Acetabular cup placement in total HIP… (F31EB040344) – Project Grant to Vanderbilt University

Abstract: Title: patient-specific image guidance for total HIP arthroplasty total HIP arthroplasty (THA) is a common and effective treatment for end-stage HIP disease, yet malposition of the acetabular component (cup) remains a major cause of dislocation, impingement, wear, and revision surgery. The main challenge is that surgeons typically rely on intra-operative fluoroscopy and table- or c-arm-based alignment, while the true functional pelvic pose is patient-specific and can vary substantially with positioning and spinopelvic mechanics. As a result, cup pose is often assessed in the imaging coordinate system rather than in a patient-specific pelvic coordinate system, limiting the ability to plan, guide, and evaluate cup placement in a consistent way. Existing navigation and robotic systems can improve accuracy, but they depend on pre-operative CT, fiducials, and expensive hardware that are not part of routine THA care. This F31 project will develop and validate a patient-specific guidance framework that operates entirely within standard x-RAY and fluoroscopy workflows, without additional scans or invasive equipment. Aim 1 will construct a large-scale statistical shape model of the pelvis and implement a conditional atlas that generates a 3D pelvic anatomy from a single pre-operative anteroposterior radiograph and basic patient information. Aim 2 will DE- velop a landmark-based 2D/3D registration pipeline that jointly estimates pelvic pose and cup pose from a single intra-operative fluoroscopy image and expresses cup orientation in a unified pelvic coordinate system relative to patient-specific targets and accepted safe zones. Aim 3 will integrate these components into a software pack- age that supports pre-operative planning, intra-operative guidance, and post-operative assessment, presenting quantitative metrics that are directly tied to pelvic pose rather than the imaging frame. By enabling accurate and patient-specific 3D guidance using tools already present in most operating rooms, this work has the potential to reduce cup malposition. IT will improve reproducibility of cup placement, and support broader deployment of image-guided THA in diverse practice settings. The project will also provide rigorous training in statistical shape modeling, 2D/3D registration, translational orthopaedic imaging, and regular exposure to the clinical THA environment, preparing the candidate for an independent research career at the interface of computer vision and surgery.

Acetabular cup placement in total HIP arthroplasty: a pelvic pose-referenced guidance system using single 2D fluoroscopy image

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