Automated femoral landmark extraction for optimal prosthesis placement in total hip arthroplasty

Almeida, Diogo; Ruben, Rui B.; Folgado, João; Fernandes, Paulo R.; Gamelas, João; Verhegghe, Benedict; Beule, Matthieu De

doi:10.1002/cnm.2844

Cited by 10 publications

(4 citation statements)

References 28 publications

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“…Resection of the femur bone (neck and distal) and insertion of the hip stem were performed with Materialise 3-matic (version 12). The alignment of the stem in the medullary canal and the fitting of the neck shaft of the stem to the neck shaft of the femur were considered in the stem positioning, 18,19 as shown in Figure 1. The finite element model of assembled bone and stem was meshed in linear quadratic tetrahedral elements (C3D4) in Materialise 3-matic and exported to ABAQUS/CAE.…”

Section: Finite Element Modelmentioning

confidence: 99%

Study of cellular femoral stem for stress shielding and interface stability

2023

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Implant failure is due to stress shielding and interface micromotion. The application of porous structures in the femoral implant has a great effect on reducing stress shielding and improving the stability of the bone-implant interface. The performance of femoral stems with triply periodic minimal surface (TPMS) structures, IWP, and Gyroid structures was evaluated using finite element analysis. We studied the stress shielding phenomenon of the porous femoral stem based on the ability of stress transfer to the femur. The micromotion at the bone-implant interface was explored for different porous femoral stems. The effect of gradient structure design was investigated in the axial direction of the stem. These gradient designs involved a stem with an increasing volume fraction in the axial direction (IAGS) and a decreasing volume fraction along the stem (DAGS). The results showed that the axial stiffness of the stem has a direct effect on stress shielding and an inverse relation to bone-implant micromotion. The finite element analysis results inferred that bone resorption is higher in the stems with IWP structure than in Gyroid at the same volume fraction. Axially graded stems transfer higher stress to the femur than homogenous porous stems. DAGS design of IWP and Gyroid and IAGS Gyroid increased the stress on the proximal-medial of the femur. Homogeneous porous stems with high porosity (80% porosity for IWP and 70% porosity for Gyroid) and DAGS design exhibited low stress shielding and controlled bone-implant interface micromotion within an acceptable range for bone ingrowth.

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Section: Finite Element Modelmentioning

confidence: 99%

Study of cellular femoral stem for stress shielding and interface stability

2023

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“…The radiuses can be used to guide the design of IMNs. de Almeida et al (2017) presented an automated workflow to extract femoral orientation and landmarks such as the femoral neck axis and the femoral middle diaphysis axis. According to the extracted parameters, the appropriate prosthesis and placement positions can be selected for a specific patient.…”

Section: Introductionmentioning

confidence: 99%

Determination of intramedullary nail based on centerline adaptive registration

Liu

Luan

2023

Front. Bioeng. Biotechnol.

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Objective: Internal fixation with intramedullary nails is a gold standard for the treatment of femoral shaft fractures. However, both the mismatch between intramedullary nails and the medullary cavity and inaccurate positioning of entry points will lead to deformation of intramedullary nails after implantation. The study aimed to determine a suitable intramedullary nail with an optimal entry point for a specific patient based on centerline adaptive registration.Method: A homotopic thinning algorithm is employed to extract centerlines of the femoral medullary cavity and the intramedullary nail. The two centerlines are registered to obtain a transformation. The medullary cavity and the intramedullary nail are registered based on the transformation. Next, a plane projection method is employed to calculate the surface points of the intramedullary nail laid outside the medullary cavity. According to the distribution of compenetration points, an iterative adaptive registration strategy is designed to decide an optimal position of the intramedullary nail in medullary cavity. The isthmus centerline is extended to the femur surface, where the entry point of the intramedullary nail is located. The suitability of an intramedullary nail for a specific patient was calculated by measuring the geometric quantities reflecting the interference between the femur and nail, and the suitability values of all nails are compared and the most suitable one is determined.Results: The growth experiment indicated that the bone to nail alignment is indeed affected by the extension of the isthmus centerline, including the extension direction and velocity. The geometrical experiment showed that this method could find the best registration position of intramedullary nails and select the optimal intramedullary nail for a specific patient. In the model experiments, the determined intramedullary nail could be successfully placed into the medullary cavity through the optimal entry point. A pre-screening tool to determine nails which can be successfully used has been given. In addition, the distal hole was accurately located within 14.28 s.Conclusion: These results suggest that the proposed method can select a suitable intramedullary nail with an optimal entry point. The position of the intramedullary nail can be determined in the medullary cavity, while deformation is avoided. The proposed method can determine the largest diameter intramedullary nail with as little damage to the intramedullary tissue as possible. The proposed method provides preparation aid for internal fixation with intramedullary nails guided by navigation systems or extracorporeal aimers.

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“…Total hip replacement (THR) technique is considered as the most useful treatment option for osteoarthritis and rheumatoid arthritis on the hip joint, enabling the patients to recover painfree mobility [1,2]. That is the reason THR attracted the interest of many specialists during the last decades.…”

Section: Introductionmentioning

confidence: 99%

Numerical study of stress shielding evaluation of hip implant stems coated with composite (carbon/PEEK) and polymeric (PEEK) coating materials.

Darwich¹,

Nazha²,

Abbas³

2019

biomedicalresearch

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The forces applied to the prosthesis during human activity produce dynamic stresses varying in time and may causing stress shielding in prosthesis-bone system. Therefore, it is important to reduce stress shielding effect. This study aimed to investigates, using finite element analysis, how a PEEK and carbon/ PEEK composite coating materials on a titanium alloy hip implant stem could reduce stress shielding effect corresponding to different human activities: standing up, normal walking and climbing stairs under dynamic loadings to find out which of all these models have a better performance. A 3D finite element model of femur, hip implants, coating layers with composite (carbon/PEEK) and polymeric (PEEK) coating materials were constructed for finite element analysis. A time-dependent cycling load was applied on the prosthesis head. The maximum increase in load transfer to the bone was 207% for the prosthesis coated with carbon/PEEK configuration I (fibers orientated with 0, +45,-45, and 90 degrees) in average compared to uncoated one. Numerical result showed that the carbon/PEEK composite material (configuration I) seems to be a good solution to distribute the applied load and transfer it to the bone, thus to reduce stress shielding problems and to prolong lifetime of the prosthesisbone system. It will prevent aseptic loosening and enhance the stability of the system.

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Automated femoral landmark extraction for optimal prosthesis placement in total hip arthroplasty

Cited by 10 publications

References 28 publications

Study of cellular femoral stem for stress shielding and interface stability

Study of cellular femoral stem for stress shielding and interface stability

Determination of intramedullary nail based on centerline adaptive registration

Numerical study of stress shielding evaluation of hip implant stems coated with composite (carbon/PEEK) and polymeric (PEEK) coating materials.

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