Computer-implemented method of preoperatively determining the optimized external shape of a prosthetic femoral hip stem
Computer-implemented method of preoperatively determining the optimized external shape of a prosthetic femoral hip stem for use in partial cementing hip replacement procedures and of a reamer for reaming a cavity in the femur of a patient for implanting the prosthetic femoral hip stem, comprising: a) setting an initial external shape of the prosthetic femoral hip stem based on the reconstructed femur anatomy of a patient, b) generating an associated initial reamer by negatively offsetting the initial external shape of the prosthetic femoral hip stem by an uniform offset value δ, c) calculating contact stresses at the interface of the prosthetic femoral hip stem and the patient's femur when reamed by the initial reamer and d) optimizing the offset value δ, so that the contact stresses are within a predetermined acceptable range.
1. A computer-implemented method of preoperatively determining an optimized external shape of a prosthetic femoral hip stem having a proximal and a distal segment as well as an intermediate segment between them, the proximal and distal segments to be press-fitted with an intramedullary canal of a femur of a patient and the intermediate segment having a reduced cross section for injecting cement, for use in partial cementing hip replacement procedures and of a reamer for reaming a cavity in the femur of a patient for implanting the prosthetic femoral hip stem, the method comprising:
a) setting an initial external shape of the prosthetic femoral hip stem based on a reconstructed femur anatomy of a patient;
b) generating an associated initial reamer by negatively offsetting the initial external shape of the prosthetic femoral hip stem by a offset value δ;
c) calculating contact stresses at an interface of the prosthetic femoral hip stem and the patient's femur when reamed by the initial reamer; and
d) optimizing the offset value δ, so that the contact stresses are within a predetermined acceptable range for promotion of bone formation and osseointegration, by shrinking the prosthetic femoral hip stem and/or the reamer as required.
2. The method of claim 1 further comprising optimizing said offset value δ, by shrinking the prosthetic femoral hip stem and/or the reamer as required, with regard to the prosthetic femoral hip stem pull out force.
3. The method of claim 1 further comprising optimizing said offset value δ, by shrinking the prosthetic femoral hip stem and/or the reamer as required, wherein:
if the calculated contact stresses are above said predetermined acceptable range, decreasing the offset value δ by shrinking the prosthetic femoral hip stem and calculating contact stresses at the interface of the shrinked prosthetic femoral hip stem and the patient's femur when reamed by the reamer; and
if the calculated contact stresses are below said predetermined acceptable range, increasing the offset value δ by shrinking the reamer and calculating contact stresses at the interface of the prosthetic femoral hip stem and the patient's femur when reamed by the shrinked reamer.
4. The method of claim 1 wherein said setting an initial external shape of the prosthetic femoral hip stem based on the reconstructed femur anatomy of a patient comprises:
acquiring a CT-scan of a pelvis and the femur of the patient; and
developing a 3D-solid model of the initial prosthetic femoral hip stem.
5. The method of claim 4 wherein said generating an associated initial reamer by negatively offsetting the initial external shape of the prosthetic femoral hip stem by a preferably uniform offset value δ comprises generating a CAD surface model of the associated reamer to carry out a Boolean operation intended for simulating cancellous bone reaming.
6. The method of claim 5 wherein said calculating contact stresses at the interface of the prosthetic femoral hip stem and the patient's femur when reamed by the initial reamer comprises:
extracting cortical and cancellous bone layers.
7. The method of claim 6 , wherein extracting the cortical and cancellous bone layers is performed by using a medical image editor software.
8. The method of claim 6 wherein extracting the cortical and cancellous bone layers is performed by creating a finite element mesh for each bone layer for estimating the bone material properties based on an element bone density.
9. The method of claim 8 wherein creating said finite element mesh for each bone layer for estimating the bone material properties based on said element bone density is represented by the average pixel's Hounsfield unit.
10. The method of claim 1 further comprising providing a head and neck to the prosthetic femoral hip before calculating contact stress at the interface of the prosthetic femoral hip stem and the patient's femur.
11. The method of claim 1 further comprising performing a calculating step before using finite element analysis.