Digitally-enabled design guides the way for children’s orthopaedic surgery

Dr Chris Carty

New virtual-reality technology and 3D printing techniques will create ‘digital patients’ to improve surgery for Queensland children with orthopaedic deformity.

This is the way of the future with new Australian-first work from Griffith University showing that virtual technology techniques can guide the way for orthopaedic surgeons to more accurately plan and undertake their surgery.

Aided by a $300,000 Advance Queensland Fellowship and working in collaboration with the Children’s Health Queensland Hospital and Health Service, Dr Chris Carty from Griffith’s Menzies Health Institute Queensland is at the forefront of the work, which aims to provide orthopaedic surgeons with the ability to provide personalised patient solutions including better surgical results and enhanced post-operative function.

“The personalisation of the ‘digital patient’ represents a step change in the treatment of children with lower limb deformity,” says Dr Carty. “Current treatment involves consultation with a doctor, then surgery followed by evaluation.

“Unfortunately the current methods ignore the fact that bones move — the innovation in this research is the addition of movement to static models by merging MRI or CT scans with motion capture to understand functional consequences of any proposed surgical intervention”

Personalised digital patient

“A personalised digital patient allows the surgeon to use a computer simulation to perform and evaluate multiple surgery options in a digital environment before operating on the child. Surgery will be quicker, less invasive and more effective.”
Dr Carty says the technology, which has already been used to inform surgeries on children with hip fractures, also offers the capability to 3D print personalised cutting guides for children with bone deformity.

“3D printing is a technology capable of fabricating complex shapes and so we can utilise this to provide personalised cutting guides for children with bone deformity. This inclusion will result in better surgical correction for the child, leading to reduced surgical revision and enhanced post-operative function and ultimately increased capacity for activity and community participation.

“The rapidly growing 3D printing infrastructure and advanced material testing equipment at Griffith University provides potential, in the future, to design, test and print patient specific bone implants for patients in Queensland” says Dr Carty.

Dr Sheanna Maine, a surgeon at Brisbane’s Lady Cilento Children’s Hospital, is currently working towards implementing the virtual reality guided surgery.

“We are now able to use this technology to generate a digital model of the patient by overlaying an MRI scan with the patient’s gait analysis. We visualise their anatomy and pre-empt how our planned surgical procedures on both the bone and soft tissue, will positively impact on their gait.

“We are in the early stages of the technology but there is an amazing potential here, to implement successful outcomes for individual patients.”

The combination of digital musculoskeletal modelling, virtual surgery planning and personalised 3D printed surgical tools are expected to be a game changer on the international stage, with Griffith’s expertise to be brought together in the next few years as part of the Advanced Design and Manufacturing (ADaM) Institute.

This is a state-of-the-art equipment, knowledge and research hub to be located at the Gold Coast Health and Knowledge Precinct following the 2018 Commonwealth Games.