For Orthopedic Injuries, A Robot That Follows Patients As They Move

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For Orthopedic Injuries, A Robot That Follows Patients As They Move

http://www.medicalnewstoday.com/medicalnews.php?newsid=36445

The MRI and CT scan may one day have a robotic cousin capable of

following and peering into patients as they move around.

A University of Florida engineer has designed a robot to shadow and

shoot X-ray video of sufferers of orthopedic injuries as they walk,

climb stairs, stand up from a seated position or pursue other normal

activities - and maybe even athletic ones like swinging a bat.

UF mechanical and aerospace engineer Banks' goal is to augment

static images of patients' bones, muscles and joints with an interior

view of these and other parts in action during normal physical

activity. By merging such full-motion X-rays with computerized

representations, orthopedic surgeons will make better diagnoses,

suggest more appropriate treatments and get a clearer idea of post-

operative successes and failures, he said.

" Our goal is come up with a way to observe and measure how joints are

moving when people are actually using them, " Banks said. " We think

this will be tremendously powerful, not only for research but also in

the clinical setting as well. "

Complaints about orthopedic injuries are among the most common

reasons people visit the doctor, according to the American Academy of

Orthopedic Surgeons. More than 8 million people were hospitalized in

2003 for musculoskeletal conditions or injuries, which are estimated

to cost the United States at least $215 billion annually.

Orthopedic surgeons have long diagnosed patients by touch or with

static X-rays, MRI and CT scans. They also may use X-ray video, but

current technologies provide only a tight view of a very limited

range of motion in a controlled laboratory setting.

While all of these techniques can be effective, they do not work well

with injuries that manifest themselves when a joint is in motion,

Banks said. These include, for example, injuries to the patella, or

kneecap, and injuries of the shoulder. Surgeons sometimes have to

operate to diagnose these and other injuries, which can lead to

unnecessary surgeries.

After operations, surgeons have few tools beyond the patient's

experience to tell them whether a procedure worked as intended and

whether it will forestall additional joint damage.

Banks hopes his robot - actually, a system that uses two robots

because one robot will be necessary to shoot the X-ray video and

another to hold the image sensor -- will lead to a radical

improvement.

He has one working robot currently. The robot, which has a one-meter

mechanical arm, is a commercial product normally used in robotically

assisted surgeries and silicon chip manufacturing that Banks and his

graduate students have re-engineered. The robot can shadow a person's

knee, shoulder or other joint with its hand as he or she moves.

In its completed form, the hand will hold lightweight equipment

capable of shooting X-rays, while another robot will hold the sensor

that captures images of the body as moving videos. Although the

robots will be attached to a fixed base, there is room for a person

to move around normally within their reach. And in the future, said

Banks, " we could put these robots on wheels and they could follow you

around. "

For now, the single robot holds a standard video camera.

To use it, a patient wears an LED-lit patch on the body part that is

intended for targeting. The patch, several cameras placed around the

room and a networked computer command the robots to hone in on and

track the joint.

In a slightly spooky demonstration, using a graduate student instead

of a patient, the camera-tipped hand followed the student's thigh as

he walked and otherwise moved normally. While the hand appeared

accurate to the untrained eye, Banks said the video image, which

included shots of the student's jeans, showed that it couldn't yet

track the small LED patch with the accuracy needed for video X-ray.

Improving the accuracy is one of several challenges that remain in

the project, Banks said. He has applied for a $275,000 grant from the

National Institutes of Health to continue the work. UF has also

applied for a patent on the new imaging technique, and Banks said

it's possible that it could become standard equipment in hospitals.

Mike Moser, a UF orthopedic surgeon working with Banks on the

project, said he thinks the robot system would be very useful to

surgeons.

" The biggest thing that this technology could offer in treating

orthopedic injuries is that it has the ability to visualize joint

motion dynamically, as it changes, " he said. " I think this would be

good for many different conditions of the shoulder, knee, elbow and

ankle. And I think it could be extrapolated to pretty much any

orthopedic injury or condition. "