Automated femoral landmark extraction for optimal prosthesis placement in total hip arthroplasty. (25th November 2016)

• Record Type: Journal Article
• Authors: de Almeida, Diogo F.; Ruben, Rui B.; Folgado, João; Fernandes, Paulo R.; Gamelas, João; Verhegghe, Benedict; De Beule, Matthieu
• Is Part Of: International journal for numerical methods in biomedical engineering. Volume 33:Number 8(2017:Aug.)
• Page Start: n/a
• Page End: n/a
• Publication Date: 2016-11-25
• Subjects: 3D landmark extraction -- 3D surface mesh -- computed tomography -- hip prosthesis -- preoperative planning -- total hip arthroplasty; Biomedical engineering -- Periodicals; Imaging systems in medicine -- Periodicals; Numerical analysis -- Periodicals; Engineering mathematics -- Periodicals; 610.28
• DOI: 10.1002/cnm.2844
• Languages: English
• ISSNs: 2040-7939

Abstract

Abstract: The automated extraction of anatomical reference landmarks in the femoral volume may improve speed, precision, and accuracy of surgical procedures, such as total hip arthroplasty. These landmarks are often hard to achieve, even via surgical incision. In addition, it provides a presurgical guidance for prosthesis sizing and placement. This study presents an automated workflow for femoral orientation and landmark extraction from a 3D surface mesh. The extraction of parameters such as the femoral neck axis, the femoral middle diaphysis axis, both trochanters and the center of the femoral head will allow the surgeon to establish the correct position of bony cuts to restore leg length and femoral offset. The definition of the medullary canal endosteal wall is used to position the prosthesis' stem. Furthermore, prosthesis alignment and sizing methods were implemented to provide the surgeon with presurgical information about performance of each of the patient‐specific femur‐implant couplings. The workflow considers different commercially available hip stems and has the potential to help the preoperative planning of a total hip arthroplasty in an accurate, repeatable, and reliable way. The positional and orientation errors are significantly reduced, and therefore, the risk of implant failure and subsequent revision surgery are also reduced. Abstract : The presented method provides an automated presurgical guidance for prosthesis sizing and placement. In a first stage, it is able to accurately locate key anchor points in the 3D femoral mesh volume. Moreover, optimal prosthesis alignment and sizing estimation can be achieved based on the patient‐specific femoral and medullary canal dimensions in an accurate, repeatable, and reliable way. The positional and orientation errors are significantly reduced, and therefore, the risk of implant failure and consequent revision surgery are minimized.