What is the best hip center location method to compute HKA angle in computer-assisted orthopedic surgery? In silico and in vitro comparison of four methods

Dardenne, Guillaume; Dib, Zoheir; Poirier, Nicolas; Letissier, Hoël; Lefèvre, Christian; Stindel, Éric

doi:10.1016/j.otsr.2018.11.011

Cited by 6 publications

(8 citation statements)

References 17 publications

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“…Therefore, there is an urgent need for a convenient and effective method to measure HKA. Traditional HKA measurement methods [5][6][7] rely on the doctors to calculate the angle. No automatic measurement system has emerged yet.…”

Section: Introductionmentioning

confidence: 99%

Automated measurement of hip–knee–ankle angle on the unilateral lower limb X-rays using deep learning

et al. 2020

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Significant inherent extra-articular varus angulation is associated with abnormal postoperative hip-knee-ankle (HKA) angle. At present, HKA is manually measured by orthopedic surgeons and it increases the doctors' workload. To automatically determine HKA, a deep learning-based automated method for measuring HKA on the unilateral lower limb X-rays was developed and validated. This study retrospectively selected 398 double lower limbs X-rays during 2018 and 2020 from Jilin University Second Hospital. The images (n = 398) were cropped into unilateral lower limb images (n = 796). The deep neural network was used to segment the head of hip, the knee, and the ankle in the same image, respectively. Then, the mean square error of distance between each internal point of each organ and the organ's boundary was calculated. The point with the minimum mean square error was set as the central point of the organ. HKA was determined using the coordinates of three organs' central points according to the law of cosines. In a quantitative analysis, HKA was measured manually by three orthopedic surgeons with a high consistency (176.90 ° ± 12.18°, 176.95 ° ± 12.23°, 176.87 ° ± 12.25°) as evidenced by the Kandall's W of 0.999 (p < 0.001). Of note, the average measured HKA by them (176.90 ° ± 12.22°) served as the ground truth. The automatically measured HKA by the proposed method (176.41 ° ± 12.08°) was close to the ground truth, showing no significant difference. In addition, intraclass correlation coefficient (ICC) between them is 0.999 (p < 0.001). The average of difference between prediction and ground truth is 0.49°. The proposed method indicates a high feasibility and reliability in clinical practice.

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Section: Introductionmentioning

confidence: 99%

Automated measurement of hip–knee–ankle angle on the unilateral lower limb X-rays using deep learning

et al. 2020

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“…Previous studies within the discipline of orthopedics have demonstrated the benefit and improved outcomes that come with personalized in silico simulations [ 6 , 7 , 14 , 15 ]. Our analysis of the femur in Fig.…”

Section: Discussionmentioning

confidence: 99%

An open-access plug-in program for 3D modelling distinct material properties of cortical and trabecular bone

et al. 2022

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Background Finite element modelling the material behavior of bone in-silico is a powerful tool to predict the best suited surgical treatment for individual patients. Results We demonstrate the development and use of a pre-processing plug-in program with a 3D modelling image processing software suite (Synopsys Simpleware, ScanIP) to assist with identifying, isolating, and defining cortical and trabecular bone material properties from patient specific computed tomography scans. The workflow starts by calibrating grayscale values of each constituent element with a phantom – a standardized object with defined densities. Using an established power law equation, we convert the apparent density value per voxel to a Young’s Modulus. The resulting “calibrated” scan can be used for modeling and in-silico experimentation with Finite Element Analysis. Conclusions This process allows for the creation of realistic and personalized simulations to inform a surgeon’s decision-making. We have made this plug-in program open and accessible as a supplemental file.

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“…Kirkwood [18] aslo agreed with the above point of view. Although these methods take the hip rotation center as three-dimentional concept into consideration, however, they rely on accurate palpation of bony landmarks and estimation of the distance between them to locate the hip joint center,which have limited value to instruct surgeons to locate the hip rotation center in the operation.Dardenne [19] reported that the hip center could be determined by the Pivot method accurately in computer-assisted (or navigated) orthopedic surgery. Computer-assisted technology could promote the accuracy of locating hip rotation center, but it needs high requirements of devices and technology, which is di cult to be popularized.In previous study, we have reported there was a constant relationship between the acetabular center and Harris fossa ,as well as acetabular notches,which could be used to locate the acetabular center.…”

Section: Discussionmentioning

confidence: 99%

How to Restore Rotation Center in Total Hip Arthroplasty for Developmental Dysplasia of the Hip with the Assistance of Three Dimensional Printing Technology? A Pilot Study

Zhang

Liu

et al. 2020

Preprint

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Background: It is technically challenging to restore hip rotation center exactly in total hip arthroplasty (THA) for patients with end-stage osteoarthritis secondary to developmental dysplasia of the hip (DDH) due to the complicated acetabular morphology changes.In this study, we developed a new method to restore hip rotation center exactly and rapidly in THA with the assistance of three dimensional (3-D) printing technology.Methods: Seventeen patients (21 hips) with end-stage osteoarthritis secondary to DDH who underwent THA were included in this study. Simulated operations were performed on 3-D printed hip models for preoperative planning. The Harris fossa and acetabular notches were recognized and restored to locate acetabular center. The agreement in the size of acetabular cup and bone defect between simulated operations and actual operations were analyzed.Clinical and radiographic outcomes were recorded and evaluated.Results: The sizes of the acetabular cup of simulated operations on 3-D printing models showed a high rate of coincidence with the actual sizes in the operations(ICC value=0.930) There was no significant difference statistically between the sizes of bone defect in simulated operations and the actual sizes of bone defect in THA( t value=0.03，P value=0.97). The average Harris score of the patients was improved from (38.33±6.07) preoperatively to the last follow-up (88.61±3.44) postoperatively.The mean vertical and horizontal distances of hip rotation center on the pelvic radiographs were restored to (15.12 ± 1.25）mm and ( 32.49±2.83) mm respectively. No case presented dislocation or radiological signs of loosening until last follow-up.Conclusions: The application of 3-D printing technology faciliate orthopedists to recognize the morphology of Harris fossa and acetabular notches , locate the acetabular center and restore the hip rotation center rapidly and acurately.

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What is the best hip center location method to compute HKA angle in computer-assisted orthopedic surgery? In silico and in vitro comparison of four methods

Cited by 6 publications

References 17 publications

Automated measurement of hip–knee–ankle angle on the unilateral lower limb X-rays using deep learning

Automated measurement of hip–knee–ankle angle on the unilateral lower limb X-rays using deep learning

An open-access plug-in program for 3D modelling distinct material properties of cortical and trabecular bone

How to Restore Rotation Center in Total Hip Arthroplasty for Developmental Dysplasia of the Hip with the Assistance of Three Dimensional Printing Technology? A Pilot Study

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