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Planning and evaluation of reorienting osteotomies of the proximal femur in cases of SCFE using virtual three-dimensional models

  • Jens A. Richolt
  • Matthias Teschner
  • Peter Everett
  • Bernd Girod
  • Michael B. Millis
  • Ron Kikinis
Conference paper
Part of the Lecture Notes in Computer Science book series (LNCS, volume 1496)

Abstract

Slipped Capital Femoral Epiphysis (SCFE) is a disease affecting the geometry of adolescent hips. Evaluation of the slippage as well planning of correction surgeries is a major three-dimensional problem. Therefore, the current clinical approach, which is based on biplanar plain radiographs, is not satisfying.

We have developed a software environment for planning and evaluation of reorienting osteotomies in severe cases of SCFE. In our system CT-based virtual surface models fitted by oriented bounding boxes (OBB) are manipulated. The hip motion as well as a correction surgery can be simulated. Both are controlled by collision detection. Therefore, the motion is based on the surface geometry of the joint partners rather than on a predefined, fixed rotation center. The pre- and simulated postoperative evaluation uses the range of motion as the essential parameter. The surgeon can obtain valuable information about the geometric correlation of the physiologic joint faces along hip motion.

References

  1. 1.
    Altobelli D, Kikinis R, Mulliken J, Cline H, Lorensen W, and Jolesz F, 1993 Computer-assisted three-dimensional planning in cranofacial surgery. Plast Reconst Surg, 92: 576–585.CrossRefPubMedGoogle Scholar
  2. 2.
    Boyer DW, Mickelson MR, and Ponseti IV, 1981 Slipped capital femoral epiphysis. Long-term follow-up study of one hundred and twenty-one patients. J Bone Joint Surg [Am], 63: 85–95.CrossRefGoogle Scholar
  3. 3.
    Cohen MS, Gelberman RH, Griffin PP, Kasser JR, Emans JB, and Millis MB Slipped capital femoral epiphysis: assessment of epiphyseal displacement and angulation. J Pediatr Orthop, 6: 259–264.Google Scholar
  4. 4.
    Gerber JD, Ney DR, Magid D, and Fishman EK, 1991 Simulated Femoral Repositioning with Three-Dimensional CT. J Comput Assist Tomogr, 15: 121–125.CrossRefPubMedGoogle Scholar
  5. 5.
    Gottschalk S, Lin M, and Manocha D, 1996 OBB-Tree: A Hierarchical Structure for Rapid Interference Detection. Proc. ACM Siggraph ’96, 171–180.Google Scholar
  6. 6.
    Imhäuser G, 1957 Zur Pathogenese und Therapie der jugendlichen Hüftkopflösung. Z Orthop, 88: 3–41.Google Scholar
  7. 7.
    Lorensen W and Cline H, 1987 Marching cubes: A high resolution 3D surface construction algorithm. Computer Graphics, 21: 163–169.CrossRefGoogle Scholar
  8. 8.
    Mantyla M, 1988 An Introduction to Solid Modelling. Computer Science Press, Rockville, MD.Google Scholar
  9. 9.
    Murphy SB, Kijewski PK, Millis MB, and Harless A, 1989 Simulation of Osteotomy Surgery about the Hip Joint. Computer Assisted Radiology, Proc. CAR ’91, Lemke, H. U. et al. (eds.), Springer-Verlag, Berlin.Google Scholar
  10. 10.
    Pflesser B, Tiede U, and Höhne KH, 1994 Simulating Motion of Anatomical Object with Volume-Based 3D-Visualisation. Visualization in Biomedical Computing, Proc., R. A. Robb (ed.), SPIE 2359, Rochester, MN, 291–300.Google Scholar
  11. 11.
    Schroeder W, Martin K, and Lorensen W, 1997 The Visualization Toolkit. 2nd ed., Prentice-Hall, New Jersey.Google Scholar
  12. 12.
    Schroeder, W., J. Zarge, and W. Lorensen. 1992. Decimation of Triangle Meshes. Computer Graphics 26(2):65–70.CrossRefGoogle Scholar
  13. 13.
    Southwick WO, 1967 Osteotomy through the Lesser Trochanter for Slipped Capital Femoral Epiphysis. J Bone Joint Surg, 49-A: 807–835.CrossRefGoogle Scholar
  14. 14.
    Vannier M and Marsh J, 1996 Three-dimensional imaging, surgical planning and image-guided therapy. Rad Clin North Am, 34: 545–563.Google Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1998

Authors and Affiliations

  • Jens A. Richolt
    • 1
  • Matthias Teschner
    • 2
  • Peter Everett
    • 1
  • Bernd Girod
    • 2
  • Michael B. Millis
    • 3
  • Ron Kikinis
    • 1
  1. 1.Surgical Planning Laboratory, Brigham and Women’s HospitalHarvard Medical SchoolBostonUSA
  2. 2.Telecommunications InstituteUniversity Erlangen-NurembergErlangenGermany
  3. 3.Children’s Hospital, Orthopaedic SurgeryHarvard Medical SchoolBostonUSA

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