Abstract
The risk for patients during the standard procedure of revision of cemented artificial hip joints is unsatisfactorily highdue to its high level of invasiveness and limited access to the operative field. To reduce this risk we are developing anImpedance Controlled Surgical Instrumentation (ICOS) system, which aims to establish real-time control during a BoneCement (BC) milling process. For this, the relationship between the thickness of the BC and its frequency-dependentelectrical impedance is used to estimate the residual BC thickness. The aim is to avoid unintended cutting of boneby detecting the passage of the BC/bone boundary layer by the milling head. In a second step, an estimation of theresidual BC thickness will be used to improve process control. As a first step towards demonstrating the feasibility ofour approach, presented here are experimental studies to characterize the BC permittivity and to describe the process indetail. The results show that the permittivity properties of BC are dominated by its polymethyl methacrylate (PMMA)fraction. Thus, PMMA can be used as a substitute for future experiments. Furthermore, a Femoral Test Bed (FTB) wasdesigned. Using this setup we show it is feasible to accurately distinguish between slightly different thicknesses of BC.
Highlights
In industrialized countries procedures such as total hip replacement are frequently performed to improve quality of life and maintain mobility of the aging society
The results show that the permittivity properties of Bone Cement (BC) are dominated by its polymethyl methacrylate (PMMA) fraction
A Femoral Test Bed (FTB) was designed. Using this setup we show it is feasible to accurately distinguish between slightly different thicknesses of BC
Summary
In industrialized countries procedures such as total hip replacement are frequently performed to improve quality of life and maintain mobility of the aging society. The old BC has to be removed to ensure fixation of the new implant [9] This is done by manual control of surgical hammer and chisel. This requires an additional step before or during the operation, apart from the actual milling process [6, 5, 8]. These additional steps cause stress, and CT imaging exposes the patient to ionizing radiation. To avoid these disadvantages, our approach uses real-time control of the milling process during BC removal. The measured values are used to calculate the spectral two-point bioimpedance from which we want to deduce the thickness of the residual BC in the femur
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