Objectives

To quantify the functional behaviour of patients undergoing severe musculo-skeletal surgery. The measurements are done before and after surgery to enable the TLEMsafe consortium to quantify the effect of the surgical intervention on the functional outcome.

Progress

The overall goal of the TLEMsafe project is to improve the functional outcome of complex orthopaedic interventions of the lower limb. Work package 5 can be considered a ‘core work package’, since measurements are performed on patients who actually undergo an orthopaedic intervention. The TLEMsafe project could provide assistance to the surgeon before and during various kinds of complex surgeries, such as for removal of sarcoma and for particularly difficult hip operations as performed on hip dysplasia patients (Figure 1) and on patients that have to undergo a complex revision surgery. For example, during a hip operation some of the important decisions that have to be made are: position of the centre of rotation, the amount of femoral shortening, and soft-tissue release. All of these aspects have an effect on the ability of the patient to perform activities of daily living after the operation.

Figure 1 - Patient suffering hip dysplasia with luxation. This is one of the types of patients included in the TLEMsafe project.

Besides functionality, TLEMsafe could also improve safety for difficult operations. It could do so by:

1. providing more pre-OR information from the detailed MRI
2. allowing the pre-planning of the most optimal surgical scenario
3. creating failsafe scenarios
4. shortening OR time
5. reducing exposure
6. reducing blood loss.

In this work package, we analyze spatiotemporal, kinematic and kinetic parameters during activities of daily living both before and after the surgery. Spatiotemporal parameters express gait characteristics such as cadence, step frequency and stride length. Kinematic parameters describe different joint angles during movement, while kinetic parameters are used to describe the forces acting across joints. This includes moments and power generation and absorption. With these extensive measurements of activities of daily living performed at UMC St Radboud, the University of Twente and AnyBody Technology can run and validate functional outcome predictions.