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A Marker-Free 2D Image-Guided Method for Robot-Assisted Fracture Reduction Surgery

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Abstract

The closed fracture reduction is the first step of the minimally invasive treatment for long bone fractures, while it remains a challenging task due to heavy physical burden, excessive radiation exposure and poor accuracy. The robot-assisted fracture reduction (RAFR) shows potential to address these problems, while most existing methods rely on 3D images, optical tracking equipment and invasive robot-bone fixations. Such methods usually have a tedious surgery workflow, complicated hardware requirements, and iatrogenic injury risks, which prevent them from clinical applications. In this paper, we proposed a novel marker-free RAFR method using the image-based visual servoing technique. Firstly, an image feature vector based on 2D intraoperative images are defined for path planning and feedback control, and an online estimated Jacobian matrix is used to map the image variation to robot motion. Secondly, a geometry-based method is developed for Jacobian initialization without exploratory movements. Thirdly, a novel state-dependent weighted least square (SD-WLS) algorithm for online Jacobian estimation is proposed according to the characteristic of fracture reduction tasks. In the proposed RAFR framework, requirements for 3D images, optical markers and rigid robot-bone fixations are avoided. Experiments on fracture models with highly flexible robot-bone fixations are performed. All the tested fracture cases were well reduced within acceptable steps, which shows the feasibility of the proposed method.

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Data Availability

All data generated in this study are available from the corresponding author on reasonable request.

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Funding

This work is sponsored by Tsinghua University and Cyrus Tang Foundation.

Author information

Author notes

  1. Shijie Zhu and Zhe Zhao contributed equally to this work.

Authors and Affiliations

  1. School of Aerospace Engineering, Tsinghua University, Beijing, China

    Shijie Zhu, Yu Chen, Bicong Zhang, Yitong Chen & Gangtie Zheng

  2. Department of Orthopaedics, Beijing Tsinghua Changgung Hospital, Beijing, China

    Zhe Zhao, Jiuzheng Deng, Jianjin Zhu, Dawei He & Yongwei Pan

Authors
  1. Shijie Zhu
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  2. Zhe Zhao
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  3. Yu Chen
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  4. Jiuzheng Deng
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  5. Bicong Zhang
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  6. Jianjin Zhu
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  7. Yitong Chen
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  8. Dawei He
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  9. Yongwei Pan
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  10. Gangtie Zheng
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Contributions

Shijie Zhu developed the control method, designed the experiment system, analyzed the data and wrote the paper. Zhe Zhao designed and prepared the fracture model, performed the experiment and revised the paper. Yu Chen, Bicong Zhang and Yitong Chen built the experiment system. Jiuzheng Deng, Jianjin Zhu and Dawei He prepared the fracture model, interpreted and evaluated the data. Gangtie Zheng and Yongwei Pan initiated and supervised this study and revised the paper.

Corresponding authors

Correspondence to Yongwei Pan or Gangtie Zheng.

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Conflict of Interest

The authors have a patent application (US20190125461A1) based on the method described in this paper.

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Zhu, S., Zhao, Z., Chen, Y. et al. A Marker-Free 2D Image-Guided Method for Robot-Assisted Fracture Reduction Surgery. J Intell Robot Syst 103, 67 (2021). https://doi.org/10.1007/s10846-021-01453-8

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