Startseite Patient-specific hip prostheses designed by surgeons
Artikel Open Access

Patient-specific hip prostheses designed by surgeons

  • Florian Coigny EMAIL logo , Adi Todor , Horatiu Rotaru , Ralf Schumacher und Erik Schkommodau
Veröffentlicht/Copyright: 30. September 2016
Artikel downloaden (PDF)
Veröffentlichen auch Sie bei De Gruyter Brill
Informationen für Autor*innen Erkunden Sie dieses Fachgebiet
Current Directions in Biomedical Engineering
Aus der Zeitschrift Current Directions in Biomedical Engineering Band 2 Heft 1

Abstract

Patient-specific bone and joint replacement implants lead to better functional and aesthetic results than conventional methods [1], [2], [3]. But extracting 3D shape information from CT Data and designing individual implants is demanding and requires multiple surgeon-to-engineer interactions. For manufacturing purposes, Additive Manufacturing offers various advantages, especially for low volume manufacturing parts, such as patient specific implants. To ease these new approaches and to avoid surgeon-to-engineer interactions a new design software approach is needed which offers highly automated and user friendly planning steps.

Keywords: bone; design; 3d-printing; implant; patient-specific; software

1 Introduction

Patient-specific shaped implants for bone support or bone replacement are an emerging trend in surgical interventions [1]. Implants in the facial area for example need to match the shape of the face in order to create an acceptable functional and aesthetic result [2]. For other indications, patient specific implants have a better surgical outcome or faster recovery times. Revisions of joint implants, for example, need a good interface between the implant and the patient’s remaining specific bone structure. Shape matching surfaces of patient bone and implant improve stability and preserve most of the patient’s remaining bone [3]. Today, two main methods are used to customize bone implants. One is that the surgeon intra-operatively bends and cuts implants in order to match the desired shape. This procedure prolongs the operation time and results in high expenses for the time in the operating theatre. Further, the bending adaptations weaken the metal structures and implants could break under biomechanical loads. Additionally, this surgical approach is seldom as accurate as a patient specific preoperatively produced implant. Another approach to implant customization starts by designing the implant pre-operatively based on the patient’s own computer tomography (CT) image data. This is realized by collaborating surgeons and design engineers and needs several interactions and iteration steps which take time and lead to a risk of errors. The implant is then produced according to this design with conventional machining methods such as milling or turning. This is cost and time intensive because such production methods are used for mass production.

The aim is to develop a novel production chain where the engineer is no longer the originator of the implant design. The surgeon becomes the designer of patient specific solutions while the classic design phase is eliminated and shorter lead-times can be achieved. Additionally 3D-printing is used, which is suitable for low volume production. Patient-specific stem parts of hip joint prostheses served as an example indication to demonstrate the feasibility of the whole new process chain. The design process starts by importing a patient’s CT scan dataset and ends with the design of a patient-specific hip stem. This design data then gets sent out to a manufacturer for production and post-processing.

2 Methods

The process starts with the surgeon using highly automated and user friendly software. It enables surgeons to plan and create 3D implant designs based on patient CT data with few interaction steps and without needing any engineering or computer aided design (CAD) know-how. The software implements a design workflow which has been developed in close collaboration with surgeons where users are guided step by step. The surgeon starts the workflow by importing patient CT images from a USB-Stick or other data media. Uni-lateral 3D slice images that contain the hip cup and stem area with maximum 2 millimetres slice thickness and a gantry angle of 0 degrees are required.

After checking and complementing missing patient information, the surgeon marks anatomical properties such as the patient’s leg axis or the hip center in the patient images (Figure 1). This information is acquired on virtually generated 2D x-ray images that surgeons are already used to working with. 3D coordinates of the properties are gained by letting the surgeon work on two orthogonally oriented images.

Figure 1: User interface for defining anatomical properties.
Figure 1:

User interface for defining anatomical properties.

In the next steps, the surgeon defines size and position of the implant based on the previously acquired anatomical properties. The last planning step requires the surgeon to define the area of the hip stem that will have a patient specific shape. A new algorithm then modifies standard implant geometry in the marked areas in order to match the automatically recognized cortical bone from the images. For the final check, the surgeon sees a 3D model of the patient specific implant, which can be inspected from all directions and in detail by rotating and zooming. A slice by slice overlay of implant contours on patient images allows verification of the surface match and the correct positioning. If the surgeon agrees to the design, it can be exported and uploaded to a manufacturer (Figure 2).

Figure 2: Left: Screenshot of finished patient-specific implant design. Right: 3D-printed from titanium.
Figure 2:

Left: Screenshot of finished patient-specific implant design. Right: 3D-printed from titanium.

For the validation, twelve individual hip stem implants have been designed by surgeons using this new planning and design process. Four different surgeons that where using the software, filled out a questionnaire that was based on the usability measurement method of Lewis [4]. The questionnaire contained 22 goals about usability and functionality that should be reached. Each goal could be rated with “very positive” “positive”, “medium”, “negative” and “very negative”.

3 Results

With this method, an individual hip implant stem is typically planned and designed within 10 min. The feedback revealed that 19 out of 22 goals were rated “positive” or “very positive” by the subjects. The questions 9, 13 and 21 received “medium” rating from some of the participants (Figure 3). They concerned clarity of error messages, user instructions, and the performance of one particular workflow step. A working web platform for uploading the design file, tracking of implant production and delivery status was also developed.

Figure 3: Results of the software evaluation.
Figure 3:

Results of the software evaluation.

4 Conclusion and outlook

The successful test series of surgeon-designed implants showed that the approach is feasible. Complex shaped individual implants could be designed by surgeons themselves in only minutes. No surgeon-to-engineer interactions were needed anymore. For the future, the customised design of the stem needs further work to ensure that the proximal region of the stem is suitably supported by the surround bone. The customised region of the stem needs to be extended through the proximal body to the reference line for the incision depth.

Taking manufacturing guidelines of 3D printing processes into account during the design phase could further automate the process and thereby reduce production costs.

Acknowledgement

We would like to thank the whole project team consisting of Daniel Xander1, John Truong1, Markus Degen1, Dominique Brodbeck1, Sozon Tsopanos2, Andy Payne2, Edward Draper3, Sarrawat Rehman3, Ruben Wauthle4, Thomas Kosche5, Manfred Boretius6 and Matthias Fockele7 for their contributions.

1University of Applied Sciences and Arts Northwestern Switzerland 2The Welding Institute (United Kingdom) 3JRI Orthopaedics (United Kingdom) 4Layerwise NV (Belgium) 5BCT GmbH (Germany) 6Listemann AG (Liechtenstein) 7ReaLizer GmbH (Germany)

Author’s Statement

Research funding: The research leading to these results has received funding from the European Union’s Seventh Framework Programme managed by REA Research Executive Agency [FP7/2007–2013] under grant agreement no 2623859. Conflict of interest: Authors state no conflict of interest. Informed consent: Informed consent has been obtained from all individuals included in this study. Ethical approval: The research related to human use complies with all the relevant national regulations, institutional policies and was performed in accordance to the tenets of the Helsinki Declaration, and has been approved by the authors’ institutional review board or equivalent committee.

References

[1] Jun Y, Choi K. Design of patient-specific hip implants based on the 3D geometry of the human femur. Adv Eng Softw. 2010;41:537–47.10.1016/j.advengsoft.2009.10.016Suche in Google Scholar

[2] Binder WJ, Kaye A. Reconstruction of posttraumatic and congenital facial deformities with three-dimensional computer-assisted custom-designed implants. Plast Reconstr Surg. 1994;94:775–85; discussion 786–77.10.1097/00006534-199411000-00004Suche in Google Scholar

[3] Holt GE, Dennis DA. Use of custom triflanged acetabular components in revision total hip arthroplasty. Clin Orthop Relat Res. 2004:209–214.10.1097/01.blo.0000150252.19780.74Suche in Google Scholar PubMed

[4] Lewis JR. Ibm computer usability satisfaction questionnaires - psychometric evaluation and instructions for use. Int J Hum-Comput Int. 1995;7:57–78.10.1080/10447319509526110Suche in Google Scholar

Published Online: 2016-9-30
Published in Print: 2016-9-1

©2016 Florian Coigny et al., licensee De Gruyter.

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 License.

Artikel in diesem Heft

  1. Synthesis and characterization of PIL/pNIPAAm hybrid hydrogels
  2. Novel blood protein based scaffolds for cardiovascular tissue engineering
  3. Cell adhesion and viability of human endothelial cells on electrospun polymer scaffolds
  4. Effects of heat treatment and welding process on superelastic behaviour and microstructure of micro electron beam welded NiTi
  5. Long-term stable modifications of silicone elastomer for improved hemocompatibility
  6. The effect of thermal treatment on the mechanical properties of PLLA tubular specimens
  7. Biocompatible wear-resistant thick ceramic coating
  8. Protection of active implant electronics with organosilicon open air plasma coating for plastic overmolding
  9. Examination of dielectric strength of thin Parylene C films under various conditions
  10. Open air plasma deposited antimicrobial SiOx/TiOx composite films for biomedical applications
  11. Systemic analysis about residual chloroform in PLLA films
  12. A macrophage model of osseointegration
  13. Towards in silico prognosis using big data
  14. Technical concept and evaluation of a novel shoulder simulator with adaptive muscle force generation and free motion
  15. Usability evaluation of a locomotor therapy device considering different strategies
  16. Hypoxia-on-a-chip
  17. Integration of a semi-automatic in-vitro RFA procedure into an experimental setup
  18. Fabrication of MEMS-based 3D-μECoG-MEAs
  19. High speed digital interfacing for a neural data acquisition system
  20. Bionic forceps for the handling of sensitive tissue
  21. Experimental studies on 3D printing of barium titanate ceramics for medical applications
  22. Patient specific root-analogue dental implants – additive manufacturing and finite element analysis
  23. 3D printing – a key technology for tailored biomedical cell culture lab ware
  24. 3D printing of hydrogels in a temperature controlled environment with high spatial resolution
  25. Biocompatibility of photopolymers for additive manufacturing
  26. Biochemical piezoresistive sensors based on pH- and glucose-sensitive hydrogels for medical applications
  27. Novel wireless measurement system of pressure dedicated to in vivo studies
  28. Portable auricular device for real-time swallow and chew detection
  29. Detection of miRNA using a surface plasmon resonance biosensor and antibody amplification
  30. Simulation and evaluation of stimulation scenarios for targeted vestibular nerve excitation
  31. Deep brain stimulation: increasing efficiency by alternative waveforms
  32. Prediction of immediately occurring microsleep events from brain electric signals
  33. Determining cardiac vagal threshold from short term heart rate complexity
  34. Classification of cardiac excitation patterns during atrial fibrillation
  35. An algorithm to automatically determine the cycle length coverage to identify rotational activity during atrial fibrillation – a simulation study
  36. Deriving respiration from high resolution 12-channel-ECG during cycling exercise
  37. Reducing of gradient induced artifacts on the ECG signal during MRI examinations using Wilcoxon filter
  38. Automatic detection and mapping of double potentials in intracardiac electrograms
  39. Modeling the pelvic region for non-invasive pelvic intraoperative neuromonitoring
  40. Postprocessing algorithm for automated analysis of pelvic intraoperative neuromonitoring signals
  41. Best practice: surgeon driven application in pelvic operations
  42. Vasomotor assessment by camera-based photoplethysmography
  43. Classification of morphologic changes in photoplethysmographic waveforms
  44. Novel computation of pulse transit time from multi-channel PPG signals by wavelet transform
  45. Efficient design of FIR filter based low-pass differentiators for biomedical signal processing
  46. Nonlinear causal influences assessed by mutual compression entropy
  47. Comparative study of methods for solving the correspondence problem in EMD applications
  48. fNIRS for future use in auditory diagnostics
  49. Semi-automated detection of fractional shortening in zebrafish embryo heart videos
  50. Blood pressure measurement on the cheek
  51. Derivation of the respiratory rate from directly and indirectly measured respiratory signals using autocorrelation
  52. Left cardiac atrioventricular delay and inter-ventricular delay in cardiac resynchronization therapy responder and non-responder
  53. An automatic systolic peak detector of blood pressure waveforms using 4th order cumulants
  54. Real-time QRS detection using integrated variance for ECG gated cardiac MRI
  55. Preprocessing of unipolar signals acquired by a novel intracardiac mapping system
  56. In-vitro experiments to characterize ventricular electromechanics
  57. Continuous non-invasive monitoring of blood pressure in the operating room: a cuffless optical technology at the fingertip
  58. Application of microwave sensor technology in cardiovascular disease for plaque detection
  59. Artificial blood circulatory and special Ultrasound Doppler probes for detecting and sizing gaseous embolism
  60. Detection of microsleep events in a car driving simulation study using electrocardiographic features
  61. A method to determine the kink resistance of stents and stent delivery systems according to international standards
  62. Comparison of stented bifurcation and straight vessel 3D-simulation with a prior simulated velocity profile inlet
  63. Transient Euler-Lagrange/DEM simulation of stent thrombosis
  64. Automated control of the laser welding process of heart valve scaffolds
  65. Automation of a test bench for accessing the bendability of electrospun vascular grafts
  66. Influence of storage conditions on the release of growth factors in platelet-rich blood derivatives
  67. Cryopreservation of cells using defined serum-free cryoprotective agents
  68. New bioreactor vessel for tissue engineering of human nasal septal chondrocytes
  69. Determination of the membrane hydraulic permeability of MSCs
  70. Climate retainment in carbon dioxide incubators
  71. Multiple factors influencing OR ventilation system effectiveness
  72. Evaluation of an app-based stress protocol
  73. Medication process in Styrian hospitals
  74. Control tower to surgical theater
  75. Development of a skull phantom for the assessment of implant X-ray visibility
  76. Surgical navigation with QR codes
  77. Investigation of the pressure gradient of embolic protection devices
  78. Computer assistance in femoral derotation osteotomy: a bottom-up approach
  79. Automatic depth scanning system for 3D infrared thermography
  80. A service for monitoring the quality of intraoperative cone beam CT images
  81. Resectoscope with an easy to use twist mechanism for improved handling
  82. In vitro simulation of distribution processes following intramuscular injection
  83. Adjusting inkjet printhead parameters to deposit drugs into micro-sized reservoirs
  84. A flexible standalone system with integrated sensor feedback for multi-pad electrode FES of the hand
  85. Smart control for functional electrical stimulation with optimal pulse intensity
  86. Tactile display on the remaining hand for unilateral hand amputees
  87. Effects of sustained electrical stimulation on spasticity assessed by the pendulum test
  88. An improved tracking framework for ultrasound probe localization in image-guided radiosurgery
  89. Improvement of a subviral particle tracker by the use of a LAP-Kalman-algorithm
  90. Learning discriminative classification models for grading anal intraepithelial neoplasia
  91. Regularization of EIT reconstruction based on multi-scales wavelet transforms
  92. Assessing MRI susceptibility artefact through an indicator of image distortion
  93. EyeGuidance – a computer controlled system to guide eye movements
  94. A framework for feedback-based segmentation of 3D image stacks
  95. Doppler optical coherence tomography as a promising tool for detecting fluid in the human middle ear
  96. 3D Local in vivo Environment (LivE) imaging for single cell protein analysis of bone tissue
  97. Inside-Out access strategy using new trans-vascular catheter approach
  98. US/MRI fusion with new optical tracking and marker approach for interventional procedures inside the MRI suite
  99. Impact of different registration methods in MEG source analysis
  100. 3D segmentation of thyroid ultrasound images using active contours
  101. Designing a compact MRI motion phantom
  102. Cerebral cortex classification by conditional random fields applied to intraoperative thermal imaging
  103. Classification of indirect immunofluorescence images using thresholded local binary count features
  104. Analysis of muscle fatigue conditions using time-frequency images and GLCM features
  105. Numerical evaluation of image parameters of ETR-1
  106. Fabrication of a compliant phantom of the human aortic arch for use in Particle Image Velocimetry (PIV) experimentation
  107. Effect of the number of electrodes on the reconstructed lung shape in electrical impedance tomography
  108. Hardware dependencies of GPU-accelerated beamformer performances for microwave breast cancer detection
  109. Computer assisted assessment of progressing osteoradionecrosis of the jaw for clinical diagnosis and treatment
  110. Evaluation of reconstruction parameters of electrical impedance tomography on aorta detection during saline bolus injection
  111. Evaluation of open-source software for the lung segmentation
  112. Automatic determination of lung features of CF patients in CT scans
  113. Image analysis of self-organized multicellular patterns
  114. Effect of key parameters on synthesis of superparamagnetic nanoparticles (SPIONs)
  115. Radiopacity assessment of neurovascular implants
  116. Development of a desiccant based dielectric for monitoring humidity conditions in miniaturized hermetic implantable packages
  117. Development of an artifact-free aneurysm clip
  118. Enhancing the regeneration of bone defects by alkalizing the peri-implant zone – an in vitro approach
  119. Rapid prototyping of replica knee implants for in vitro testing
  120. Protecting ultra- and hyperhydrophilic implant surfaces in dry state from loss of wettability
  121. Advanced wettability analysis of implant surfaces
  122. Patient-specific hip prostheses designed by surgeons
  123. Plasma treatment on novel carbon fiber reinforced PEEK cages to enhance bioactivity
  124. Wear of a total intervertebral disc prosthesis
  125. Digital health and digital biomarkers – enabling value chains on health data
  126. Usability in the lifecycle of medical software development
  127. Influence of different test gases in a non-destructive 100% quality control system for medical devices
  128. Device development guided by user satisfaction survey on auricular vagus nerve stimulation
  129. Empirical assessment of the time course of innovation in biomedical engineering: first results of a comparative approach
  130. Effect of left atrial hypertrophy on P-wave morphology in a computational model
  131. Simulation of intracardiac electrograms around acute ablation lesions
  132. Parametrization of activation based cardiac electrophysiology models using bidomain model simulations
  133. Assessment of nasal resistance using computational fluid dynamics
  134. Resistance in a non-linear autoregressive model of pulmonary mechanics
  135. Inspiratory and expiratory elastance in a non-linear autoregressive model of pulmonary mechanics
  136. Determination of regional lung function in cystic fibrosis using electrical impedance tomography
  137. Development of parietal bone surrogates for parietal graft lift training
  138. Numerical simulation of mechanically stimulated bone remodelling
  139. Conversion of engineering stresses to Cauchy stresses in tensile and compression tests of thermoplastic polymers
  140. Numerical examinations of simplified spondylodesis models concerning energy absorption in magnetic resonance imaging
  141. Principle study on the signal connection at transabdominal fetal pulse oximetry
  142. Influence of Siluron® insertion on model drug distribution in the simulated vitreous body
  143. Evaluating different approaches to identify a three parameter gas exchange model
  144. Effects of fibrosis on the extracellular potential based on 3D reconstructions from histological sections of heart tissue
  145. From imaging to hemodynamics – how reconstruction kernels influence the blood flow predictions in intracranial aneurysms
  146. Flow optimised design of a novel point-of-care diagnostic device for the detection of disease specific biomarkers
  147. Improved FPGA controlled artificial vascular system for plethysmographic measurements
  148. Minimally spaced electrode positions for multi-functional chest sensors: ECG and respiratory signal estimation
  149. Automated detection of alveolar arches for nasoalveolar molding in cleft lip and palate treatment
  150. Control scheme selection in human-machine- interfaces by analysis of activity signals
  151. Event-based sampling for reducing communication load in realtime human motion analysis by wireless inertial sensor networks
  152. Automatic pairing of inertial sensors to lower limb segments – a plug-and-play approach
  153. Contactless respiratory monitoring system for magnetic resonance imaging applications using a laser range sensor
  154. Interactive monitoring system for visual respiratory biofeedback
  155. Development of a low-cost senor based aid for visually impaired people
  156. Patient assistive system for the shoulder joint
  157. A passive beating heart setup for interventional cardiology training
https://doi.org/10.1515/cdbme-2016-0163
Schlagwörter für diesen Artikel
bone; design; 3d-printing; implant; patient-specific; software
Creative Commons
BY-NC-ND 4.0

Artikel in diesem Heft

  1. Synthesis and characterization of PIL/pNIPAAm hybrid hydrogels
  2. Novel blood protein based scaffolds for cardiovascular tissue engineering
  3. Cell adhesion and viability of human endothelial cells on electrospun polymer scaffolds
  4. Effects of heat treatment and welding process on superelastic behaviour and microstructure of micro electron beam welded NiTi
  5. Long-term stable modifications of silicone elastomer for improved hemocompatibility
  6. The effect of thermal treatment on the mechanical properties of PLLA tubular specimens
  7. Biocompatible wear-resistant thick ceramic coating
  8. Protection of active implant electronics with organosilicon open air plasma coating for plastic overmolding
  9. Examination of dielectric strength of thin Parylene C films under various conditions
  10. Open air plasma deposited antimicrobial SiOx/TiOx composite films for biomedical applications
  11. Systemic analysis about residual chloroform in PLLA films
  12. A macrophage model of osseointegration
  13. Towards in silico prognosis using big data
  14. Technical concept and evaluation of a novel shoulder simulator with adaptive muscle force generation and free motion
  15. Usability evaluation of a locomotor therapy device considering different strategies
  16. Hypoxia-on-a-chip
  17. Integration of a semi-automatic in-vitro RFA procedure into an experimental setup
  18. Fabrication of MEMS-based 3D-μECoG-MEAs
  19. High speed digital interfacing for a neural data acquisition system
  20. Bionic forceps for the handling of sensitive tissue
  21. Experimental studies on 3D printing of barium titanate ceramics for medical applications
  22. Patient specific root-analogue dental implants – additive manufacturing and finite element analysis
  23. 3D printing – a key technology for tailored biomedical cell culture lab ware
  24. 3D printing of hydrogels in a temperature controlled environment with high spatial resolution
  25. Biocompatibility of photopolymers for additive manufacturing
  26. Biochemical piezoresistive sensors based on pH- and glucose-sensitive hydrogels for medical applications
  27. Novel wireless measurement system of pressure dedicated to in vivo studies
  28. Portable auricular device for real-time swallow and chew detection
  29. Detection of miRNA using a surface plasmon resonance biosensor and antibody amplification
  30. Simulation and evaluation of stimulation scenarios for targeted vestibular nerve excitation
  31. Deep brain stimulation: increasing efficiency by alternative waveforms
  32. Prediction of immediately occurring microsleep events from brain electric signals
  33. Determining cardiac vagal threshold from short term heart rate complexity
  34. Classification of cardiac excitation patterns during atrial fibrillation
  35. An algorithm to automatically determine the cycle length coverage to identify rotational activity during atrial fibrillation – a simulation study
  36. Deriving respiration from high resolution 12-channel-ECG during cycling exercise
  37. Reducing of gradient induced artifacts on the ECG signal during MRI examinations using Wilcoxon filter
  38. Automatic detection and mapping of double potentials in intracardiac electrograms
  39. Modeling the pelvic region for non-invasive pelvic intraoperative neuromonitoring
  40. Postprocessing algorithm for automated analysis of pelvic intraoperative neuromonitoring signals
  41. Best practice: surgeon driven application in pelvic operations
  42. Vasomotor assessment by camera-based photoplethysmography
  43. Classification of morphologic changes in photoplethysmographic waveforms
  44. Novel computation of pulse transit time from multi-channel PPG signals by wavelet transform
  45. Efficient design of FIR filter based low-pass differentiators for biomedical signal processing
  46. Nonlinear causal influences assessed by mutual compression entropy
  47. Comparative study of methods for solving the correspondence problem in EMD applications
  48. fNIRS for future use in auditory diagnostics
  49. Semi-automated detection of fractional shortening in zebrafish embryo heart videos
  50. Blood pressure measurement on the cheek
  51. Derivation of the respiratory rate from directly and indirectly measured respiratory signals using autocorrelation
  52. Left cardiac atrioventricular delay and inter-ventricular delay in cardiac resynchronization therapy responder and non-responder
  53. An automatic systolic peak detector of blood pressure waveforms using 4th order cumulants
  54. Real-time QRS detection using integrated variance for ECG gated cardiac MRI
  55. Preprocessing of unipolar signals acquired by a novel intracardiac mapping system
  56. In-vitro experiments to characterize ventricular electromechanics
  57. Continuous non-invasive monitoring of blood pressure in the operating room: a cuffless optical technology at the fingertip
  58. Application of microwave sensor technology in cardiovascular disease for plaque detection
  59. Artificial blood circulatory and special Ultrasound Doppler probes for detecting and sizing gaseous embolism
  60. Detection of microsleep events in a car driving simulation study using electrocardiographic features
  61. A method to determine the kink resistance of stents and stent delivery systems according to international standards
  62. Comparison of stented bifurcation and straight vessel 3D-simulation with a prior simulated velocity profile inlet
  63. Transient Euler-Lagrange/DEM simulation of stent thrombosis
  64. Automated control of the laser welding process of heart valve scaffolds
  65. Automation of a test bench for accessing the bendability of electrospun vascular grafts
  66. Influence of storage conditions on the release of growth factors in platelet-rich blood derivatives
  67. Cryopreservation of cells using defined serum-free cryoprotective agents
  68. New bioreactor vessel for tissue engineering of human nasal septal chondrocytes
  69. Determination of the membrane hydraulic permeability of MSCs
  70. Climate retainment in carbon dioxide incubators
  71. Multiple factors influencing OR ventilation system effectiveness
  72. Evaluation of an app-based stress protocol
  73. Medication process in Styrian hospitals
  74. Control tower to surgical theater
  75. Development of a skull phantom for the assessment of implant X-ray visibility
  76. Surgical navigation with QR codes
  77. Investigation of the pressure gradient of embolic protection devices
  78. Computer assistance in femoral derotation osteotomy: a bottom-up approach
  79. Automatic depth scanning system for 3D infrared thermography
  80. A service for monitoring the quality of intraoperative cone beam CT images
  81. Resectoscope with an easy to use twist mechanism for improved handling
  82. In vitro simulation of distribution processes following intramuscular injection
  83. Adjusting inkjet printhead parameters to deposit drugs into micro-sized reservoirs
  84. A flexible standalone system with integrated sensor feedback for multi-pad electrode FES of the hand
  85. Smart control for functional electrical stimulation with optimal pulse intensity
  86. Tactile display on the remaining hand for unilateral hand amputees
  87. Effects of sustained electrical stimulation on spasticity assessed by the pendulum test
  88. An improved tracking framework for ultrasound probe localization in image-guided radiosurgery
  89. Improvement of a subviral particle tracker by the use of a LAP-Kalman-algorithm
  90. Learning discriminative classification models for grading anal intraepithelial neoplasia
  91. Regularization of EIT reconstruction based on multi-scales wavelet transforms
  92. Assessing MRI susceptibility artefact through an indicator of image distortion
  93. EyeGuidance – a computer controlled system to guide eye movements
  94. A framework for feedback-based segmentation of 3D image stacks
  95. Doppler optical coherence tomography as a promising tool for detecting fluid in the human middle ear
  96. 3D Local in vivo Environment (LivE) imaging for single cell protein analysis of bone tissue
  97. Inside-Out access strategy using new trans-vascular catheter approach
  98. US/MRI fusion with new optical tracking and marker approach for interventional procedures inside the MRI suite
  99. Impact of different registration methods in MEG source analysis
  100. 3D segmentation of thyroid ultrasound images using active contours
  101. Designing a compact MRI motion phantom
  102. Cerebral cortex classification by conditional random fields applied to intraoperative thermal imaging
  103. Classification of indirect immunofluorescence images using thresholded local binary count features
  104. Analysis of muscle fatigue conditions using time-frequency images and GLCM features
  105. Numerical evaluation of image parameters of ETR-1
  106. Fabrication of a compliant phantom of the human aortic arch for use in Particle Image Velocimetry (PIV) experimentation
  107. Effect of the number of electrodes on the reconstructed lung shape in electrical impedance tomography
  108. Hardware dependencies of GPU-accelerated beamformer performances for microwave breast cancer detection
  109. Computer assisted assessment of progressing osteoradionecrosis of the jaw for clinical diagnosis and treatment
  110. Evaluation of reconstruction parameters of electrical impedance tomography on aorta detection during saline bolus injection
  111. Evaluation of open-source software for the lung segmentation
  112. Automatic determination of lung features of CF patients in CT scans
  113. Image analysis of self-organized multicellular patterns
  114. Effect of key parameters on synthesis of superparamagnetic nanoparticles (SPIONs)
  115. Radiopacity assessment of neurovascular implants
  116. Development of a desiccant based dielectric for monitoring humidity conditions in miniaturized hermetic implantable packages
  117. Development of an artifact-free aneurysm clip
  118. Enhancing the regeneration of bone defects by alkalizing the peri-implant zone – an in vitro approach
  119. Rapid prototyping of replica knee implants for in vitro testing
  120. Protecting ultra- and hyperhydrophilic implant surfaces in dry state from loss of wettability
  121. Advanced wettability analysis of implant surfaces
  122. Patient-specific hip prostheses designed by surgeons
  123. Plasma treatment on novel carbon fiber reinforced PEEK cages to enhance bioactivity
  124. Wear of a total intervertebral disc prosthesis
  125. Digital health and digital biomarkers – enabling value chains on health data
  126. Usability in the lifecycle of medical software development
  127. Influence of different test gases in a non-destructive 100% quality control system for medical devices
  128. Device development guided by user satisfaction survey on auricular vagus nerve stimulation
  129. Empirical assessment of the time course of innovation in biomedical engineering: first results of a comparative approach
  130. Effect of left atrial hypertrophy on P-wave morphology in a computational model
  131. Simulation of intracardiac electrograms around acute ablation lesions
  132. Parametrization of activation based cardiac electrophysiology models using bidomain model simulations
  133. Assessment of nasal resistance using computational fluid dynamics
  134. Resistance in a non-linear autoregressive model of pulmonary mechanics
  135. Inspiratory and expiratory elastance in a non-linear autoregressive model of pulmonary mechanics
  136. Determination of regional lung function in cystic fibrosis using electrical impedance tomography
  137. Development of parietal bone surrogates for parietal graft lift training
  138. Numerical simulation of mechanically stimulated bone remodelling
  139. Conversion of engineering stresses to Cauchy stresses in tensile and compression tests of thermoplastic polymers
  140. Numerical examinations of simplified spondylodesis models concerning energy absorption in magnetic resonance imaging
  141. Principle study on the signal connection at transabdominal fetal pulse oximetry
  142. Influence of Siluron® insertion on model drug distribution in the simulated vitreous body
  143. Evaluating different approaches to identify a three parameter gas exchange model
  144. Effects of fibrosis on the extracellular potential based on 3D reconstructions from histological sections of heart tissue
  145. From imaging to hemodynamics – how reconstruction kernels influence the blood flow predictions in intracranial aneurysms
  146. Flow optimised design of a novel point-of-care diagnostic device for the detection of disease specific biomarkers
  147. Improved FPGA controlled artificial vascular system for plethysmographic measurements
  148. Minimally spaced electrode positions for multi-functional chest sensors: ECG and respiratory signal estimation
  149. Automated detection of alveolar arches for nasoalveolar molding in cleft lip and palate treatment
  150. Control scheme selection in human-machine- interfaces by analysis of activity signals
  151. Event-based sampling for reducing communication load in realtime human motion analysis by wireless inertial sensor networks
  152. Automatic pairing of inertial sensors to lower limb segments – a plug-and-play approach
  153. Contactless respiratory monitoring system for magnetic resonance imaging applications using a laser range sensor
  154. Interactive monitoring system for visual respiratory biofeedback
  155. Development of a low-cost senor based aid for visually impaired people
  156. Patient assistive system for the shoulder joint
  157. A passive beating heart setup for interventional cardiology training
Jetzt anmelden und 20% sparen
Institutioneller Zugang
Wie funktioniert Authentifizierung?
Haben Sie eine Idee, wie wir unsere Website verbessern können?
Bitte schreiben Sie uns.
© 2025 De Gruyter Brill
Heruntergeladen am 19.9.2025 von https://www.degruyterbrill.com/document/doi/10.1515/cdbme-2016-0163/html
Button zum nach oben scrollen