# Image-Guided Workstation and Tools for Bone Defects

> **NIH NIH R01** · JOHNS HOPKINS UNIVERSITY · 2021 · $489,859

## Abstract

Summary
 Our long range goal is to develop an image-guided workstation that uses a novel Continuum Dexterous
Manipulator (CDM) and tools to enable next generation of minimally- and less-invasive procedures allowing
access to regions not currently accessible with conventional surgical tools in orthopaedic surgery. The system
and devices will enable treatment of bone defects such as femoroacetabular impingement, metastatic bone
disease, severe osteoporosis in areas including the pelvis/acetabulum, femoral neck, peri- and sub-
trochanteric regions, as well as the shin and foot, and finally traumatic fracture repair. The near-term focus of
this application is the core decompression for the treatment of Avascular Necrosis (AVN) of the femoral head
and reduction of pelvis fracture. We propose the development of an image-guided prototype robot-assisted
surgical system for planning, real-time intraoperative monitoring, navigation, and updating of the plans.
 In the United States, avascular necrosis (AVN, also known as osteonecrosis) of the femoral head occurs in
10000-20000 of patients per year between the ages of 20-50 years old. The incidence of the AVN is even
higher in Middle Eastern and Asian countries. AVN occurs due to the loss of blood supply to the bone, leading
to the spontaneous death of the trabecular bone, which in turn may cause microfractures in the trabecular
bone. Depending on the amount of femoral head involved, collapse of the articular surface will occur as the
disease advances. Once collapse of the femoral head occurs in these patients, the disease course rarely
regresses. Total Hip Arthroplasty (THA) will be the primary surgery of choice and will provide pain relief to
those AVN patients. However, because of the young age of the AVN patients, THA is not the most desirable
choice. Core decompression is a conventional techniques used for the treatment of the AVN prior to the
collapse of the femoral head. Typically in core decompression the lesion area (death bone) is removed by
drilling and debriding. After debriding the bone graft will be inserted and/or bioresorbable material such as
calcium phosphates will be injected into the core to fill the void and provide stability.
 The long-term success of core decompression is dependent on many parameters that may be out of the
control of surgeons given the existing tools and techniques. Some of the issues that the current conventional
techniques for core decompression does not answer are: 1) complete debriding of the death bone requires
significant increase in dexterity of the debriding tools, currently not available to the surgeons; 2) While it is ideal
to completely remove the death bone, the extent of the bone removal may be limited by the stability
requirements of the femoral head to prevent its collapse underweight bearing conditions. Biomechanical
analysis of the stability of the structure, therefore, must be important part of the planning. Further, the
successful implementation of t...

## Key facts

- **NIH application ID:** 10176482
- **Project number:** 5R01EB016703-07
- **Recipient organization:** JOHNS HOPKINS UNIVERSITY
- **Principal Investigator:** Mehran Armand
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $489,859
- **Award type:** 5
- **Project period:** 2013-09-30 → 2023-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10176482

## Citation

> US National Institutes of Health, RePORTER application 10176482, Image-Guided Workstation and Tools for Bone Defects (5R01EB016703-07). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10176482. Licensed CC0.

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