High High Quality Quality Low Low Cos Cos Tumo m u o r Kn Knee e e Pr os Pr thesis Team OrthoCAD

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1 High Quality Low Cost Tumour Knee Prosthesis Team OrthoCAD Mechanical Engineering Department Mechanical Engineering Department IIT Bombay, Mumbai

2 OrthoCAD Project [Funded by the Office of the Principal Scientific Advisor to the Govt. of India] Bone tumor in children: cancer can be treated t but limb is amputated Modular rotating hinge knee prosthesis Ti 6Al 4V Stem Frugal Manufacturing RP wax pattern investment casting HA Collar Co Cr Mo Condyle Symphony Implant Safety and Accuracy Walking Simulator UHMWPE Tibial Poly CAD model RP model Final Prosthesis Surgery plan Limb saving surgery: Resect tumour bone, reconstruct gap using prosthesis (imported) Novel Surgical Instruments OrthoSYS: 3D surgery planning software

3 How It Started Feb Fb2004, Tata Tt Memorial lhospital First GMRS TKP implantation in India by Dr. Manish Agarwal

4 Indigenous Knee Prosthesis: Implantation

5 Orthopaedic and other Reconstruction Projects Maxillofacial Reconstruction by Distraction Osteogenesis Auricular Reconstruction Pelvic Joint Reconstruction

6 Tumour Knee Prosthesis High Quality by Design and Testing Anatomy Structural Safety Functionality Service Life

7 Tumour Knee Prosthesis Low Cost by Frugal Manufacturing Material Co Cr Ti Al V UHMWPE Characteristics High wear resistance Strength/weight ratio Low friction and wear Certified Biomaterials Metal Casting Hot Die Forming Finish Machining

8 Prosthesis Implantation High Accuracy by Novel Instruments Femoral Measurement and Cutting Jig Error prone protocol replaced with guided device PATENT Tibial Cutting Jig ensures cutting plane is perpendicular to bone canal

9 Prosthesis Implantation Less Surgery Time by Preop Planning CT Images 3D Model Landmarks Deformities Bone Stock Selection Alignment

10 Project Lead Time Compression by CAx Integration 3D CAD Model FEM Mesh FEM Mesh Stress Analysis FEM Analysis Voxel model Condyle Model Computer navigation Casting Simulation RP Model Ceramic Shell Casting Simulation Automated Inspection CNC Tool Path Finish Condyle Cast Condyle CNC Machining

11 Knowledge Dissemination Clinicians, Teachers, Students

12 Knowledge Dissemination Print Media and Publications

13 Further Directions Clinical Trials and OrthoCAD Phase II

14 New Collaborations Medical Institutes and Hospitals AIIMS and NIC Network Enabled Medical Diagnosis & Education in Skeletal Imaging using X Rays Indigenous Arthritic Knee Anatomy and Implant NORMAL KNEE ARTHRITIC KNEE

15 New Collaborations Orthopedics Manufacturers Sushrut Surgicals Indigenous Shoulder and Elbow Prosthesis Safety Evaluation of Bone Plates

16 OrthoCAD Lab Refurbishment (March July 2009)

17 OrthoCAD Lab Today

18 OrthoCAD Team IIT B, NFTDC Hyderabad, Dr. Manish Agarwal Thank you! PSA Office & PRMC: Dr. R. Chidambaram, Mr. Neeraj Sinha, Dr. P.P. Kotwal, Dr. G. Bhuvaneshwar, Dr. V.K. Suri, Dr. S. Rastogi NFTDC Hyderabad: Dr. K. Balasubramanian, Nirmal Panda, Nagsen Phule, Nitin Kanoongo, Shiva Gautam, P. K. Jayakumar, D. Lokeshwara Rao, Sarika Mishra, Shireesha, Rati Ranjana, M. Govinda Raju, Udai Raj Kumar, Soby Verghase, Satyam Babu IITB Project Team: K. Subburaj, Rupesh Ghyar, Sandeep Anasane, Vikas Karade, Ravi Kumar, Himanshu Mangal, Kapil Kumar Rathi, Shanta Kumar, Siddharth Sekhsaria, Anshul Pandey, Ajay Kashyap, Amar Jadhav, Chinmay Kantak, Soumyojit Sen IITB Admin: Prof. D.V. Khakhar, Prof. R.K. Mallik, Prof. K.V.K. Rao, Prof. Prof. S.L. Bapat. IDC: Prof. B.K. Chakravarthy IRCC: Prof. K. Ramamritham, Prof. Kurien Issac, Prof. Rangan Banerjee, Sandhya Gholkar Varada Kulkarni, Ravindra Gaikwad Estate Office: V.B. Mamdapur, K.R.P. Unnithan, Rajesh Mate, Mr. B.K. Sahoo, Adhare, Bagde, Shaikh; Lalit Asso.: Rajiv Shah

19 Challenge Growing Children Minimal / Non Invasive Solution