Intraoperative Ultrasound in Orthopaedics (orthoMIT)

The central area of focus in one of Germany’s largest orthopaedic research projects is the development of future strategies for operations performed on the knee, hip and vertebral column. Around 30 project partners from various hospitals, research institutes and industries all over Germany work side by side on this mission. The Institute of Medical Imaging at the Ruhr- University is one of its key partners. The German Federal Ministry of Education and Research (BMBF) puts about 13 Million Euros at orthoMIT’s disposal till the end of 2010 to accomplish this task.

The Institute of Medical engineering at the Ruhr- University in Bochum aims is to integrate ultrasound into the intraoperative workflow so as to enable intraoperative visualization of the soft tissue on one hand and allow intraoperative navigation using multimodal image registration with preoperative data like for e.g. CT or MRT images on the other. A multimodal image registration of preoperative CT or MRT images with 3 D ultrasound volume facilitates navigation based on the preoperative data. Hence prior to the operation, proper planning of various cutting planes or drilling paths can be done. During the surgery, the required surgical instruments can be superimposed into the preoperative data, allowing the surgeon to orient himself based on his prior plan.

Since registration of preoperative data is reliable only for rigid structures such as bones, visualisation of non-rigid structures like soft tissue, which undergo deformation and shift in position based on patient position, should be preformed directly with the aid of ultrasound imaging. Segmentation of various soft tissue structures within an ultrasound image may be achieved using different image processing techniques. A superimposed visualization of registered bone structures from the preoperative data onto the current soft tissue image enhances the orientation during surgery.

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