07/4 Medical consulting (applications)

		Surgical intervention for improving an abnormal hip joint

A clinical examination framework with multimodal medical data inputs (e.g. computer tomography, magnetic resonance imaging, ultrasound, optical motion capture, EMG) will be developed to enhance patient diagnosis and surgical treatment planning (Project 1). Its objective is to provide surgeons with an interactive visualisation framework for individualised hip joint examination. Femero-acetabular impingement, or contact of the femoral neck with the rim of the hip socket, is a major contributing factor to joint pain and may severely limit the joint's natural range of motion. Furthermore, impingement may initiate osteoarthritic degeneration of the joint. A conceptual system for predicting femero-acetabular impingement based on patient-specific anatomy will be further developed and implemented in the second phase of Co-Me. Potential improvements include the addition of soft-tissue structures to the model - our previous systems allowed prediction of only bone to bone contact - to fully characterise the individual patient's pathology. Close integration of kinematical predictions with the simulation of the internal contact pressures and forces within the joint will allow the surgeon to accurately visualise the harmful consequences of joint abnormalities and to predict the potential improvements which can be achieved with surgical intervention. Functional simulation of the hip joint will provide objective guidance for the surgeon when decisions must be made on the location and extent of reshaping of the acetabular rim or femoral neck (femoral head corrective surgery, periacetabular osteotomy). Pre and post operative hip joints will be analysed with the system at HUG and Inselspital, and the quality of the examination will be compared to traditional diagnosis. The goal is to assess 1) the added value of the proposed examination framework, in the clinical environment 2) the accuracy of prediction techniques provided by the system 3) possible improvements of the system, with regards to physicians comments.