@inproceedings{EixelbergerWittenbergPerretetal., author = {Eixelberger, Thomas and Wittenberg, Thomas and Perret, Jerome and Katzky, Uwe and Simon, Martina and Schmitt-R{\"u}th, Stephanie and Hofer, Mathias and Sorge, M. and Jacob, R. and Engel, Felix B. and Gostian, A. and Palm, Christoph and Franz, Daniela}, title = {A haptic model for virtual petrosal bone milling}, series = {17. Jahrestagung der Deutschen Gesellschaft f{\"u}r Computer- und Roboterassistierte Chirurgie (CURAC2018), Tagungsband, 2018, Leipzig, 13.-15. September}, volume = {17}, booktitle = {17. Jahrestagung der Deutschen Gesellschaft f{\"u}r Computer- und Roboterassistierte Chirurgie (CURAC2018), Tagungsband, 2018, Leipzig, 13.-15. September}, pages = {214 -- 219}, abstract = {Virtual training of bone milling requires realtime and realistic haptics of the interaction between the "virtual mill" and a "virtual bone". We propose an exponential abrasion model between a virtual one and the mill bit and combine it with a coarse representation of the virtual bone and the mill shaft for collision detection using the Bullet Physics Engine. We compare our exponential abrasion model to a widely used linear abrasion model and evaluate it quantitatively and qualitatively. The evaluation results show, that we can provide virtual milling in real-time, with an abrasion behavior similar to that proposed in the literature and with a realistic feeling of five different surgeons.}, subject = {Osteosynthese}, language = {en} } @article{DePieriAtzoriFergusonetal., author = {De Pieri, Enrico and Atzori, Federica and Ferguson, Stephen J. and Dendorfer, Sebastian and Leunig, Michael and Aepli, Martin}, title = {Contact force path in total hip arthroplasty: effect of cup medialisation in a whole-body simulation}, series = {HIP International}, volume = {31}, journal = {HIP International}, number = {5}, publisher = {Sage}, doi = {10.1177/1120700020917321}, pages = {624 -- 631}, abstract = {Background: Cup medialisation down to the true acetabular floor in total hip arthroplasty with a compensatory femoral offset increase seems to be mechanically advantageous for the abductor muscles due to the relocation of the lever arms (body weight lever arm decreased, abductor lever arm increased). However, limited information is currently available about the effects of this reconstruction type at the head cup interface, compared to an anatomical reconstruction that maintains the natural lever arms. Through a whole-body simulation analysis, we compared medialised versus anatomical reconstruction in THA to analyse the effects on: (1) contact force magnitude at the head cup interface; (2) contact force path in the cup; and (3) abductor activity. Methods: Musculoskeletal simulations were performed to calculate the above-mentioned parameters using inverse dynamics analysis. The differences between the virtually implanted THAs were calculated to compare the medialised versus anatomical reconstruction. Results: Cup medialisation with compensatory femoral offset increase led to: (1) a reduction in contact force magnitude at the head cup interface up to 6.6\%; (2) a similar contact force path in the cup in terms of sliding distance and aspect ratio; and (3) a reduction in abductor activity up to 17.2\% (gluteus medius). Conclusions: In our opinion, these potential biomechanical gains do not generally justify a fully medialised reconstruction, especially in younger patients that are more likely to undergo revision surgery in their lifetime. Cup medialisation should be performed until sufficient press fit and bony coverage of a properly sized and oriented cup can be achieved.}, subject = {H{\"u}ftgelenkprothese}, language = {en} } @article{LenichBachmeierDendorferetal., author = {Lenich, Andreas and Bachmeier, S. and Dendorfer, Sebastian and Mayr, E. and Nerlich, Michael and F{\"u}chtmeier, Bernd}, title = {Development of a test system to analyze different hip fracture osteosyntheses under simulated walking}, series = {Biomedizinische Technik. Biomedical engineering}, volume = {57}, journal = {Biomedizinische Technik. Biomedical engineering}, number = {2}, doi = {10.1515/bmt-2011-0999}, pages = {113 -- 119}, abstract = {The mechanical complications of osteosyntheses after hip fractures are previously investigated by mostly static or dynamic uniaxial loading test systems. However, the physiologic loading of the hip joint during a normal gait is a multiplanar, dynamic movement. Therefore, we constructed a system to test osteosyntheses for hip fractures under physiologic multiplanar loading representative of normal gait. To evaluate the testing system, 12 femora pairs were tested under 25,000 cycles with two standard osteosyntheses (Proximal Femoral Nail Antirotation/Gamma3 Nail). For angular movement, the varus collapse to cut out (∝CO) (∝CO=4.8°±2.1° for blade and ∝CO=7.8°±3.8° for screw) was the dominant failure mode, and only slight rotational angle shifts (∝Rot) (∝Rot=1.7°±0.4° for blade and ∝Rot=2.4°±0.3° for screw) of the femoral head around the implant axis were observed. Angular displacements in varus direction and rotation were higher in specimens reinforced with screws. Hence, the cut out model and the migration directions showed a distinction between helical blade and hip screw. However, there were no significant differences between the different implants. The new setup is able to create clinical failures and allows to give evidence about the anchorage stability of different implant types under dynamic gait motion pattern.}, subject = {H{\"u}ftgelenk}, language = {en} } @article{MelznerEngelhardtSimonetal., author = {Melzner, Maximilian and Engelhardt, Lucas and Simon, Ulrich and Dendorfer, Sebastian}, title = {Electromyography-Based Validation of a Musculoskeletal Hand Model}, series = {Journal of Biomechanical Engineering}, volume = {144}, journal = {Journal of Biomechanical Engineering}, number = {2}, publisher = {American Society of Mechanical Engineers, ASME}, doi = {10.1115/1.4052115}, pages = {8}, abstract = {Regarding the prevention of injuries and rehabilitation of the human hand, musculoskeletal simulations using an inverse dynamics approach allow for insights of the muscle recruitment and thus acting forces on the hand. Currently, several hand models from various research groups are in use, which are mainly validated by the comparison of numerical and anatomical moment arms. In contrast to this validation and model-building technique by cadaver studies, the aim of this study is to further validate a recently published hand model [1] by analyzing numerically calculated muscle activities in comparison to experimentally measured electromyographical signals of the muscles. Therefore, the electromyographical signals of 10 hand muscles of five test subjects performing seven different hand movements were measured. The kinematics of these tasks were used as input for the hand model, and the numerical muscle activities were computed. To analyze the relationship between simulated and measured activities, the time difference of the muscle on- and off-set points was calculated, which resulted in a mean on- and off-set time difference of 0.58 s between the experimental data and the model. The largest differences were detected for movements that mainly addressed the wrist. One major issue comparing simulated and measured muscle activities of the hand is cross-talk. Nevertheless, the results show that the hand model fits the experiment quite accurately despite some limitations and is a further step toward patient-specific modeling of the upper extremity.}, subject = {Elektromyographie}, language = {en} } @article{AurbachSpickaSuessetal., author = {Aurbach, Maximilian and Spicka, Jan and S{\"u}ß, Franz and Dendorfer, Sebastian}, title = {Evaluation of musculoskeletal modelling parameters of the shoulder complex during humeral abduction above 90°}, series = {Journal of Biomechanics}, volume = {106}, journal = {Journal of Biomechanics}, number = {June}, publisher = {Elsevier}, doi = {10.1016/j.jbiomech.2020.109817}, abstract = {Based on electromyographic data and force measurements within the shoulder joint, there is an indication that muscle and resulting joint reaction forces keep increasing over an abduction angle of 90°. In inverse dynamics models, no single parameter could be attributed to simulate this force behaviour accordingly. The aim of this work is to implement kinematic, kinetic and muscle model modifications to an existing model of the shoulder (AnyBody™) and assess their single and combined effects during abduction up to 140° humeral elevation. The kinematics and the EMG activity of 10 test subjects were measured during humeral abduction. Six modifications were implemented in the model: alternative wrapping of the virtual deltoid muscle elements, utilization of a three element Hill model, strength scaling, motion capture driven clavicle elevation/protraction, translation of the GH joint in dependency of the acting forces and an alteration of the scapula/clavicle rhythm. From the six modifications, 16 different combinations were considered. Parameter combinations with the Hill model changed the resultant GH joint reaction force and led to an increase in force during abduction of the humerus above 90°. Under the premise of muscle activities and forces within the GH joint rising after 90° of humeral abduction, we propose that the Hill type muscle model is a crucial parameter for accurately modelling the shoulder. Furthermore, the outcome of this study indicates that the Hill model induces the co-contraction of the muscles of the shoulder without the need of an additional stability criterion for an inverse dynamics approach.}, subject = {Schultergelenk}, language = {en} } @inproceedings{JungtaeublSchmitzGrossetal., author = {Jungt{\"a}ubl, Dominik and Schmitz, Paul and Gross, Simon and Dendorfer, Sebastian}, title = {FEA of the transiliacal internal fixator as an osteosynthesis of pelvic ring fractures}, series = {CMBEBIH 2017, Proceedings of the International Conference on Medical and Biological Engineering 2017}, booktitle = {CMBEBIH 2017, Proceedings of the International Conference on Medical and Biological Engineering 2017}, editor = {Badnjevic, Almir}, publisher = {Springer}, address = {Singapore}, isbn = {978-981-10-4165-5}, doi = {10.1007/978-981-10-4166-2_32}, pages = {212 -- 217}, abstract = {Common Schanz screw systems can be used to stabilize pelvic ring fractures. In order to accommodate for different patient's requirements, implants can be placed in cranio-caudal direction into the os ilium (T1), or into the supraacetabular bone canal, and thus, in dorso-ventral direction (T2). Whereas both techniques are currently used, no data of the biomechanical behavior is available up to this date. The aim of this study is to analyze, whether T2 shows biomechanical advantages with respect to tissue and implant stresses due to the enlarged bone-implant interface. Forces acting on the pelvis were analyzed using motion capture data of a gait cycle obtained by the utilization of a musculoskeletal simulation program. A three dimensional finite element (FE) model of the pelvis with grayscale-based material properties was generated. The muscle and joint reaction forces at toe-off were applied to the FE model and instable pelvis fractures were implemented. The osteosynthesis systems were positioned within the model in order to enable the comparison between the two different surgical techniques. Stresses and displacements were analyzed for bone tissue, fracture zone and implant. T2 lead to approx. 30\% larger displacements in the fracture zone. Von-Mises stresses were larger for T2 in the implant (80 MPa vs. 227 MPa), whereas T1 leads to larger stresses in the bone tissue (200 MPa vs. 140 MPa). Both implantation techniques showed a good biomechanical behavior. Differences could be found with respect to tissue strains and deformations in the fracture zone. If bone quality or fracture healing are of concern, T2 or T1 should be used, respectively. However, both techniques seem to be applicable for cases with no special requirements. Further analyses aim to investigate the behavior under cyclic loading.}, subject = {Beckenbruch}, language = {en} } @inproceedings{MaierHuberKatzkyetal., author = {Maier, Johannes and Huber, Michaela and Katzky, Uwe and Perret, Jerome and Wittenberg, Thomas and Palm, Christoph}, title = {Force-Feedback-assisted Bone Drilling Simulation Based on CT Data}, series = {Bildverarbeitung f{\"u}r die Medizin 2018; Algorithmen - Systeme - Anwendungen; Proceedings des Workshops vom 11. bis 13. M{\"a}rz 2018 in Erlangen}, booktitle = {Bildverarbeitung f{\"u}r die Medizin 2018; Algorithmen - Systeme - Anwendungen; Proceedings des Workshops vom 11. bis 13. M{\"a}rz 2018 in Erlangen}, publisher = {Springer}, address = {Berlin}, doi = {10.1007/978-3-662-56537-7_78}, pages = {291 -- 296}, abstract = {In order to fix a fracture using minimally invasive surgery approaches, surgeons are drilling complex and tiny bones with a 2 dimensional X-ray as single imaging modality in the operating room. Our novel haptic force-feedback and visual assisted training system will potentially help hand surgeons to learn the drilling procedure in a realistic visual environment. Within the simulation, the collision detection as well as the interaction between virtual drill, bone voxels and surfaces are important. In this work, the chai3d collision detection and force calculation algorithms are combined with a physics engine to simulate the bone drilling process. The chosen Bullet-Physics-Engine provides a stable simulation of rigid bodies, if the collision model of the drill and the tool holder is generated as a compound shape. Three haptic points are added to the K-wire tip for removing single voxels from the bone. For the drilling process three modes are proposed to emulate the different phases of drilling in restricting the movement of a haptic device.}, subject = {Handchirurgie}, language = {en} } @inproceedings{FranzKatzkyNeumannetal., author = {Franz, Daniela and Katzky, Uwe and Neumann, S. and Perret, Jerome and Hofer, Mathias and Huber, Michaela and Schmitt-R{\"u}th, Stephanie and Haug, Sonja and Weber, Karsten and Prinzen, Martin and Palm, Christoph and Wittenberg, Thomas}, title = {Haptisches Lernen f{\"u}r Cochlea Implantationen}, series = {15. Jahrestagung der Deutschen Gesellschaft f{\"u}r Computer- und Roboterassistierte Chirurgie (CURAC2016), Tagungsband, 2016, Bern, 29.09. - 01.10.}, booktitle = {15. Jahrestagung der Deutschen Gesellschaft f{\"u}r Computer- und Roboterassistierte Chirurgie (CURAC2016), Tagungsband, 2016, Bern, 29.09. - 01.10.}, pages = {21 -- 26}, abstract = {Die Implantation eines Cochlea Implantates ben{\"o}tigt einen chirurgischen Zugang im Felsenbein und durch die Paukenh{\"o}hle des Patienten. Der Chirurg hat eine eingeschr{\"a}nkte Sicht im Operationsgebiet, die weiterhin viele Risikostrukturen enth{\"a}lt. Um eine Cochlea Implantation sicher und fehlerfrei durchzuf{\"u}hren, ist eine umfangreiche theoretische und praktische (teilweise berufsbegleitende) Fortbildung sowie langj{\"a}hrige Erfahrung notwendig. Unter Nutzung von realen klinischen CT/MRT Daten von Innen- und Mittelohr und der interaktiven Segmentierung der darin abgebildeten Strukturen (Nerven, Cochlea, Geh{\"o}rkn{\"o}chelchen,...) wird im HaptiVisT Projekt ein haptisch-visuelles Trainingssystem f{\"u}r die Implantation von Innen- und Mittelohr-Implantaten realisiert, das als sog. „Serious Game" mit immersiver Didaktik gestaltet wird. Die Evaluierung des Demonstrators hinsichtlich Zweckm{\"a}ßigkeit erfolgt prozessbegleitend und ergebnisorientiert, um m{\"o}gliche technische oder didaktische Fehler vor Fertigstellung des Systems aufzudecken. Drei zeitlich versetzte Evaluationen fokussieren dabei chirurgisch-fachliche, didaktische sowie haptisch-ergonomische Akzeptanzkriterien.}, subject = {Cochlea-Implantat}, language = {de} } @inproceedings{WeberDendorferDullienetal., author = {Weber, Tim A. and Dendorfer, Sebastian and Dullien, Silvia and Grifka, Joachim and Verkerke, Gijsbertus Jacob and Renkawitz, Tobias}, title = {Measuring functional outcome after total hip replacement with subject-specific hip joint loading}, series = {Proceedings of the Institution of Mechanical Engineers. Part H, Journal of engineering in medicine}, volume = {226}, booktitle = {Proceedings of the Institution of Mechanical Engineers. Part H, Journal of engineering in medicine}, number = {12}, doi = {10.1177/0954411912447728}, pages = {939 -- 946}, abstract = {Total hip replacement is an often-performed orthopedic surgical procedure; the amount of procedures undertaken will increase since our life expectancy is growing. In order to optimize function, hip biomechanics should be restored to as near normal as possible. The goal of this pilot study was to determine whether or not it is feasible to compute the vectorial hip reaction force pathways on the head of the prosthesis and the force angles relative to the cup of the prosthesis that occur during gait in total hip replacement patients, serving as an objective measurement of the functional outcome following hip replacement. A three-dimensional gait analysis, measuring ground reaction forces and kinematics, was performed. The data retrieved from the gait analysis was used as the input for the musculoskeletal model to compute vectorial joint reaction forces for data processing. To evaluate the position and orientation of the joint reaction forces, the force path, as well as the force angles for the operated and non-operated joint, has been calculated during the stance phase of the specific leg. The force path for subject 2 on the non-operated side is only located in the posterior-lateral quarter, as is the force path for subject 1. In contrast to this subject, the force path for subject 2 at the operated hip joint can be found only within the anterior quarter of the head of the implant, where it is nearly equally distributed in the medio-lateral half of the prosthesis head. The force-inclination angles on the cup of subject 1, with respect to the plane of the socket face, indicates that the force vector is mainly positioned in the same quadrant when compared with subject 2 (in a cup-fixed coordinate system). The force-anteversion angle behaves similarly to the force-inclination angle, even when the effects are not as pronounced. The proposed methods in this article are aiming to define two functional outcomes of total hip replacement that are related to wear and rim loading. It is accepted that wear is not only a function of time, but a function of use. Owing to the methods listed in this article, we are able to determine a) the applied force and b) the sliding distance (force pathway) in a subject-specific manner. The computed hip-reaction force angles and the distance to the rim cup are a measurement for cup or rim loading, and occurs in the so-called safe-zones. This method may well give us insight into the biomechanical situation during gait, after receiving total hip replacement, that we need to fully understand the mechanisms acting on a hip joint and to prove a possible increase of functional outcome after receiving total hip replacement.}, subject = {H{\"u}ftgelenkprothese}, language = {en} } @article{DendorferWeberKennedy, author = {Dendorfer, Sebastian and Weber, Tim and Kennedy, O.}, title = {Musculoskeletal modeling for hip replacement outcome analyses and other applications}, series = {The Journal of the American Academy of Orthopaedic Surgeons}, volume = {22}, journal = {The Journal of the American Academy of Orthopaedic Surgeons}, number = {4}, doi = {10.5435/JAAOS-22-04-268}, pages = {268 -- 269}, subject = {H{\"u}ftgelenkprothese}, language = {en} }