Pelvic Osteolysis Evacuation and Filling Felicia Shay Computer

Pelvic Osteolysis: Evacuation and Filling Felicia Shay Computer Integrated Surgery II Checkpoint Presentation

Plan of Action • • Project Description Project Management Considerations Data Contacts Conclusions Lessons Learned

What is the Problem? • How does the problem arise? – Location – Necrosed bone • Current Situation/Technology • Importance of Project • Project/Goal Project Description

Project Description • • • ID material/potential Plan for tool design Explore Options Evaluate Build tools Testing Project Description

Deliverables Minimal: • Research and documentation of potential material – Tools – Filling • Potential tool design with evaluations and considerations • Bone filler material and analysis of potential material Expected: • Prototyping of instrument and filling • Modeling and evaluation of each • Potential integration and mechanism for whisking, evacuation and filling Maximal: • Integration with robot Project Description

Initial Constraints • Physiologically • Problem • In the material: – Biocompatibility – Flexibility to access the material • In the shape of lesion • In the design and tools needed: – Need for suction and irrigation – Feasibility Project Description

Implications • Minimally invasive • Pre-Operative – More planning time – More cost • Post-Operative – Faster healing time – Less likely for infection – Cost distribution to hospital and insurance • Most Importantly: Corrects a currently inoperative condition Project Description

Plan of Action • • Project Description Project Management Considerations Data Contacts Conclusions Lessons Learned

Initial Proposed Dates • 2. 22. 01 Official Start Date • 3. 1. 01 Meetings scheduled/attended and research on potential evacuation and filler material • 3. 8. 01 Research weight bearing material • 3. 15. 01 Read papers, begin brainstorming on designs, purchase material and background reading. • 3. 22. 01 Model different designs and evaluate according to the constraints theoretically • 4. 7. 01 Begin prototyping and testing of different size tubing and wires with tool constraint, filling • 4. 14. 01 Evaluating different prototypes • 5. 1. 01 Completion of project and documentation Project Management

Progress by Checkpoint • 2. 22. 01 Official Start Date • 3. 1. 01 Meetings scheduled/attended and research on potential evacuation and filler material • 3. 8. 01 Research weight bearing material • 3. 15. 01 Read papers, begin brainstorming on designs, purchase material and background reading. • 3. 22. 01 Model different designs and evaluate according to the constraints theoretically • Checkpoint Project Management

Current Status • 4. 30. 01 Meeting with Dr. Horowitz. • 5. 1. 01 Met with Mark Kuntz, set up lab meeting • 5. 7. 01 Wire material arrives Tubing from Wilmer Oncology (Thanks Aaron) • 5. 8. 01 Mark Kuntz, Undergraduate Design Lab furnace, plate (machine shop), potential testing • 5. 9. 01 Tubing arrives Mechanical setting/testing of wires • 5. 10. 01 Preparation for final presentation Mechanical setting/testing/loading of wires Project Management

Relevant Papers • • Yang, F. , Wu, K. H. , Pu, Z. J. “The Effect of Strain Rate and Sample Size Effects on the Superelastic Behavior of Superelastic Alloys” Proceedings of the Second International Conference on Shape Memory and Superelastic Technologies. (CA) 1997, p 23 -28. Berg, B. “Twist and Stretch: Combined Loading of Pseudoelastic Ni. Ti Tubing” Proceedings of the Second International Conference on Shape Memory and Superelastic Technologies. (CA) 1997, 443 -448. Ueki, T. , Mogi, H. , Horikawa, H. “Torsion Property of Ni-Ti Superelastic Alloy Thin Tubes” Proceedings of the Second International Conference on Shape Memory and Superelastic Technologies. (CA) 1997, 467 -472. Yang, Jianhua. “Fatigue Characterization of Superelastic Nitinol”. Proceedings of the Second International Conference on Shape Memory and Superelastic Technologies. (CA) 1997, 479 -484.

Plan of Action • • Project Description Project Management Considerations Data Contacts Conclusions Lessons Learned

Considerations • Torque • Repeat cycling (Compression/Tension) – Strain Rate – Fatigue • • Angulation to gain access to site Room for tools and evacuation Tight fit vs Loose fit Range of Motion Considerations

Additional Considerations after Testing • Force Generated – Rotational Mechanism • Crank • Attachment to drill bit head • How can you keep track of the site • General Testing Methods • Importance of Irrigation/Suction due to Force Generation Considerations

Setting and Shaping Superelastic SMA • Shape – 2 Aluminum plates – 30, 45, 90 degree threads drilled as guides – 2 bolts • Furnace – 500 C for 15 minutes – Slow cooling time

Effects of Rotational Movement • Types – Crank – Attachment to drill bit head • ~500 rotations/minute – How can you keep track of the site Effects of Cyclic Wear Force Generation

Cyclic Strain vs Fracture Considerations

Mechanical Testing • Methods – Tensile Strength – Force for Compression • Parameters – Copper tube • Straight • 45 degree – Different bends/lengths

Current Choices of Angulation in Testing and Considerations • Angles of wire end effector/tubing • Length of wire/tubing from bend to tip KEY: Accessing all of the site with angles/length • Force Generated • Cyclic loading/compression/friction with different end effectors and tubing Considerations

Plan of Action • • Project Description Project Management Considerations Data Contacts Conclusions Lessons Learned

Parameters • Wire Degree Bends: – 80 degree bend – 40 degree bend – 30 degree bend • Wire Thickness – 0. 0020” and 0. 0010” • Tube Thickness 45 degree bend – 0. 0028” and 0. 0017”

Data (10 trials + highest and lowest trial) Angle thickness Length Insert (lbf) Withdraw 0. 0020” (lbf) 80 Short -0. 415 +0. 42 40 Short -0. 38 +0. 41 30 Short -0. 050 +0. 055 80 Long -0. 385 +0. 42 40 Long -0. 062 +0. 075 30 Long -0. 019 +0. 025

Design Changes • Considerations: – Force Generation – Rotational Movement – Deformity • Cyclic wear • Tightness down tube • Guidewire with Rubber Tubing Considerations

New Contacts Made • Emanuel Horowitz, Ph. D. Johns Hopkins Material Science and Engineering • James B. Spicer, Ph. D. Johns Hopkins Material Science and Engineering • Mark Kuntz Johns Hopkins Material Science and Engineering Undergraduate Design Lab and Machine Shop • Shape Memory Applications, Inc. www. sma-inc. com Contact: Holly

Dependencies Before • Receipt of the materials to begin prototyping

Dependencies Now • TIME • Limited testing facilities • Certain force testing variability

5. 26. 01 Potential/Projected Deliverables • Completion of Testing • Integration of Tubing • Finding most suitable Rotational Movement • Integration of Suction/Irrigation • Final Testing

Conclusion • Feasibility • Effective • Just takes more: – Time – Work – Planning – Designs – Testing Designs all need to be tested.

Significance • TO: – Patient – Surgeons – Insurance Companies – Technology Development • Less post op recovery time • Treats an existing untreatable condition • Introduction of new technology • Continued interaction b/n surgeons and engineers to solve existing surgical problems where technology is hindering development

Retrospective • Don’t be completely dependent on material • Can’t plan ahead enough • Try to find additional suppliers • Although some things are unforeseeable, you can work around it

Special Thanks to: Niccole Herbert Mark Kuntz