title: Automated femoral landmark extraction for optimal prosthesis placement in total hip arthroplasty.
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.
authors: IDMEC, Instituto Superior Técnico, Universidade de Lisboa, Lisbon, Portugal.|IBiTech-bioMMeda, Ghent University, Ghent, Belgium.
authors: Diogo F
authors: DF
authors: de Almeida
authors: ESTG, CDRSP, Polytechnic Institute of Leiria, Leiria, Portugal.
authors: Rui B
authors: RB
authors: Ruben
authors: IDMEC, Instituto Superior Técnico, Universidade de Lisboa, Lisbon, Portugal.
authors: João
authors: J
authors: Folgado
authors: IDMEC, Instituto Superior Técnico, Universidade de Lisboa, Lisbon, Portugal.
authors: Paulo R
authors: PR
authors: Fernandes
authors: Medical School, Universidade Nova de Lisboa, Lisbon, Portugal.
authors: João
authors: J
authors: Gamelas
authors: IBiTech-bioMMeda, Ghent University, Ghent, Belgium.
authors: Benedict
authors: B
authors: Verhegghe
authors: IBiTech-bioMMeda, Ghent University, Ghent, Belgium.
authors: Matthieu
authors: M
authors: De Beule
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D019644:Arthroplasty, Replacement, Hip / Q000295:instrumentation* / Q000379:methods*; D001331:Automation; D005260:Female; D005269:Femur / Q000502:physiology / Q000601:surgery*; D005270:Femur Head; D005272:Femur Neck; D006622:Hip Prosthesis; D006801:Humans; D007091:Image Processing, Computer-Assisted; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D010027:Osteotomy; D025341:Principal Component Analysis; D011474:Prosthesis Design
keywords: 3D landmark extraction; 3D surface mesh; computed tomography; hip prosthesis; preoperative planning; total hip arthroplasty