Design of patient-specific hip implants based on the 3D geometry of the human femur
Design of patient-specific hip implants based on the 3D geometry of the human femur
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DOI：
10.1016/j.advengsoft.2009.10.016
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发表时间：
2010-04-01
影响因子：
4.8
通讯作者：
Choi, Kuiwoon
中科院分区：
文献类型：
--
作者：
Jun, Yongtae;Choi, Kuiwoon
全髋关节置换术(THR)是一种用植入物取代患病髋关节的外科手术。由于每个人髋关节的大小和形状各不相同，选择的商业髋关节植入物有时可能不是最适合患者的，甚至因为它的差异而无法应用。为了解决选定的植入物和髋关节之间可能存在的几何不匹配的问题，我们开发了一个软件系统，通过研究患者髋关节的解剖几何来设计特定于患者的髋关节植入物。提出的系统的主要技术挑战是根据患者的3D骨骼解剖提取一些典型的3D几何参数，然后基于提取的参数创建定制的髋关节植入物。本文描述了根据患者股骨的几何形状创建针对患者的髋关节植入物的整个过程。参数包括股骨干峡部、解剖股骨轴、股骨头中心/半径、股骨头偏置长度、股骨颈、颈干角、前倾角和椎管张开指数(CA)。其中一些是半自动识别和提取的，但另一些必须在外科医生的干预下确定。所有参数都足以构建指定股骨的原始3D几何模型。从而可以从这些提取的几何参数的信息中确定针对单个患者的患者特定的髋关节植入物。通过最大限度地扩大与骨骼的接触面积，患者专用植入物的稳定性得到了提高。目前，建议的系统只适用于髋关节植入物的设计：然而，这些概念足够通用，可以应用于任何其他人类关节，如肩膀、膝盖或脊柱。通过算例验证了该方法的可行性和可靠性。(C)2009爱思唯尔有限公司。保留所有权利。
Total hip replacement (THR) is a surgical procedure that replaces a diseased hip joint with implants. Due to the various size and shapes of human hip joint of every individual, a chosen commercial hip implant sometimes may not be the best-fit to a patient, or even it cannot be applied because of its discrepancy. To solve the problem of a possible geometric mismatch between a selected implant and the hip joint, we develop a software system that designs a patient-specific hip implant by investigating the anatomical geometry of the patient's hip joints. The major technical challenge of the proposed system is to extract some typical 3D geometry parameters with respect to the patient's 3D bone anatomy and then creates a custom-made hip implant based upon the extracted parameters. This paper describes the overall procedure of creating a patient-specific hip implant based upon the geometry of the patient's femur. The parameters include femoral shaft isthmus, anatomical femoral axis, femoral head center/radius, head offset length, femoral neck, neck shaft angle, anteversion, and canal flare index (CA). Some of them are semiautomatically recognized and extracted, but others must be determined with the surgeon's intervention. All the parameters are sufficient to construct a primitive 3D geometry model of the specified femur. so that a patient-specific hip implant for individual patients can then be determined from the information of those extracted geometry parameters. The stability of patient-specific implants has been increased by maximizing contact area with the bone. Currently the proposed system is exclusive for the design of a hip implant: however, the concepts are general enough to be applied to any other human joints such as the shoulder, the knee, or the spine. The feasibility and reliability of the method has been tested on some examples. (C) 2009 Elsevier Ltd. All rights reserved.