors. The displacement distributions for the surgical plates were similar, and the maximum total deformation occurred at the screw hole of the anterior segment of the surgical plates. However, there were differences in the Von Mises stress distributions for the surgical plates. In reconstructed mandibles fixed using 3D-printed surgical plates, the maximum equivalent Von Mises stress occurred at the screw hole of the posterior segment, while in those fixed using conventional surgical plates, the maximum equivalent Von Mises stress was at the screw hole of the anterior segment. In the mandible models reconstructed with the same free flap but fixed with different surgical plates, the plates had similar biomechanical behaviors. The biomechanical behavior of 3D-printed surgical plates was similar to conventional surgical plates, suggesting that 3D-printed surgical plates used to reconstruct mandibular body defects with vascularized autogenous bone grafts could lead to secure and stable fixation.

本研究旨在探讨三维打印手术钢板用于下颌缺损重建的生物力学行为,并与传统手术钢板进行比较,为其临床应用提供实验依据。建立了正常下颌骨的三维模型,并利用游离腓骨和旋髂深动脉皮瓣重建下颌骨体缺损。建立3d打印和常规手术钢板固定重建下颌骨的三维有限元模型。对剩余牙施加垂直咬合力,采用有限元方法研究其位移和Von Mises应力分布。正常下颌骨与重建下颌骨具有相似的生物力学行为。手术钢板的位移分布相似,最大的总变形发生在手术钢板前段的螺钉孔处。然而,手术钢板的Von Mises应力分布存在差异。使用3d打印手术钢板固定重建下颌骨时,最大等效Von Mises应力出现在后节螺钉孔处,而使用常规手术钢板固定重建下颌骨时,最大等效Von Mises应力出现在前节螺钉孔处。在同种游离皮瓣重建的下颌骨模型中,用不同的手术钢板固定,钢板具有相似的生物力学行为。3d打印手术板的生物力学行为与传统手术板相似,表明3d打印手术板用于带血管的自体骨移植重建下颌骨体缺损可以实现安全稳定的固定。
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引用次数: 0
Tibial component rotation alters soft tissue balance in a cruciate retaining total knee arthroplasty 保留交叉韧带的全膝关节置换术中胫骨组件旋转改变软组织平衡
IF 2.1 4区 医学 Q3 SURGERY Pub Date : 2022-06-01 DOI: 10.1080/24699322.2022.2078738
G. Clark, M. Quinn, J. Murgier, D. Wood
Abstract Our aim was to understand whether using different landmarks for tibial component rotation influenced articular contact pressures in a balanced total knee arthroplasty (TKA). Twelve patients underwent TKA (Triathlon CR, Stryker Inc., Mahwah, NJ) and contact pressures were assessed using a wireless sensor. Robotic arm assisted TKA using a functional alignment technique was performed, with balanced gaps between medial and lateral compartments. Compartment pressures were measured with the trial tibial component rotated to Akagi's line and to Insall's axis respectively. Rotating the tibial component to Akagi's line resulted in a significantly greater proportion of knees being balanced and lower contact pressures than when the tibial component was rotated to Insall's axis at 10°, 45° and 90° of flexion (p < 0.05). Medial compartment pressures were significantly increased in 10° of flexion, as were lateral compartment pressures in all positions when the tibial component was aligned to Insall's axis (p < 0.05). The mean difference in rotation observed with the two landmarks was 6.9° (range 4.1–9.1°). Rotational alignment of the tibial component using Akagi's line reduced contact pressures, improved balance and reduced the need for soft tissue release when compared with Insall's axis in robotic arm assisted TKA.
摘要我们的目的是了解在平衡型全膝关节置换术(TKA)中,使用不同的胫骨部件旋转标志是否会影响关节接触压力。12名患者接受了TKA(铁人三项CR,Stryker股份有限公司,新泽西州Mahwah),并使用无线传感器评估接触压力。使用功能对准技术进行机器人手臂辅助TKA,内侧和外侧隔室之间的间隙平衡。在试验胫骨部件分别旋转至Akagi线和Insall轴的情况下测量隔室压力。与屈曲10°、45°和90°时将胫骨部件旋转至Insall轴相比,将胫骨部件转动至Akagi线可使膝盖平衡的比例显著增加,接触压力显著降低(p<0.05)。屈曲10°时内侧隔室压力显著增加,当胫骨部件与Insall轴对齐时,所有位置的外侧隔室压力也是如此(p < 0.05)。观察到的两个界标旋转的平均差异为6.9°(范围4.1–9.1°)。与机械臂辅助TKA中的Insall轴相比,使用Akagi线旋转对齐胫骨部件降低了接触压力,改善了平衡,并减少了软组织释放的需要。
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引用次数: 0
Dimensional accuracy of TKA cut surfaces with an active robotic system 基于主动机器人系统的TKA切削面尺寸精度研究
IF 2.1 4区 医学 Q3 SURGERY Pub Date : 2022-05-30 DOI: 10.1080/24699322.2022.2080116
S. Kreuzer, A. Brar, V. Campanelli
Abstract This is a study of the dimensional accuracy of the bone cut surfaces in robotic TKA. One surgeon performed robotic TKA on four cadaveric knees. A novel technique was developed for measuring the dimensional accuracy of both the femoral and tibial cut surfaces. CT scans were used to create a pre-operative plan and generate nominal cut surfaces on the 3D bone model. After TKA, the cut surfaces were then laser scanned. Two femoral components were also scanned and compared to nominal dimensions. Flatness was computed as the standard deviation between each of the cut surfaces and the best-fit plane. The angles between the five femoral best-fit planes were compared to the nominal values. The point-to-point distances between the femoral cut surfaces and the nominal cut planes were computed to estimate the bone-to-implant gap. The cut surfaces had an average flatness of 0.16 ± 0.06 mm with low variability between different cut planes. The femoral cut surfaces had average angular errors of 0.47 ± 0.39°, which are of similar magnitude as the errors found for the implants. The bone-to-implant gap was within ±1 mm for 97.9% of the surface on average. Using a novel methodology, the dimensional accuracy of an active robotic system for TKA was found to be very high for both the femoral and tibial bone cuts. Comparison studies are needed with other robotic systems as well as studies comparing manual and robotic techniques.
摘要对机器人TKA中骨切割面尺寸精度进行了研究。一名外科医生对四具尸体的膝盖进行了机器人TKA。开发了一种测量股骨和胫骨切面尺寸精度的新技术。CT扫描用于创建术前计划,并在3D骨模型上生成标称切面。TKA后,对切割表面进行激光扫描。两个股骨组成部分也被扫描并与标称尺寸进行比较。平面度计算为每个切割面与最佳拟合平面之间的标准差。将五个股骨最佳拟合平面之间的角度与标称值进行比较。计算股骨切面与标称切面之间的点对点距离,以估计骨与种植体之间的间隙。切割表面的平均平整度为0.16±0.06 mm,不同切割平面之间的变化较小。股骨切面的平均角度误差为0.47±0.39°,与假体的误差幅度相似。97.9%表面的骨与种植体间隙平均在±1mm以内。使用一种新颖的方法,发现主动机器人系统的TKA尺寸精度对于股骨和胫骨切割都非常高。需要与其他机器人系统以及人工和机器人技术进行比较研究。
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引用次数: 2
Optimal definitions for computing HKA angle in caos: an in-vitro comparison study 计算caos中HKA角的最佳定义:体外比较研究
IF 2.1 4区 医学 Q3 SURGERY Pub Date : 2022-05-13 DOI: 10.1080/24699322.2022.2066023
G. Dardenne, B. Borotikar, H. Letissier, A. Zemirline, E. Stindel
Abstract The goal of this study was to assess and compare the precision and accuracy of nine and seven methods usually used in Computer Assisted Orthopedic Surgery (CAOS) to estimate respectively the Knee Center (KC) and the Frontal Plane (FP) for the determination of the HKA angle (HKAA). An in-vitro experiment has been realized on thirteen cadaveric lower limbs. A CAOS software application was developed and allowed the computation of the HKAA according to these nine KC and seven FP methods. The precision and the accuracy of the HKAA measurements were measured. The HKAA precision was highest when the FP is determined using the helical method. The HKAA accuracy was highest using the helical approach to determine the FP and either the notch or the tibial spines to determine the KC. This study shows that the helical approach to determine the FP and either the notch or the middle of tibia spines are the combinations that provide both a good enough accuracy and precision to estimate the HKA.
摘要本研究的目的是评估和比较计算机辅助骨科手术(CAOS)中常用的九种和七种方法的精度和准确性,分别估计膝关节中心(KC)和额平面(FP),以确定HKA角(HKAA)。在13具尸体下肢上进行了体外实验。开发了一个CAOS软件应用程序,允许根据这九种KC和七种FP方法计算HKAA。测量了HKAA测量的精度和准确性。当使用螺旋法测定FP时,HKAA的精度最高。使用螺旋入路确定FP,使用切口或胫骨棘确定KC,HKAA的准确度最高。这项研究表明,确定FP的螺旋方法和胫骨棘的凹口或中间是提供足够好的准确性和精度来估计HKA的组合。
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引用次数: 0
Deep learning for assessing liver fibrosis based on acoustic nonlinearity maps: an in vivo study of rabbits 基于声学非线性图的深度学习评估肝纤维化:兔体内研究
IF 2.1 4区 医学 Q3 SURGERY Pub Date : 2022-05-13 DOI: 10.1080/24699322.2022.2063760
Jinzhen Song, Hao Yin, Jianbo Huang, Zhenru Wu, Chenchen Wei, Tingting Qiu, Yan Luo
Abstract This study aimed to assess liver fibrosis in rabbits by deep learning models based on acoustic nonlinearity maps. Injection of carbon tetrachloride was used to induce liver fibrosis. Acoustic nonlinearity maps, which were built by data of echo signals, were used as input data for deep learning model. Convolutional neural network (CNN), CNN combined with support vector machine (SVM), CNN combined with random forest and CNN combined with logistic regression were used as deep learning model. Nested 10-fold cross-validation was used to search hyperparameters and evaluate performance of models. Histologic examination of liver specimens of the rabbits was performed to evaluate the fibrosis stage. Receiver operator characteristic curve and area under curve (AUC) were used for estimating the probability of the correct prediction of liver fibrosis stages. A total of 600 acoustic nonlinearity maps were used. Model of CNN combined with SVM demonstrated the best diagnostic performance compared with all other methods for diagnosis of significant fibrosis (≥F2, AUC = 0.82), advanced fibrosis (≥F3, AUC = 0.88) and cirrhosis (F4, AUC = 0.90). Model of CNN showed the second highest AUCs. The deep learning model based on acoustic nonlinearity maps demonstrated potential for evaluation of liver fibrosis.
摘要本研究旨在利用基于声学非线性图的深度学习模型评估家兔肝纤维化。采用注射四氯化碳诱导肝纤维化。利用回波信号数据构建声学非线性映射,作为深度学习模型的输入数据。采用卷积神经网络(CNN)、CNN与支持向量机(SVM)结合、CNN与随机森林结合、CNN与逻辑回归结合作为深度学习模型。使用嵌套10倍交叉验证来搜索超参数并评估模型的性能。对家兔肝脏标本进行组织学检查,评价肝纤维化分期。使用受试者操作者特征曲线和曲线下面积(AUC)来估计正确预测肝纤维化分期的概率。共使用了600张声学非线性图。CNN联合SVM模型对显著纤维化(≥F2, AUC = 0.82)、晚期纤维化(≥F3, AUC = 0.88)、肝硬化(F4, AUC = 0.90)的诊断效果优于其他方法。CNN模型的auc第二高。基于声学非线性图的深度学习模型显示了评估肝纤维化的潜力。
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引用次数: 1
Nonlinear ultrasonic imaging in pulse-echo mode using Westervelt equation: a preliminary research 基于Westervelt方程的脉冲回波模式非线性超声成像初步研究
IF 2.1 4区 医学 Q3 SURGERY Pub Date : 2019-09-24 DOI: 10.1080/24699322.2019.1649065
Wuxuan Chen, Peng Wang, Zhihong Zhang, Xudong Deng, C. Zhang, Shenggen Ju
Abstract Acoustic nonlinear parameter β, was of great interest in tissue characterization in recent years. Nonlinear imaging methods have been reported to provide improved spatial and contrast resolution. We introduce a nonlinear imaging method derived from nonlinear wave equation based on Gaussian-form solution assumption, which can be applied in pulse-echo mode on diagnostic ultrasound. Through making the use of two pulse transmission, only nonlinear effects are reserved and other effects like scattering, diffraction and linear attenuation can be eliminated. For validation of this method a set of simulation results are generated with a nonlinear simulator. Simulated images also indicate that our method clearly describes the spatial distribution of B/A in the medium.
摘要近年来,声学非线性参数β在组织表征中引起了极大的兴趣。据报道,非线性成像方法提供了改进的空间分辨率和对比度分辨率。我们介绍了一种基于高斯形式解假设的非线性波动方程的非线性成像方法,该方法可以应用于诊断超声的脉冲回波模式。通过使用双脉冲传输,只保留了非线性效应,可以消除散射、衍射和线性衰减等其他效应。为了验证该方法,使用非线性模拟器生成了一组模拟结果。模拟图像还表明,我们的方法清楚地描述了B/A在介质中的空间分布。
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引用次数: 5
Notice of Duplicate Publication 复本公告
IF 2.1 4区 医学 Q3 SURGERY Pub Date : 2019-09-16 DOI: 10.1080/24699322.2019.1646921
(2019). Notice of Duplicate Publication. Computer Assisted Surgery: Vol. 24, Advances in Minimally Invasive Surgery and Clinical Measurement. Guest Editors: Chengyu Liu & Lung-kwang Pan, pp. 184-185.
(2019)。副本出版通知。计算机辅助手术:第24卷,微创手术和临床测量的进展。特邀编辑:刘成玉、潘龙光,页184-185。
{"title":"Notice of Duplicate Publication","authors":"","doi":"10.1080/24699322.2019.1646921","DOIUrl":"https://doi.org/10.1080/24699322.2019.1646921","url":null,"abstract":"(2019). Notice of Duplicate Publication. Computer Assisted Surgery: Vol. 24, Advances in Minimally Invasive Surgery and Clinical Measurement. Guest Editors: Chengyu Liu & Lung-kwang Pan, pp. 184-185.","PeriodicalId":56051,"journal":{"name":"Computer Assisted Surgery","volume":"26 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2019-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138530079","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Quantitative assessment of three vendor’s metal artifact reduction techniques for CT imaging using a customized phantom 定量评估三个供应商的金属伪影减少技术用于CT成像使用定制的幻影
IF 2.1 4区 医学 Q3 SURGERY Pub Date : 2019-09-10 DOI: 10.1080/24699322.2019.1649075
R. Chou, Jung-Hui Li, Liu-Kuo Ying, Cheng-Hsun Lin, Wan Leung
Abstract A metal implant was placed in an acrylic phantom to enable quantitative analysis of the metal artifact reduction techniques used in computed tomography (CT) scanners from three manufacturers. Two titanium rods were placed in a groove in a cylindrical phantom made by acrylic, after which the groove was filled with water. The phantom was scanned using three CT scanners (Toshiba, GE, Siemens) under the abdomen CT setting. CT number accuracy, contrast-to-noise ratio, area of the metal rods in the images, and fraction of affected pixel area of water were measured using ImageJ. Different iterative reconstruction, dual energy, and metal artifact reduction techniques were compared within three vendors. The highest contrast-to-noise ratio of three scanners were 85.7 ± 8.4 (Toshiba), 85.9 ± 11.7 (GE), and 55.0 ± 14.8 (Siemens); and the most correct results of metal area were 157.1 ± 1.4 mm2 (Toshiba), 155.0 ± 1.0 (GE), and 170.6 ± 5.3 (Siemens). The fraction of affected pixel area obtained using single-energy metal artifact reduction of Toshiba scanner was 2.2% ± 0.7%, which is more favorable than 4.1% ± 0.7% obtained using metal artifact reduction software of GE scanner (p = 0.002). Among all quantitative results, the estimations with fraction of affected pixel areas matched the effect of metal artifact reduction in the actual images. Therefore, the single-energy metal artifact reduction technique of Toshiba scanner had a desirable effect. The metal artifact reduction software of GE scanner effectively reduced the effect of metal artifacts; however, it underestimated the size of the metal rods. The monoenergetic and dual energy composition techniques of Siemens scanner could not effectively reduce metal artifacts.
将金属植入物放置在丙烯酸体中,以便对来自三家制造商的计算机断层扫描(CT)扫描仪中使用的金属伪影减少技术进行定量分析。将两根钛棒放在一个由丙烯酸制成的圆柱形幻影的凹槽中,然后将凹槽填满水。在腹部CT设置下使用三台CT扫描仪(东芝、GE、西门子)扫描幻体。利用ImageJ测量CT数精度、图像中金属棒的面积、水的影响像元面积的比例。不同的迭代重建、双能量和金属伪影减少技术在三个供应商之间进行了比较。三种扫描仪的最高噪比分别为东芝(Toshiba) 85.7±8.4、GE (GE) 85.9±11.7、西门子(Siemens) 55.0±14.8;最正确的金属面积分别为东芝(Toshiba) 157.1±1.4 mm2、GE (GE) 155.0±1.0 mm2、Siemens (Siemens) 170.6±5.3 mm2。东芝扫描仪单能量金属伪影还原获得的影响像元面积占比为2.2%±0.7%,优于GE扫描仪金属伪影还原软件获得的4.1%±0.7% (p = 0.002)。在所有的定量结果中,受影响像素面积比例的估计与实际图像中金属伪影的减少效果相匹配。因此,东芝扫描仪的单能金属伪影还原技术具有理想的效果。GE扫描仪的金属伪影降低软件有效降低了金属伪影的影响;然而,它低估了金属棒的大小。西门子扫描仪的单能和双能组成技术不能有效地减少金属伪影。
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引用次数: 5
Evaluation of laparoscopic forceps jaw contact pressure and distribution using pressure sensitive film 用压敏膜评价腹腔镜钳颌接触压力及分布
IF 2.1 4区 医学 Q3 SURGERY Pub Date : 2019-08-29 DOI: 10.1080/24699322.2019.1649073
Rui Zhu, M. Maréchal, I. Yamamoto, M. Lawn, T. Nagayasu, Keitaro Matsumoto
Abstract In this study, the authors used the Fujifilm Prescale Pressure Measuring System to measure the contact pressure and distribution at the jaws of laparoscopic grasping forceps. This data was then correlated with measured pressures at the forceps handles to understand the relationship between the surgeon’s actuating pressure and that on the organ being manipulated. The purpose of this study is to create a database of tactile information to provide guidelines in defining minimally invasive surgery (MIS). This is expected to be important as today's society continues to progress in the use of automation, IoT, AI and MIS. In order to achieve the above, the authors developed an experimental device consisting of an actuator, a load cell and an MCU to stably actuate and control the handle side of grasping forceps. Target organs were simulated using triangular prisms of various silicone rubber materials. The experimental method involved actuating the handle side with preset pressure values for fixed time periods and using sensitive film to measure the pressure at the forceps tip. The film data was then scanned, processed and analyzed.
在本研究中,作者使用富士胶片预刻度压力测量系统测量腹腔镜钳钳钳口处的接触压力和分布。然后将这些数据与钳柄处测量的压力相关联,以了解外科医生的驱动压力与被操作器官的压力之间的关系。本研究的目的是建立触觉信息数据库,为微创手术(MIS)的定义提供指导。随着当今社会在自动化、物联网、人工智能和管理信息系统的使用方面不断进步,这一点预计将非常重要。为了实现上述目标,作者开发了一种由执行器、称重传感器和单片机组成的实验装置,以稳定地驱动和控制抓取钳的手柄侧。用不同硅橡胶材料的三角棱镜模拟靶器官。实验方法是在固定的时间段内以预设的压力值驱动手柄侧,并使用敏感薄膜测量钳尖处的压力。然后对胶片数据进行扫描、处理和分析。
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引用次数: 4
Design and control of a MRI-compatible pneumatic needle puncture robot 磁共振兼容气动穿刺机器人的设计与控制
IF 2.1 4区 医学 Q3 SURGERY Pub Date : 2019-08-26 DOI: 10.1080/24699322.2019.1649067
Baoliang Zhao, Y. Fu, Yuanyuan Yang, Peng Zhang, Ying Hu
Abstract Percutaneous needle puncture operation is widely used in the image-guided interventions, including biopsy and ablation. MRI guidance has the advantages of high-resolution soft tissue imaging and thermal monitoring during energy-based ablation. This paper proposes the design of a 5-DOF pneumatic needle puncture robot, with all the cylinders, sensors and structure material MRI-compatible. Also, a hybrid fuzzy-PID controller is designed for the pneumatic driven system to adjust the PID parameters adaptively. The experiment validation result shows that, compared with the traditional fix-parameter PID control, the proposed hybrid fuzzy-PID control has no overshoot, and the settle time/steady state error remains low even with increasing load. This proves that the hybrid fuzzy-PID control strategy can increases the positioning accuracy and robustness of the pneumatic driven needle puncture robot, which is significant for the safety of percutaneous needle puncture operation.
摘要经皮穿刺术广泛应用于图像引导下的介入治疗,包括活检和消融。MRI引导在基于能量的消融过程中具有高分辨率软组织成像和热监测的优势。本文提出了一种五自由度气动穿刺机器人的设计,该机器人的所有气缸、传感器和结构材料MRI都兼容。针对气动驱动系统,设计了一种混合模糊PID控制器,对PID参数进行自适应调节。实验验证结果表明,与传统的定参数PID控制相比,所提出的混合模糊PID控制没有超调,即使在负载增加的情况下,稳定时间/稳态误差也很低。这证明了混合模糊PID控制策略可以提高气动穿刺机器人的定位精度和鲁棒性,对经皮穿刺操作的安全性具有重要意义。
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引用次数: 5
期刊
Computer Assisted Surgery
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