TLEMsafe: Improving safety and predictability of complex musculoskeletal surgery using a patient-specific navigation system

The burden of musculo-skeletal diseases and prosthetic revision operations is huge and increasing rapidly with the aging population. For patients that require a major surgical intervention, procedures are unsafe, uncertain in outcome and have a high complication rate.

TLEMsafe aims to create a patient-specific surgical navigation system, based on innovative ICT tools, for training, pre-operative planning and execution of complex musculo-skeletal surgery. It aims to help the surgeon to safely reach the optimal functional result for the patient, and it will be a user-friendly training for surgeons.

TLEMsafe is developed by generating automated 3-D image-analyzing tools to parameterize the M-S system. The patient-specific parameters are fed into a recently developed M-S model with which the patient-specific functional outcome can be predicted. This consists of a direct effect (e.g. due to the removal of a muscle in a tumor patient), but has also a secondary effect in the sense that the patient will generate adaptive behaviour to the altered musculo-skeletal system. Implementation of the adaptive capacity will be a unique (but essential) feature which allows valid predictions of the functional effects of surgical interventions. The next step is that the surgeon can virtually operate on the patient-specific model after which the model predicts the functional effects. Once the optimal plan is selected, this is fed into a system that allows the surgeon to reproduce the selected surgical plan during the actual surgery.

TLEMsafe is a navigation system based on innovative ICT tools for training and pre-operative planning. Extensive, innovative validation techniques including quantitative indicators to improve safety (of surgical operation) and quality (highly predictable effects of complex surgery) are included. The emphasis on the musculo-skeletal pathologies and the adaptive capabilities of the human musculo-skeletal system creates a unique system. Co-developing the software of the visual and interactive (surgical) parts with clinicians and companies eases the successful introduction to (future) surgeons.


TLEMsafe is a project funded by the Seventh Framework Programme (FP7) of the European Union.

Project coordinator: Prof. Dr. Ir. Nico Verdonschot

Project manager: MSc. Vincenzo Carbone

University of Twente
Faculty of Engineering Technology
MIRA Institute
Laboratory of Biomechanical Engineering
P.O. Box 217
7500 AE Enschede
The Netherlands

tel. +31 (0)53 489 2436