Computer simulation of surgery to reduce implant complications
8 May 2008
A computer simulation breakthrough could mean fewer medical
complications and better surgical outcomes for patients undergoing hip,
knee or spinal implant surgery.
The EU-funded OrthoSim project was set up to develop an orthopaedic
surgery planning tool. It has developed a platform that can
significantly reduce the risk of post-op complications, as well as
provide a means for testing new implant devices, the researchers claim.
And in the very near future the platform will provide the base for a new
surgical training tool.
Each year surgeons across Europe perform 900,000 hip, knee and spinal
implant operations. Implant surgery is one of the most remarkable
advances in medical science. Such operations restore increased mobility
and a vastly improved quality of life to millions of Europeans.
Implant surgery also has one of the most remarkable success rates in
medical practice, with reliable, predictable outcomes and very few
complications. But it is not complication free.
“About 10% of operations have complications, often requiring a new
implant, or a further surgery,” explains Dr Ing Ruben Lafuente,
technical manager of the Spanish IT consulting firm Adapting S. and
co-ordinator of the OrthoSim project. “It means increased pain and
inconvenience, a drain on human resources and of course it is expensive,
Simulating the interface The OrthoSim platform is a system using
computer software to create anatomical and implant simulations. The
simulation models are based on the work of two leading European
biomechanics research centres.
“Our lumbar spinal region model is the result of over 20 years of
research at the Laboratoire de Biomecanique of L’Ecole Nationale
Superieure d’Arts et Metiers in Paris,” explains Lafuente. “It was
enhanced and complemented by a lumbar implant model provided by the
Instituto de Biomecánica de Valencia in Spain.”
These models were combined to provide a reliable simulation of the
interface between the artificial implant and the living tissue,
providing surgeons with vital pre-op information.
“With this service, a surgeon or implant engineer can effectively
call on the expertise of the best people in any field of orthopaedic
surgery, where biomechanical simulation can offer new insights for
patient care,” Lafuente says.
Even better, the tool can be used to study the suitability of new
implant devices and can help pinpoint any problems with the design at an
“Implant designers get the opportunity to test their new designs
initially without the need for actual implantations,” notes Lafuente.
“It will mean better implant designs at an early stage, cutting costs
and research time, as well as improving outcomes early on.”
Solving the integration problem
The models are linked together and are hosted at an online service.
Integrating the various models and algorithms into a unified platform
was a difficult computer science problem to solve.
“We had to work very hard to get the protocols right and we spent a
lot of time developing the user interface, too,” says Lafuente. “We
wanted to make the service as simple to use as possible.”
The OrthoSim project ended in March last year, with the research team
successfully combining the various elements of the project. Since then
the partners have been developing the service offering further and are
looking for financial support.
“Initially we had a model just for lumbar spine implants, but in the
last months we have almost completed a validated model for hip
implants,” says Lafuente. “We believe that once we finish perfecting a
model for knee implants we will have a very strong set of tools to offer
But Lafuente warns that developing new products for the health market
is a very difficult task in itself.
“The quality assurance and validation issues are very important in
healthcare directed products, and will require more work,” he says.
That work continues. A follow-on project, called OrthoTraining, is
taking the OrthoSim toolset a step further. Over the next two years
OrthoTraining’s researchers plan to develop a surgical training tool
based on OrthoSim’s work.
“It will enhance training for students and it will mean that newly
qualified surgeons will have better training and an enhanced skill set,”
Lafuente says. “This will improve the medical services and quality of
life of European citizens.”
OrthoSim was funded under the EU's eTEN programme for market
validation and implementation.
The OrthoSim project website: