Anthony M. DiGioia

Bio: Anthony M. DiGioia is an academic researcher from University of Pittsburgh. The author has contributed to research in topics: Computer-assisted surgery & Health care. The author has an hindex of 37, co-authored 93 publications receiving 5892 citations. Previous affiliations of Anthony M. DiGioia include Western Pennsylvania Hospital & Carnegie Mellon University.

Computer-assisted surgery planner and intra-operative guidance system

Abstract: An apparatus for facilitating the implantation of an artificial component in one of a hip joint, a knee joint, a hand and wrist joint, an elbow joint, a shoulder joint, and a foot and ankle joint. The apparatus includes a pre-operative geometric planner and a pre-operative kinematic biomechanical simulator in communication with the pre-operative geometric planner.

Apparatus and method for facilitating the implantation of artificial components in joints

Abstract: Apparatuses and methods are disclosed for determining an implant position for at least one artificial component in a joint and facilitating the implantation thereof. The apparatuses and methods include creating a joint model of a patient's joint into which an artificial component is to be implanted and creating a component model of the artificial component. The joint and artificial component models are used to simulate movement in the patient's joint with the artificial component in a test position. The component model and the joint model are used to calculate a range of motion in the joint for at least one test position based on the simulated motion. An implant position, including angular orientation, in the patient's joint is determined based on a predetermined range of motion and the calculated range of motion. In a preferred embodiment, the implant position can be identified in the joint model and the joint model aligned with the joint by registering positional data from discrete points on the joint with the joint model. Such registration also allows for tracking of the joint during surgical procedures. A current preferred application of the invention is for determining the implant position and sizing of an acetabular cup and femoral implant for use in total hip replacement surgery.

The Otto Aufranc Award. Image guided navigation system to measure intraoperatively acetabular implant alignment.

Abstract: There has been little clinical research to examine the effects of patient positioning and pelvic motion on the alignment of the acetabular implant during total hip replacement surgery. Until now, no tools were capable of accurately measuring these variables during the actual procedure. As part of a broader program in medical robotics and computer assisted surgery, a clinical system has been developed that includes several enabling technologies. The hip navigation system (HipNav) continuously and precisely measures pelvic location and tracks relative implant alignment intraoperatively. HipNav technology is used to gauge current clinical practice and provide intraoperative feedback to surgeons with the goal of improving the precision and accuracy of acetabular alignment during total hip replacement. This system provides surgeons with a new class of image guided measurement tools and assist devices. These tools successfully were introduced into the clinical practice of surgery with results showing the following: (1) There exist unpredictable and large variations in the initial position of patients' pelves on the operating room table and significant pelvic movement during surgery and during intraoperative range of motion testing; (2) current mechanical acetabular alignment guides do not account for these variations, and result in variable and in the majority of cases unacceptable acetabular alignment; and (3) press fitting oversized acetabular components influences the final cup orientation.

Comparison of a mechanical acetabular alignment guide with computer placement of the socket

Abstract: We hypothesized that use of mechanical acetabular guides for intraoperative alignment leads to variations between the actual and desired implant orientation. Acetabular implant orientation using only the mechanical guide was studied in 78 patients (82 hips) undergoing primary total hip arthroplasty. A computer-assisted navigation system was used to measure alignment and to monitor the orientation of the pelvis during surgery. When using the mechanical guide, there was significant variation in cup alignment from the desired goal of 45° of abduction and 20° of flexion, and this would have resulted in unacceptable acetabular alignment in 78% of hips. With the support system used, there was significant variability in pelvic orientation during surgery. The mean anteversion of the pelvis was an average of 18° from the optimal orientation. These results show a clear need to develop more reliable tools than were used or anatomically based alignment strategies to provide reproducible and accurate acetabular alignment.

Mini-incision technique for total hip arthroplasty with navigation

Abstract: This prospective study compares a mini-incision technique and traditional posterior approach for total hip arthroplasty (THA). Thirty-three patients who had undergone a mini-incision THA were matched by diagnosis, gender, average age, and preoperative Harris Hip Score (HHS) to 33 patients who had undergone THA using the traditional posterior approach. The average length of the incision for group 1 was 11.7 cm (range, 7.3–13.0) and for group 2 was 20.2 cm (range, 14.8–26.0). At the 3-month follow-up, patients in the mini-incision group had significant improvement in limp ( P P P P P

Medical image analysis: progress over two decades and the challenges ahead

Abstract: The analysis of medical images has been woven into the fabric of the pattern analysis and machine intelligence (PAMI) community since the earliest days of these Transactions. Initially, the efforts in this area were seen as applying pattern analysis and computer vision techniques to another interesting dataset. However, over the last two to three decades, the unique nature of the problems presented within this area of study have led to the development of a new discipline in its own right. Examples of these include: the types of image information that are acquired, the fully three-dimensional image data, the nonrigid nature of object motion and deformation, and the statistical variation of both the underlying normal and abnormal ground truth. In this paper, we look at progress in the field over the last 20 years and suggest some of the challenges that remain for the years to come.

Medical robotics in computer-integrated surgery

Abstract: This paper provides a broad overview of medical robot systems used in surgery. After introducing basic concepts of computer-integrated surgery, surgical CAD/CAM, and surgical assistants, it discusses some of the major design issues particular to medical robots. It then illustrates these issues and the broader themes introduced earlier with examples of current surgical CAD/CAM and surgical assistant systems. Finally, it provides a brief synopsis of current research challenges and closes with a few thoughts on the research/industry/clinician teamwork that is essential for progress in the field.

Microsurgical robot system

Abstract: A robot system for use in surgical procedures has two movable arms each carried on a wheeled base with each arm having a six of degrees of freedom of movement and an end effector which can be rolled about its axis and an actuator which can slide along the axis for operating different tools adapted to be supported by the effector. Each end effector including optical force sensors for detecting forces applied to the tool by engagement with the part of the patient. A microscope is located at a position for viewing the part of the patient. The position of the tool tip can be digitized relative to fiducial markers visible in an MRI experiment. The workstation and control system has a pair of hand-controllers simultaneously manipulated by an operator to control movement of a respective one or both of the arms. The image from the microscope is displayed on a monitor in 2D and stereoscopically on a microscope viewer. A second MRI display shows an image of the part of the patient the real-time location of the tool. The robot is MRI compatible and can be configured to operate within a closed magnet bore. The arms are driven about vertical and horizontal axes by piezoelectric motors.

Haptic guidance system and method

Abstract: A surgical apparatus includes a surgical device, configured to be manipulated by a user to perform a procedure on a patient, and a computer system. The computer system is programmed to implement control parameters for controlling the surgical device to provide at least one of haptic guidance to the user and a limit on user manipulation of the surgical device, based on a relationship between an anatomy of the patient and at least one of a position, an orientation, a velocity, and an acceleration of a portion of the surgical device, and to adjust the control parameters in response to movement of the anatomy during the procedure.