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Biomedical subjects

Randy E Ellis

Publications and source records attributed to Randy E Ellis.

14 recordsLinked to original sources
PubMed2006

Three-dimensional analysis of alignment error in using femoral intramedullary guides in unicompartmental knee arthroplasty.

We used computerized simulations with 3-dimensional models of 20 cadaver femora, calculated from computed tomographic scans, and a model of a rod measuring 200 x 5 mm to study femoral alignment accuracy for unicompartmental knee arthroplasty via minimally invasive reconstruction. The anatomical axis and insertion site were identified on each femur. A simulation of all feasible flexion-extension and varus-valgus orientations was performed. The average rod orientation was 3.2 degrees flexion and 2.5 degrees valgus. The range of orientation was 3.2 degrees extension to 9.7 degrees flexion and 4.5 degrees varus to 8.9 degrees valgus. The study suggests that a short narrow intramedullary rod inserted according to the manufacturer's specifications does not accurately find the anatomical axis and may lead to poor alignment of the femoral prosthesis. Given our finding of consistent bias toward excessive flexion and valgus alignment, we recommend that the operating surgeon carefully plan the insertion point of the intramedullary rod during surgery to compensate for this bias.

Arthroplasty, Replacement, Knee↗
PubMed2006

Fast assessment of acetabular coverage using stereoscopic volume rendering.

Previous CT-based methods of measuring acetabular coverage of the femoral head have either been labor-intensive or have required extensive preprocessing of the data prior to visualization. We propose a method of measuring acetabular coverage using stereoscopic digitally reconstructed radiographs that required very little labor or image preprocessing time. Taking a craniocaudal view of the pelvis, we measured both preoperative and postoperative CTs of 10 patients treated with transtrochanteric periacetabular osteotomy. Measurements were then made in both monocular and stereoscopic rendering modes. Our method is fast, easy, and provides an intuitive means of visualizing an orthopedic parameter that is important in the progression of early hip arthritis.

Canada↗
PubMed2005

Repeatability of a novel technique for in vivo measurement of three-dimensional patellar tracking using magnetic resonance imaging.

PURPOSE: To determine the repeatability of a novel noninvasive MRI-based technique for measuring patellofemoral kinematics in vivo. MATERIALS AND METHODS: The patellar kinematics measurement method relies on registering bone models (with associated coordinate systems) developed from a high resolution MRI scan to loaded bone positions derived from fast, low resolution MRI scans. The intrasubject variability, high resolution to low resolution registration error, and interexperimenter repeatability were quantified in experiments on three healthy subjects. RESULTS: The intrasubject variability and registration error were within range of the accuracy of our procedure; specifically, less than or equal to 1.40 degrees for orientation and 0.81 mm for translation. The interexperimenter repeatability was less than or equal to 1.28 degrees for orientation, with the exception of patellar spin, and 0.68 mm for translation. CONCLUSION: Our novel measurement technique can measure three-dimensional patellar tracking noninvasively during loaded flexion in a repeatable manner. Our results compare well to another noninvasive tracking protocol, fast phase-contrast MRI, which has a reported subject interexam variability of 2.4 degrees or less for patellar orientation. A particular strength of our method is that axes and high-resolution bone models need only be determined once for intrasubject comparisons. The method is sufficiently accurate and repeatable to detect clinically significant changes in patellofemoral kinematics.

Biomechanical Phenomena↗
PubMed2005

Unified point selection and surface-based registration using a particle filter.

We propose an algorithm for jointly performing registration point selection and interactive, rigid, surface-based registration. The registration is computed using a particle filter that outputs a sampled representation of the distribution of the registration parameters. The distribution is propagated through a point selection algorithm derived from a stiffness model of surface-based registration, allowing the selection algorithm to incorporate knowledge of the uncertainties in the registration parameters. We show that the behavior of target registration error improves as the quality measure of the registration points increases.

Algorithms↗
PubMed2005

Kinematic geometry of osteotomies.

This paper presents a novel method for defining an osteotomy that can be used to represent all types of osteotomy procedures. In essence, we model an osteotomy as a lower-pair mechanical joint to derive the kinematic geometry of the osteotomy. This method was implemented using a commercially available animation software suite in order to simulate a variety of osteotomy procedures. Two osteotomy procedures are presented for a femoral malunion in order to demonstrate the advantages of our kinematic model in developing optimal osteotomy plans. The benefits of this kinematic model include the ability to evaluate the effects of various kinds of osteotomy and the elimination of potentially error-prone radiographic assessment of deformities.

Biomechanical Phenomena↗
PubMed2005

Experimental validation of a 3D dynamic finite-element model of a total knee replacement.

A 3D forward-dynamics model of a total knee replacement was developed using an explicit finite-element package. The model incorporated both a tibiofemoral and a patellofemoral joint and allowed full 6-DOF kinematics for both joints. Simulated quadriceps contraction was used to drive the model. For validation, a unique experimental apparatus was constructed to simulate an open-chain extension motion under quadriceps control. The ligamentous constraints of the MCL and LCL were simulated using tension springs. The kinematics of the tibia and patella were recorded along with the net forces and moments applied to the femur. Several ligament and inertial configurations were simulated. The RMS differences between the experimental data and model predictions across all simulations were excellent for both the kinematics (angles: 0.3 - 1.6 degrees, displacements: 0.1 - 0.8 mm) and kinetics (forces: 5 - 11 N, moments: 0.2 - 0.6 Nm). The validated model will be extended with physiologically realistic ligaments and utilized in surgical planning simulations.

Arthroplasty, Replacement, Knee↗
PubMed2005

Ligament strains predict knee motion after total joint replacement: a kinematic analysis of the sigma knee.

A passive forward kinematics knee model was used to predict knee motion of a total joint replacement. Given ajoint angle, maps of articular surfaces, and patient-specific ligament properties, this model predicted femorotibial contact locations based on the principle of ligament-strain minimization. The model was validated by physical experiments on a commonly implanted knee prosthesis, showing excellent correspondence between the model and actual physical motion. Results suggest that the knee prosthesis studied required an intact posterior cruciate ligament to induce the desirable roll-back motion, and that a single-bundle model of major knee ligaments generated kinematics similar to that of a multibundle ligament model. Implications are that a passive model may predict knee kinematics of a given patient, so it may be possible to optimize the implantation of a prosthesis intraoperatively.

Arthroplasty, Replacement, Knee↗
PubMed2005

2D/3D deformable registration using a hybrid atlas.

Statistical atlases built by point distribution models (PDMs) using a novel hybrid 3D shape model were used for surface reconstruction. The hybrid shape model removes the need for global scaling in aligning training examples and instance generation, thereby allowing the PDM to capture a wider range of variations. The atlases can be used to reconstruct, or deformably register, the surface model of an object from just two to four 2D x-ray projections of the object. The methods was tested using proximal and distal femurs. Results of simulated projections and fluoroscopic images of cadaver knees show that the new instances can be registered with an accuracy of about 2 mm.

Algorithms↗
PubMed2005

A tactile enhancement instrument for minimally invasive surgery.

OBJECTIVE: During minimally invasive arthroscopy, surgeons use probes as diagnostic tools to detect tissue anomalies. Improving tactile sensitivity during this activity would be valuable. MATERIALS AND METHODS: We developed an enhanced probe that could enhance the tactile sensations experienced while probing objects. It operated by detecting the acceleration signal resulting from the interaction of the tool tip with surfaces and by magnifying it for tactile and auditory reproduction. The instrument consisted of an accelerometer and an actuator arranged such that the sensing direction was orthogonal to the actuating direction so as to decouple input from output. Using the instrument, subjects were asked to detect cuts under four conditions: with no amplification, with enhanced tactile feedback, with sound feedback, and with passive touch. RESULTS: We found that for tactile reproduction, the current prototype could amplify the signals by 10 dB on average. Results from statistical methods showed significant improvements in performance in the case of tactile and auditory feedbacks. CONCLUSION: We developed a surgical probe with tactile and auditory feedbacks. Despite the moderate system gain achievable with the initial prototype, the system could measurably improve users' ability to detect small cuts in cartilage-like elastic surfaces.

Adult↗
PubMed2003

Computer-assisted distal radius osteotomy.

PURPOSE: To establish the accuracy, precision, and clinical feasibility of a novel technique of computer-assisted distal radius osteotomy for the correction of symptomatic distal radius malunion. METHODS: Six patients underwent a computer-assisted distal radius osteotomy and were followed-up for an average of 25 months. Objective radiographic measurements and functional outcomes, as measured by clinical examination including grip strength and range of motion, and Disability of the Arm, Shoulder and Hand (DASH) questionnaires, were used. RESULTS: The mean radiographic parameters included an increase of radial inclination to 21 degrees from 12 degrees (normal, 23 degrees ). Dorsal and volar tilt (malunion) were corrected to 9 degrees from -30 degrees and 21 degrees, respectively (normal, 10 degrees ). Ulnar variance was corrected to 1.9 mm from 7.5 mm (normal, +1.5 mm). Normal is defined as the average of the contralateral limb radiographs. The mean clinical outcome measures at an average of 25 months included a DASH global score of 14, a DASH individual item average score of 1.6, and an average affected side grip strength of 79% when compared with the unaffected side. CONCLUSIONS: The results of the computer-assisted technique were comparable with published results of traditional non-computer-assisted opening wedge osteotomy techniques. This technique allows a surgeon to accurately and precisely recognize and correct 3-dimensional deformities of the distal radius including axial malalignment (supination). The technique has the added benefit of reducing radiation exposure to the patient and surgical team because fluoroscopy is not used during the procedure. Additional benefits of the computer-assisted technique include the ability to perform multiple surgical simulations to optimize the alignment plan, and it serves as an excellent teaching tool for less-experienced surgeons.

Adult↗
PubMed2002

The sensitivity of carpal bone indices to rotational malpositioning.

We investigated the dependence of 20 radiographic carpal measurements (carpal indices) on rotational positioning errors in posteroanterior and lateral radiographs. The measurements were made from "true perspective" digitally reconstructed radiographs created from computed tomography data. Most posteroanterior indices were not affected by rotation. Carpal height, carpal height ratio, revised carpal height ratio, capitate-radius distance, and carpal ulnar translocation were particularly robust. Lateral-view indices involving the scaphoid were the most sensitive to simulated malpositioning: radioscaphoid, scapholunate, and scaphocapitate angles were reduced from 58 degrees, 48 degrees, and 56 degrees at true lateral to 30 degrees, 24 degrees, and 34 degrees, respectively, at 20 degrees external rotation. Observers were unable to estimate the degree of malpositioning accurately in either view. Our results support use of the "scaphopisocapitate" criterion for assessing correct positioning in lateral plain radiographs.

Adult↗
PubMedDate not supplied

A system for ultrasound-guided computer-assisted orthopaedic surgery.

Current computer-assisted orthopedic surgery (CAOS) systems typically use preoperative computed tomography (CT) and intraoperative fluoroscopy as their imaging modalities. Because these imaging tools use X-rays, both patients and surgeons are exposed to ionizing radiation that may cause long-term health damage. To register the patient with the preoperative surgical plan, these techniques require tracking of the targeted anatomy by invasively mounting a tracking device on the patient, which results in extra pain and may prolong recovery time. The mounting procedure also leads to a major difficulty of using these approaches to track small bones or mobile fractures. Furthermore, it is practically impossible to mount a heavy tracking device on a small bone, which thus restricts the use of CAOS techniques. This article presents a novel CAOS method that employs 2D ultrasound (US) as the imaging modality. Medical US is non-ionizing and real-time, and our proposed method does not require any invasive mounting procedures. Experiments have shown that the proposed registration technique has sub-millimetric accuracy in localizing the best match between the intraoperative and preoperative images, demonstrating great potential for orthopedic applications. This method has some significant advantages over previously reported US-guided CAOS techniques: it requires no segmentation and employs only a few US images to accurately and robustly localize the patient. Preliminary laboratory results on both a radius-bone phantom and human subjects are presented.

Computer Systems↗