Recurring Meeting of Cleveland Clinic Core Team

Date: Nov 5, 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 tasks progress.(Finalize specimen specification to order specimens).
2. Discuss/finalize tissue testing equipment purchase.
3. Decide tasks for the next meeting.
4. Other

Immediate action items

• See notes for details.

  All

  • Read and update joint, preparation and registration specifications.

  Snehal

  • Create a document to detail the tissue testing time requirement.

  Jason

  • Create a detailed flowchart to add preparation stages for initialisation, registration and MRI.

Notes:

1. Discuss task progress.
   • Specimen specifications and ordering
     • Team needs to deliberate on the need for ordering specimens that include pelvis to toes (registration issues, increased testing time, freeze thaw cycles, sharing/exchange with other groups etc.)
     • For immediate needs, 2 specimens (different donors) will be ordered with the current specifications (hip to toes).
     • Team will add and update as discussion points the secondary specimens and primary specimen specifications with additional requirements.
     • Access to specimens will all lower extremity joints (specimen specific) and the knowledge of specimen preparation and testing, and model development (from the knee joints), we may be able to extend. branch off to modeling specimen specific entire lower extremity (hip, knee and ankle joints).
     • x-ray imaging will need to be done with axial load on the joint.
   • Imaging specifications
     • The current protocol will be used as a starting point.
     • Specimen transportation jig needs to be designed (to hold the specimen in neutral position and applying tension on patella, without disturbing the registration markers while transporting the specimen from Clinic to Case imaging facility).
     • The design of fixture will be included in specimen preparation for MRI.
     • A test session will be conducted on Nov. 14th to test/ analyse the current protocol and check the artefacts related to the brass registration system. Other material samples will also be tested in this session.
     • Current protocol will be used to test and modify the setting based on which tissues we are interested in and the ease of automating segmentation. (T1 for ligaments, tendons and meniscus and T2 for cartilage)
   • Specimen preparation and registration specifications
     • Target outcomes were clearly defined by Ahmet.
     • The page is divided in sections for different preparation stages (imaging, joint testing etc).
     • Preparation for registration is divided into initialisation (anatomical coordinate system to optotrak) and registration preparation (image to joint coordinate system).
     • Sections for preparation for actual steps (initialization, registration , MRI etc) were clearly defined.
     • Jason will prepare a flowchart to describe the work flow including all the preparation stages for initialization and registration.
     • Information for the preparation stages for initialization and registration can be included in the specimen preparation page and will be either linked to from other pages (e.g registration specifications) or eventually be moved to dedicated pages.
     • Specimen preparation will also include preparation for tissue testing.
     • The post-processing information (analysis and mathematics) can be put in separate pages.
   • Robotics testing specifications
     • Tibiofemoral joint testing information was finalized and will be followed as prescribed.
     • Secondary conditions will be discussed and added as necessary.
     • Repeatability test ( e.g A-P laxity at 30 degrees) will be added at three stages (at time= 0,0.5 and 1) to ensure the specimen did not fail.
     • Patellofemoral joint primary test conditions were agreed upon. Suggested flexion angles are part of the gait cycle but do not entirely represent gait cycle. Conditions need to be reworded to clarify the information.
     • Secondary conditions will be added as necessary if time permits.
     • Robb will update/ attach the document describing the naming conventions for tibiofemoral joint.
   • FEBio feature specifications
     • Ahmet added a new feature request for connectors.
     • This will be a second priority feature. A test problem was provide to test the progress.
   • Tissues testing specifications
     • Snehal will try preparation and testing of a tendon sample.
   • Pressure sensor calibration task will be assigned to Jason.
   • Documentation specifications
     • Robb and Tara will update the experimentation infrastructure information.
     • Snehal will create an imaging infrastructure task to summarize facilities at UH.

2. Finalize tissue testing equipment purchase.

• Robb, Tara and Snehal talked to Biomomentum engineers and discussed the project's testing needs and the capabilities of their testing systems.
• The existing biomomntum machine with added axis will give the group more functionality that we currently do not have.
• The single axis machine that the quote was provided for has better resolution but the software has fewer capabilities than the existing system (MTS).
• No force control is currently implemented ( they are developing the functionality and may be included in the machine we purchase).
• Stress relaxation tests are built in. Currently creep cannot be performed.
• From the project perspective, the existing Biomomentum system has necessary capabilities.
• Camara attachment and control need to be discussed.
• Snehal will provide a detail of number of hours and frequency of use per specimen (Potential usage plan for 4 years).
• Snehal spoke to a representative from Bose Corp (Electroforce systems group) about one of their material testing machines (3100 system). They were informed about the budget constraints and they will provide their feedback in the coming weeks.

3. Decide tasks for the next meeting

• See immediate action items above.

4. Other

• CCF- Univ of Utah meeting minutes and advisory board meeting minutes were discussed.
• Ahmet met all the advisory board members and were updated on the progress.
• All the advisory board members will be added as members on the simtk project site so that they can oversee the project progress.
• Other projects related to Open knee can be worked on as secondary projects.
• Engineering advisory board showed interest in MRI segmentation reproducibility and a community project can be developed to accomplish that.
• Qmetrics Inc. can help the team with segmentation needs.
• The specimen transportation fixture needs to be designed.
• The team will meet and discuss the design needs.