Abstract

Surgical design in personalized medicine is often based on native anatomy, which may not accurately reflect the interaction between native musculoskeletal tissues and biomechanical artifacts. To overcome this problem, researchers have developed alternative methods based on affordance-based design. The design process can be viewed in terms of action possibilities provided by the (biological) environment. Here, we use the affordance-based approach to address possibilities for action offered by biomechanical artifacts. In anterior crucial ligament (ACL) reconstruction, the design goal is to avoid ligament impingement while optimizing the placement of the tibial tunnel. Although in the current rationale for tibial tunnel placement roof impingement is minimized to avoid a negative affordance, we show that tibial tunnel placement can rather aim to constrain the target bounds with respect to a positive affordance. We describe the steps for identifying the measurable invariants and provide a mathematical framework for the surgery affordances within the knee.

摘要

个性化医疗中的手术设计通常基于原生解剖学，这可能无法准确反映原生肌肉骨骼组织与生物力学人工制品之间的相互作用。为了克服这个问题，研究人员开发了基于可供性设计的替代方法。可以从（生物）环境提供的行动可能性的角度来看待设计过程。在这里，我们使用基于可供性的方法来解决生物力学人工制品提供的行动的可能性。在前关键韧带（ACL）重建中，设计目标是在优化胫骨隧道放置的同时避免韧带撞击。虽然在目前胫骨隧道放置的基本原理中，顶板撞击被最小化以避免负面影响可供性，我们表明胫骨隧道放置可以相对于积极的可供性来限制目标范围。我们描述了识别可测量不变量的步骤，并为膝盖内的手术能力提供了一个数学框架。