# Robot-Assisted Femoroplasty with Intraoperative Biomechanical Feedback

> **NIH NIH R01** · JOHNS HOPKINS UNIVERSITY · 2020 · $372,053

## Abstract

Project Summary
 There is a wealth of research on the extent to which bone loss may impair strength and increase the
risk of fracture. The rate of mortality after hip fracture in elderly patients with osteoporosis is reported to be as
high as 30%. It is suggested that augmentation of the femur is an effective countermeasure to reduce the risk
of fracture in highly osteoporotic hips. This technique would be especially valuable for those patients at high
risk of falls and the highest risk of mortality and morbidity if they were to sustain a fall. The few clinical case
studies that have been performed on augmentation of the femur, suggest that a successful outcome requires
detailed planning, biomechanical analysis, and precise control of the augmentation procedure to avoid
generation of areas of high stress due to augmentation.
 Our long term goal is to develop a technology that enables the surgeon to precisely determine the
extent of osteoporosis and fracture risk level, obtain an optimized surgical plan based on computerized
mechanical analysis, perform a rapid and minimally invasive hip augmentation with intraoperative
biomechanical feedback, and finally verify the outcome in one patient visit. In this project, we will develop a
surgical test bed for proximal femur augmentation and demonstrate its feasibility. Towards this goal, we
propose three aims:
1. Surgical planning workstation: based on our prior study we propose to develop a biomechanical
 planning module for patient-specific optimization of the bone augmentation procedure using
 preoperative CT scans. We propose to leverage our preliminary results and develop an integrated
 patient-specific model involving mechanical and hydrodynamic simulation of the bone strength due
 to the injection of the augmenting material that is suitable for the ubiquitous problem of predicting
 intraoperative cement injection. The planning workstation will also assess the fracture risk
 preoperatively as well as provide real-time updates of the predicted cement distribution and stress-
 state within the bone during the surgery.
2. Integrated surgical execution system: The workstation will provide key capabilities related to image-
 based registration, intraoperative updates of cement distribution, and robotic tools to control
 injection. We will integrate software and hardware components; advance the biomechanical planning
 into a viable intraoperative technology, and tackle segmentation/registration challenges identified in
 our previous studies. These challenges are described in detail in the research plan.
3. Integrated System Performance: We will investigate the functional performance, reliability, and
 overall system accuracy of precisely controlled bone augmentation through a series of cadaver
 studies. The study will also include a series of destructive cadaver tests to verify the system ability to
 strengthen osteoporotic femora. We will also investigate the safety of the procedure by performing a
 seri...

## Key facts

- **NIH application ID:** 9983725
- **Project number:** 5R01EB023939-04
- **Recipient organization:** JOHNS HOPKINS UNIVERSITY
- **Principal Investigator:** Mehran Armand
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $372,053
- **Award type:** 5
- **Project period:** 2017-09-15 → 2024-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9983725

## Citation

> US National Institutes of Health, RePORTER application 9983725, Robot-Assisted Femoroplasty with Intraoperative Biomechanical Feedback (5R01EB023939-04). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/9983725. Licensed CC0.

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