Design and manufacturing of customised femoral stems for the Indian population using rapid manufacturing: a finite element approach

Abstract

Joint replacement surgeries in India primarily involve the use of conventional implants, also referred to as 'standard implants'. There has been a little awareness about the possibility of using customised implants for such surgeries. Although standard implants from various biomedical companies are easily available in the Indian market, they are expensive and rarely conform to patient's anatomy. Studies in the past have shown that there are anatomical variations in the hip joint for different ethnic backgrounds and geographical locations. This article evaluates the feasibility of using custom-manufactured hip implants and presents a comparison between the former and standard implant from stress reduction point of view. Two CAD models of femoral stems - one from standard sized hip implant available in the market and other from customised hip implant designed as per parameters from a radiograph (specific to the patient's anatomy) - are used for evaluation. Finite element analysis was carried out for a double-legged stance. The comparative study indicated lesser stresses in head and neck region of the customised femoral stems than the standard implant. The study suggests design feasibility of customised implants for the Indian population owing to reduction in stresses in the implant.

Morphometric evaluation of proximal femur in patients with unilateral total hip prosthesis

“…Use of implants designed for each individual instead of using standard implants applied in total femoral arthroplasty is useful for the prevention of tension concentrations in the femoral neck zone (Madhugiri et al, ). Restoration of the femoral offset for the implant to be durable and to improve the joint stability are regarded as an essential part of total femoral arthroplasty.…”

“…Femur morphometry is different between populations or geographical regions (Igbigbi and Msamati, 2002;Giroux and Wescott, 2008;Mishra et al, 2009;Fang et al, 2010;Madhugiri et al, 2011;Otsianyi et al, 2011;Milner and Boldsen, 2012). Most orthopedic implants produced for femoral head prostheses and trochanteric fractures are designed for Western societies.…”

“…Incongruous implant size or design may bring about micro movements, laxation, and such reported complications as intra-operative fractures, and thus may negatively affect the outcomes of the operation (Heinert and Parker, 2007;Abdul-Kadir et al, 2008). Use of implants designed for each individual instead of using standard implants applied in total femoral arthroplasty is useful for the prevention of tension concentrations in the femoral neck zone (Madhugiri et al, 2011). Restoration of the femoral offset for the implant to be durable and to improve the joint stability are regarded as an essential part of total femoral arthroplasty.…”

Design and development of 3D printing assisted microwave sintering of elbow implant with biomechanical properties similar tohuman elbow

“…Madhugiri et al designed a custom-made femoral stem and compared the stress distribution of the implant against the market available size of the femoral stem. The results suggested reduced stresses in the head and the neck regions of the customized femoral stems as compared to other implants (Madhugiri et al , 2011). Similarly, other researchers have successfully developed customized load bearing and non-load bearing implants (De Beer and Scheffer, 2012; Arabnejad et al , 2017).…”

Applied Taguchi Method for Fatigue Testing of Customized Hip Implant

“…Therefore, these hip implants do not meet the need of Indian and Asia-Pacific populations. THA failures may occur due to the unavailability of hip implants of appropriate sizes for ethnic groups in India and Asia-Pacific (5–7). The hip implants may be oversized because of the smaller build and stature of Indians and other Asian subpopulations compared to the Western counterparts.…”