Development of an endoscopic system for chromatically contrasted imaging and laser-based removal of bone cement in revision arthroplasty
With over 1 million procedures worldwide each year, complete hip replacement is one of the most successful surgeries in modern arthroplasty. Despite long lifetimes of typically 10-15 years, the high number of procedures also implies a large number of revision procedures in which the endoprosthesis must be removed and replaced. A large proportion of the endoprosthesis are stabilized with bone cement, which must also be completely removed during revision surgery to ensure the stability of the replacement prosthesis. This represents a major challenge for the surgeon, since the residues in the narrow bone canal have to be removed without direct view and with great mechanical force. With mechanical removal, traumatization of the bone is therefore often unavoidable. Laser-based bone cement removal using an appropriate endoscopic system could represent an efficient and very gentle alternative for the patient.
In this project funded by ForTra, a laser-based approach will be developed and validated, which supports the surgeon in the segmentation and subsequent removal of the bone cement. The laser will be guided through a rigid endoscope, and a parallel view of the process should be guaranteed by the parallel video imaging. In addition, the optical contrast between the aged bone cement and the bone itself will be enhanced by selective illumination to facilitate navigation for the surgeon.
In total, the operation time and the safety profile of the operation will be improved to obtain an even greater benefit for the patient. For technical implementation and clinical translation, the Laser Zentrum Hannover e.V. will work closely with the Helios ENDO-Klinik Hamburg to be able to integrate direct clinical feedback into the development.
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Project partner:
Helios ENDO-Klinik Hamburg
Holstenstraße 2
22767 Hamburg
