Recurring Meeting of Cleveland Clinic Core Team

Date: October 29, 2013

Time: 10:30 AM EST

Means: In person meeting

Attendees:

1. Ahmet Erdemir
2. Jason Halloran
3. Snehal Chokhandre
4. Robb Colbrunn
5. Tara Bonner

Agenda:

1. Discuss assigned tasks progress.
2. Decide meeting agenda and time for tissue testing equipment purchase.
3. Decide action items for next meeting.
4. Other

Immediate Action Items:

See notes for details.

• All

Notes:

1. Discuss assigned tasks progress.
   • Specimen specifications

     • ScienceCare can provide x-rays for assessment of osteoarthritis severity before order confirmation.

     • Snehal will update the specifications and request price information for 'pelvis to toe' specimens.
     • Some knee specimens used in the pivot shift test (Dr. Saluan) may be used in this project if they fit the need.
     • Suitable specimens from the surgical skills lab may also be used if needed.
   • Ahmet send the quote for Mach-1 tissue testing machine (Biomomentum, Inc) to Tara,Robb and Snehal and is awaiting response from NIH regarding equipment purchase.
   • Imaging specifications
     • For the meeting with Chris
     • CT may also be taken to obtain better bone geometry.
   • Documentation and publications
     • Tara and Robb will update the information regarding all the project related testing equipment (Mechanical testing infrastructure).
     • Scott will work on the Open knee generation 1 manuscript.
   • Imaging specifications
     • Craig updated the page with images and information for the current settings
     • Specimen transportation information will need to be updated.
     • To make sure that the marker placement is not disturbed and also to load the patella (to avoid crimped/ wavy ligaments during imaging), a fixture will be designed.
     • This fixture will have to be big enough to accommodate the knee specimen and the registration markers at the same time small enough to fit in the knee coil in the MRI.
     • Jason, Ahmet and Snehal will meet Chris to discuss imaging requirements.
   • Experimentation workflow was explained by Jason.
   • Joint testing specifications
     • Prerequisite protocols were discussed.
     • Primary conditions are the necessary predetermined test conditions whereas secondary conditions will be developed and tested based upon availability of time and resources.
     • Previously used tibiofemoral joint testing conditions (currently listed) will be used for this project as well.
     • Registration errors will be quantified for all marker sets (for all specimens).
     • Repeatability of fiducial markers in Optotrak will need to be evaluated.
     • Robb and Tara will work on Optotrak related issues.
     • Imaging and tibiofemoral joint testing will be done on day 1 of joint testing. The specimen will be kept refrigerated and the patellofemoral joint testing and tissue testing sample preparation will be done on day 2 of joint testing.
     • Randomising order of testing steps may not be necessary as we are not testing a hypothesis.
     • A few test conditions (e.g AP laxity at 30 degrees) will be repeated at the beginning, middle and end of the session to ensure that the specimen was not damaged during the test.
     • Repeatability of the holder angle will also be tested.
     • The specifications will be finalised in the next meeting.
     • Secondary conditions will be added to patellofemoral testing protocol.
   • Tissue testing specifications
     • Some pilot tendon tests will be conducted as tendons were not previously tested.
   • Specimen preparation
     • The dissection will be done before the marker placement as it will be easier to place it in the transportation fixture.
     • Information regarding where the preparation will be done and where all the necessary tools are will be added.
     • A separate page will be created to describe the specimen preparation before it is transported to MRI facility.
     • A fixture/ clamp will be needed to make sure the bones can be cut without disturbing the marker placement.
   • Registration specification
     • Specimen preparation (marker placement etc) will be detailed in the specimen preparation page.
     • Post-processing information will be described in this page.
     • Robot 'initialization' will be included in the specimen preparation page.
     • 'Registration' will only refer to marker registration (anatomical imaging to mechanical data).
     • Target outcome: association of anatomical imaging with mechanical testing data, association of mechanical testing data to clinical coordinate system.
   • 'Anatomy gift registry' and other vendors will be contacted for buying specimens.
2. Discuss tissue testing equipment purchase.
   • The overall expected cost for minimum required tissue testing (excluding indirect expenses) for 6 specimens is approximately $36k.
   • The goals is find the most cost effective solution.
   • Paying weekly or monthly for using the existing equipment may not be optimal since we will not be continuously testing all the specimens.
   • A more open access to the testing equipment is desirable in order to test more samples without the expenses exceeding the proposed budget.
   • New testing equipment may be purchased for the project which can also be used by the Bio-robotics core for other projects (fee for service).
   • The testing equipment from Biomometum Inc. is being considered which may provide a cost effective option to perform tissues testing for the project.
   • Robb,Tara and Snehal will talk to Biomomentum engineers to make sure the testing equipment meets the project needs.
3. Decide action items for next meeting
   • See details above.