Kompendium 2020 Forschung & Klinik

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TOP-Studien 66 Figure 1: Illustration of the position of the two 3D spatial position sensors: spatial position sensor epicutaneously centrally dorsally over the os sacrum for recording the pelvic position (white arrow (A and B)), transducer with 3D-printed adapter and spatial position sensor (white star (A)). Figure 2: Illustration of the relative tilt angles between the pelvis/hip joint and the transducer in the frontal plane (roll) and axial plane (pitch): (a) transducer alignment using the navigation system, (b) conventional alignment of the transducer without navigation system. the electronic navigation system (conventional), as well as a sonogram using the electronic navigation system (navigated), whereby here the transducer was aligned by the examiner according to the displayed measurement data. In both sonograms, care was taken to ensure that the sonographic criteria according to Graf were met. Results In total, data from 25 infant hips could be used in 15 consecutive infants; in five infants, measurement was unilateral due to increasing restlessness. The tilt angles between the transducer and pelvic sensor of conventional hip sonography and navigated hip sonography are shown for the frontal plane (roll angle) and axial plane (pitch angle) in Figure 2 and Table 1. This test of variance showed significant differences for tilt in the frontal plane (roll angle, p
TOP-Studien 67 Table 1: Relative roll and pitch angles (between infant pelvis and transducer in the frontal and axial planes) for measurements without navigation (conventional) and for measurements with navigation system (nav); boldface = significant. Table 1 min max mean std.-deviation pitch-angle (conventionel) -23,8° 14,2° 0,6° 9,26 roll-angle (conventionel) -12,5° 14,3° -0,9° 7,68 pitch-angle (nav) -2,8° 4,5° 0,4° 2,23 roll-angle (nav) -3,0° 3,5° 0,3° 2,15 the navigation system significantly reduces the variance of the roll and pitch angles, i.e. the relative tilt between the infant’s pelvis and the transducer, but also that the mean value remains unchanged by the alignment with navigation with regard to these two tilt angles. This means that a more accurate alignment of the transducer with respect to the pelvis is achieved by the navigation system, while the target alignment to the original method according to Graf remains unchanged. Compared to established aids such as positioning aids for the baby (cradles) and mechanical transducer guiding devices, the main advantage of the presented system is the accurate detection of the pelvic position. An additional strength is not only the accuracy achieved, but also the documentation of the 3D data, which increases the safety of the method for patients and examiners. A limitation of this work is the small size of the collective. Therefore, although a highly significant improvement in transducer alignment in the frontal and axial planes could be shown, no significant effect on sonographic alpha angle could be presented. However, there seems to be a tendency for the alpha-angles to be reduced under a transducer alignment corresponding to the navigation data. Conclusion This work shows that the alignment between pelvis and transducer can be significantly improved by the presented navigation system. This represents a promising approach to increase the quality of the screening program. Further studies in a large collective are necessary to analyze the effects on the sonographically measured hip parameters. Priv.-Doz. Dr. Alexander Kolb Author: Alexander Kolb, senior physician, head of the outpatient clinic for femoropatellar pathologies at the Department of Orthopaedics and Trauma Surgery, Medical University of Vienna. Endocert surgeon; 2014 GOTS fellow. Specialties: Pediatric orthopedics, endoprosthetics, sports orthopedics. References: 1 Graf, R. Fundamentals of sonographic diagnosis of infant hip dysplasia. J. Pediatr. Orthop. 4, 735–740 (1984). 2 Ea, S. et al. Inter-observer agreement of ultrasonographic measurement of alpha and beta angles and the final type classification based on the Graf method. 671–678 3 Roposch, A., Graf, R. & Wright, J. G. Determining the reliability of the Graf classification for hip dysplasia. Clin. Orthop. Relat. Res. 447, 119–24 (2006). 4 Kolb, A. et al. Measurement considerations on examiner-dependent factors in the ultrasound assessment of developmental dysplasia of the hip. Int. Orthop. 41, 1245–1250 (2017). 5 Kolb, A. et al. Development of an electronic navigation system for elimination of examiner-dependent factors in the ultrasound screening for developmental dysplasia of the hip in newborns. Sci. Rep. 10, 1–5 (<strong>2020</strong>). 6 Kolb, A. Electronic Transducer Guiding Device for the Sonographic Screening for Developmental Dysplasia of the Hip. MUW Technol. Offer. 782.18 (2019). doi:10.1007/s00264-017-3455-9
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Kompendium 2020 Forschung & Klinik
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Inhalt/Impressum 3 Die Klinik 4 Edi
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Zahlen und Fakten 6 Klinische Leist
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Zahlen und Fakten 9 Hohe Ambulanzfr
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Klinik 11 Neben der Polytrauma-Vers
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Die Meniskusversorgung Alle Möglic
Page 15 and 16: Das ÄrztInnenteam 15 Universitäts
Page 17 and 18: Spherox ist das einzig EMA-zugelass
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Page 23 and 24: TOP-Studien 23 defects (≤ Interna
Page 25 and 26: WE LENGTHEN, TRANSPORT AND GROW BON
Page 27 and 28: TOP-Studien 27 5 5 Patients (-) 10
Page 29 and 30: FRESH AIR FRESH PERSPECTIVE Remove
Page 31 and 32: TOP-Studien 31 Aseptic loosening is
Page 33 and 34: Integriertes Patientenversorgungsko
Page 35 and 36: TOP-Studien 35 Figure 1: Bone miner
Page 37 and 38: TOP-Studien 37 A Prediction Model f
Page 39 and 40: TOP-Studien 39 Figure 2: Graphic vi
Page 41 and 42: TOP-Studien 41 Figure 1: Individual
Page 43 and 44: 3D Biochips for Research on Inflamm
Page 45 and 46: TOP-Studien 45 Chondro-Synovial Cro
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Page 49 and 50: TOP-Studien 49 Total Hip Arthroplas
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Page 55 and 56: TOP-Studien The Genetic Landscape o
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