全膝關節置換手術之電腦輔助導引系統

每個人的膝蓋經過經年累月長時間的彎曲與磨損，會使行動上造成疼痛，輕微程度的磨損可以藉由藥物治療減緩疼痛的現象，如果磨損程度過於嚴重影響到日常行動能力，則接受人工膝關節置換手術。在傳統人工膝關節置換手術，醫生通常是憑藉本身的臨床經驗為依據來執行手術，所以過程中難以掌握手術的切割精確度，影響手術品質，導成日後膝關節置入物鬆脫，使病人必須再次接受膝關節換置手術。利用電腦作為輔助系統來協助醫生執行高精度定位手術任務，是未來的研究重點跟發展趨勢。電腦輔助系統的導航功能的關鍵，在於影像座標系與病人患部的座標系之間的方位校準，方位校準的精確度對於手術器械的定位有舉足輕重的影響。本研究主要針對電腦影像跟病人患部做方位校準進行精密計算，在此利用3D Digitizer取得點數據後，再透過Iterative closest point (ICP)計算獲得精確的轉換關係，所得出的轉換關係，做為計算電腦影像中的股骨頭座標數據，與病患骨頭座標的關係，並應用於電腦輔助導航手術系統，以上述方法所進行之手術規劃結果，顯示本研究所提之方法無論在效率上，或手術規劃精度上，均滿足臨床之需求。

關鍵字

全膝關節置換手術；方位校準；手術規劃軟體；手術導航

並列摘要

Registration between the anatomy and its image is one of the key functions in computer assisted surgical system. This research uses a 3D Digitizer to firstly measure the anatomical feature points and then use the result as the initial solution for ICP to calculate the Transformation matrix between a patient’s anatomy and the image. The preliminary results showed that the proposed surgical planning system could produce sufficiently accurate cutting boundary for the bone preparation in total knee replacement procedure

並列關鍵字

Iterative Closest Point (ICP) ； Registration ； Total Knee Replacement ； Computer Navigation System

參考文獻

[1] D. A. Simon , "Techniques for Fast and Accurate Intra-Surgical Registration" , The Journal of Image Guided Surgery , Vol. 1, No. 1. , April 1995 , pp. 17-29.

[2] D. A. Simon "Development and Validation of a Navigational Guidance System for Acetabular Implant Placement" , Computer Vision, Virtual Reality and Robotics in Medicine and Medial Robotics and Computer-Assisted Surgery Lecture Notes In Computer Science , Vol. 1205,1997 , pp. 583-592.

[3] D. A. Simon and T. Kanade , "Geometric Constraint Analysis and Synthesis: Method for Improving Shape-Based Registration Accuracy" , Computer Vision, Virtual Reality and Robotics in Medicine and Medial Robotics and Computer-Assisted Surgery , 1997 , pp. 181-190.

[4] P. Gomes, J. Cobb , and B.L. Davies , "The Hands-On Orthopaedic Robot "Acrobot": Early Clinical Trials of Total Knee Replacement Surgery" , IEEE TRANSACTIONS ON ROBOTICS AND AUTOMATION , VOL. 19 , NO. 5 , OCTOBER 2003 , pp. 902-911.

[5] R.H. Taylor , "An Image-Directed Robotic System for Precise Orthopaedic Surgery" , IEEE TRANSACTIONS ON ROBOTICS AND AUTOMATION. , VOL. 10 , NO. 3 , JUNE 1994 , pp. 261-275.

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全膝關節置換手術之電腦輔助導引系統

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