Mahsan Bakhtiarinejad; Cong Gao; Amirhossein Farvardin; Gang Zhu; Yu Wang; Julius K. Oni; Russell H. Taylor; Mehran Armand
Minimally-invasive Osteoporotic Hip Augmentation (OHA) by injecting bone cement is a potential treatment option to reduce the risk of hip fracture. This treatment can significantly benefit from computer-assisted planning and execution system to optimize the pattern of cement injection. We present a novel robotic system for the execution of OHA that consists of a 6-DOF robotic arm and integrated drilling and injection component. The minimally-invasive procedure is performed by registering the robot and preoperative images to the surgical scene using multi-view image-based 2D/3D registration with no external fiducial attached to the body. The performance of the system is evaluated through experimental sawbone studies as well as cadaveric experiments with intact soft tissues. In the cadaver experiments, distance errors of 3.28 mm and 2.64 mm for entry and target points and orientation error of 2.30° are calculated. Moreover, the mean surface distance error of 2.13 mm with translational error of 4.47 mm is reported between injected and planned cement profiles. The experimental results demonstrate the first application of the proposed Robot-Assisted combined Drilling and Injection System (RADIS), incorporating biomechanical planning and intraoperative fiducial-less 2D/3D registration on human cadavers with intact soft tissues.