[Silvestros P., Athwal G.S and Giles J.W., 2023; Journal of Orthopaedic Research (Under Review)]
This is a project that aims to improve surgical pre-operative planning technology by progressing for pure geometrical surgery planning to functional and biomechanical outcome based planning.
They are many variables that influence a surgeon's decisions when performing a RTSA which include:
- anatomy and morphology of the patient
- construct (i.e. implant) size
- construct placement
- construct orientation on the scapula and humerus.
All these decisions alter the mechanical system of the shoulder joint (center of rotation, muscle function and joint loading) all of which have complicated interactions that influence the capability of the shoulder to perform functional tasks.
[Roche, C.P, 2022]
Surgical decisions primarily aim to reduce pain and improve function for patients whilst guaranteeing safety and longevity of the implanted constructs. To do so surgeons may use pre-operative planning software to assist in the placement of the implanted constructs based on the patient's patho-anatomy however the functional outcomes of the surgery are left to the surgeon's experience and intuition.
To assist in this complex decision making the goal of this project is to develop a framework that will advance existing geometrical pre-operative planning technology by combining representative patient anatomy with biomechanical modelling (OpenSim) and predictive musculoskeletal simulations (Optimal Control) to evaluate and direct surgical decisions toward the best functional outcomes for the patient.