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Generic Asian Pelvic Bone Model

Generic Asian Pelvic Bone Model

An update on an AO Strategy Fund project in which the AO Research Institute, SYNBONE,  and the University of Malaya collaborate.

Development and production of the first evidence-based anatomical model of the Asian pelvic bone is the aim of an international collaboration between the AO Research Institute (ARI), leading anatomical model manufacturer SYNBONE AG, and the University of Malaya. That project, Generic Asian Pelvic Bone Model, got under way this spring thanks to a grant from the AO Strategy Fund.

“ARI Director Geoff Richards came up with the idea. There is a need in medical education for such a model, and several factors—and people—came together to make our project possible,” said Project Leader Prof Boyko Gueorguiev-Rüegg, Program Leader Biomedical Development at ARI. Also supporting the project at ARI are Senior Project Leaders Lukas Kramer and Hansrudi Noser; collaborators from SYNBONE are Managing Director Heinz Hügli and Head of Development Felix Burr.

Behind the project is the AO’s long relationship with SYNBONE, which produces all of the AO Foundation’s anatomical models for teaching; an existing collaboration with the University of Malaya; a recent AO Fellow to support this collaboration; and the 2015 launch of SYNBONE’s Asia Pacific subsidiary. Together, the University of Malaya, ARI and SYNBONE will not only advance trauma education by developing the model but—ultimately—the care of Asian patients, as well.

“Human bones exhibit complex variations in size and shape across individuals and demographic populations, and this is particularly true for the complex anatomy of the pelvis,” Gueorguiev-Rüegg explained. “For example, the Caucasian and Asian pelvises differ in terms of size and form. Our aim is to develop a generic hardware Asian pelvic bone model as a base for training, education and further development of more anatomically correct Asian implants.”

That’s essential, he said, because Asia is growing and today represents more than 50 percent of the global population. In parallel, the AO is expanding in the region and, through the AO Alliance Foundation, is focused on improving patient care in low income countries.

“Trauma is the most common orthopedic problem in developing countries. With rapid population growth and an increasing number of people sustaining fractures in daily scenarios—including traffic accidents and workplace injuries—the education of trauma surgeons in Asia is a priority,” Gueorguiev-Rüegg said. That’s where the Generic Asian Pelvic Bone Model project will make a significant contribution: by using evidence-based development to produce a pelvic bone model specific to the needs of Asian patients.

“The currently available models for training and education do not properly represent the Asian population,” he added.

In a first phase of the project, which launched in April 2016, the University of Malaya is gathering—based on discussion with surgeons—computerized tomography (CT) scans of Asian patients of Indian, Chinese and Malay descent.

“Malaysia is the only Asian country with these three ethnic groups available in sufficient numbers to support our project,” Gueorguiev-Rüegg said.

Once the clinical CT data is gathered, it will be anonymized and sent to ARI this fall for implementation into the ARI CT database for processing and detailed analysis and comparison to Caucasian CT data.

“Based on these anonymized CT scans, in 2017 ARI will design and develop a statistical pelvic bone model, followed by evaluation and creation of an average computer model considering both genders,” he said.

After the 3D model is completed, ARI will deliver the data to SYNBONE, which will begin preparing the hardware prototypes. SYNBONE will adjust the 3D model to the computer-aided design (CAD) files for production and produce a prototype series of the generic Asian pelvic bone model, which will be evaluated by expert AOTrauma surgeons. Then, a “zero series” of 50 pelvises will be delivered in spring 2018 with documentation, including all data contained in ARI’s statistical bone model. The pelvic bone models will be made of polyurethane foam and will represent healthy bone quality and osteoporotic bone.

“The idea is that during training, surgeons will be able to address the most complex fracture with a soft tissue cover, so they will actually be able to practice cutting through soft tissue, opening the wound, reducing a fracture as they would in a real-life case, and then fixing the fracture with implants,” Gueorguiev-Rüegg explained.

“What’s exciting to me as a scientist is this whole approach of evidence-based research and development. Our project combines the technical and medical knowledge which have always been fundamental bases for success within the AO, with the production expertise of SYNBONE,” he said. “The AO Strategy Fund is really making it possible for this collaboration to make a positive difference in patient care,” he said. “At the same time, it fulfills the ARI strategy of conducting evidence-based research and development.”

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