Development of a Customised Novel Model for Surgical Planning in Paediatric Flat Foot Corrective Surgery
Lead Research Organisation:
CRANFIELD UNIVERSITY
Department Name: Cranfield Defence and Security
Abstract
Children often suffer from 'Flatfoot' a condition associated with foot arch flattening and extreme foot joints malalignment. True incidence of flatfoot is unknown, but according to several studies 50% of children have flatfoot initially which while growing corrects itself by developing a normal foot arch, ending with 10% of adolescents still having the condition. Treatment depends on the type of flatfoot. Surgery is recommended when patients experience pain, to prevent disability and arthritis in adulthood. However, surgery brings its own challenges. Given the complex structure and the not fully understood foot biomechanics, there is no universal agreement on how to treat flatfoot successfully and no optimal surgical methodology has yet been established. Surgical planning still today relies on educated guessing by the foot surgeon based on experience, therefore there is a lot of disagreement about optimal surgery for individual patients. This research project aims to develop a parametric model to improve our understanding of flatfoot surgery. The project entails foot scans, parametric modelling, tissue assessment, geometrical analysis and pressure mapping on the floor both pre- and post-surgery. Successful surgery greatly improves the quality of life of the patients. On the other hand, unsuccessful surgery raises questions and may lead to litigation and expensive after surgery care; so this new surgical planning 'tool' will safeguard against failures, failures being painful, embarrassing and costly!
People |
ORCID iD |
| Yanni Cai (Student) |
Studentship Projects
| Project Reference | Relationship | Related To | Start | End | Student Name |
|---|---|---|---|---|---|
| EP/N509450/1 | 01/10/2016 | 30/09/2021 | |||
| 2345718 | Studentship | EP/N509450/1 | 03/02/2020 | 01/08/2024 | Yanni Cai |
| EP/R513027/1 | 01/10/2018 | 30/09/2023 | |||
| 2345718 | Studentship | EP/R513027/1 | 03/02/2020 | 01/08/2024 | Yanni Cai |
| EP/T518104/1 | 01/10/2020 | 30/09/2025 | |||
| 2345718 | Studentship | EP/T518104/1 | 03/02/2020 | 01/08/2024 | Yanni Cai |
| Description | -Collaborated with a research group from University of Perugia about the parametrisation of two main bones: calcaneus and medial cuneiform -It has been developed a new dataset about calcaneuses and medial cuneiforms with statistical significant analysis about their shape -Aston University has purchased MIMICS license, so I am going to be able to analyse the two bones from a material property point of view, which MIMICS is able to determine from the greyscale values of the CT scans. -Significantly increased knowledge about the foot, its functioning and bones and learned about how to segment bones better from CT scans |
| Exploitation Route | This research study uses a very limited amount of patients in order to develop a model, hence it is reasonable to assume that it needs a much bigger study with the involvement of many more patients before an actual model that can be used in clinic can be developed. From the planning stage of this study, it was thought to be a very first step towards learning more about surgery outcomes of foot and ankle surgeries and developing in future a tool that can be used for robotic surgeries based on the outcomes of this research. |
| Sectors | Digital/Communication/Information Technologies (including Software),Healthcare |
| Description | CDS Research Conference Funding |
| Amount | £1,422 (GBP) |
| Organisation | Cranfield University |
| Sector | Academic/University |
| Country | United Kingdom |
| Start | 07/2023 |
| End | 07/2023 |
| Title | Parametrisation of the calcaneus and medial cuneiform |
| Description | The methodology developed is based on the paper written by Pascoletti et al. (2021) and applied using the MATLAB (v.17, The MathWorks, Inc., Natick, MA, USA) script written by Pascoletti. This method was used to analyse the morphological differences in two bones, the calcaneus and medial cuneiform, using five CT scans of feet acquired from cadavers. In iso-topological meshes all nodes in the surface mesh are treated as landmarks. They are created implementing some transformations and the RBF (Radial Basis Function) method, where the information of each individual shape in the database related to location, scale and rotation are eliminated to make the shapes comparable. GPA (Generalised Procrustes Analysis) and PCA (Principal Component Analysis) are applied on the database to find the variability model (P·b) that describes the dataset: x=x ¯+P·b. The outputs of this analysis were used to carry out further statistical PCA and regression analysis to identify and quantify specific dimentional variations between bones. |
| Type Of Material | Improvements to research infrastructure |
| Year Produced | 2022 |
| Provided To Others? | No |
| Impact | This methodology will be useful for the research study because the two bones analysed are the bones directly reshaped during flatfoot surgery. The data taken from the patients include CT scans of the flatfoot before and after surgery that will be used to create 3D models of the shape of the two bones. Then this methodology will be applied on these 3D models in order to obtain statistically significant data comparing the shapes before and after surgery and see if there is any correlation between bones belonging to feet affected by flatfoot. This will make sure that the flatfoot surgery and what affects its success is going to be more understood. This complete workflow will be used in the clinical study to analyse the two selected bone before and after foot surgery and to analyse bone variation between patients. |
| Description | Collaboration with Prof. Zanetti from the University of Perugia in Italy |
| Organisation | University of Perugia |
| Country | Italy |
| Sector | Academic/University |
| PI Contribution | We provided the dataset of foot scans so that their methodology could be applied to our research study about flatfeet and come up with a new dataset. This allowed them to test their methodology on a different dataset and it allowed us to get some data to answer our research questions. |
| Collaborator Contribution | The research group from the University of Perugia developed a statistical analysis tool they developed based on mandibular bones. This methodology was adapted and applied to our dataset. |
| Impact | A research report written in September 2022. Submitted as an abstract to the International Conference ESB 2023 in Maastricht, Netherlands. |
| Start Year | 2022 |
| Description | Guest Lecture to third year Biomedical Engineers |
| Form Of Engagement Activity | A talk or presentation |
| Part Of Official Scheme? | No |
| Geographic Reach | Local |
| Primary Audience | Undergraduate students |
| Results and Impact | Guest lecture to third year Biomedical Engineering students about the research study. The main purpose was to show them a real-life case scenario where Finite Element Analysis (FEA) could be applied and used and inspire final year students to consider a career in research. |
| Year(s) Of Engagement Activity | 2022 |