A methodology to develop a patient-specific 3D musculoskeletal model based on MRI, ground reaction forces and motion capture data

2015 ◽  
Vol 6 (2) ◽  
pp. 5
Author(s):  
Arnaud Van Branteghem ◽  
Jan Victor ◽  
Patrick De Baets ◽  
Matthias Verstraete
Keyword(s):  
Motion Capture ◽  
Reaction Force ◽  
3D Models ◽  
Lower Limbs ◽  
Patient Specific ◽  
Knee Prostheses ◽  
Replacement Surgery ◽  
Precise Calculation ◽  
Musculoskeletal Models ◽  
Total Knee

The well-documented dissatisfaction of patients with the results of their total knee replacement surgery has been the incentive for deeper research into the optimisation of knee prostheses. One way to optimise total knee replacements is to develop patient-specific 3D musculoskeletal models, enabling a better understanding of the kinematics and kinetics affecting the lower limbs of the patient. This paper suggests a particular methodology to build such personalised models, by implementing data of additional measurement systems. MRI scanning ensures a morphological match between the model and the patient. Additionally, ground reaction force measurements coupled with motion capture provide the kinematic input. A squat test was performed to illustrate the usefulness of the data obtained through the force plates. The combination of this data into the 3D models allows for a more precise calculation and simulation of knee joints. This will ultimately improve the quality of prosthesis testing in a knee-rig setup by providing more accurate boundary conditions.

scholarly journals Anti-Phospholipid Antibodies in Patients Undergoing Total Joint Replacement Surgery

Thrombosis ◽  
2012 ◽  
Vol 2012 ◽  
pp. 1-5 ◽  
Author(s):  
Melissa Simpson ◽  
Michael J. Sanfelippo ◽  
Adedayo A. Onitilo ◽  
James K. Burmester ◽  
William Hocking ◽  
...  
Keyword(s):  
Joint Replacement ◽  
Total Joint Replacement ◽  
Patient Specific ◽  
Preoperative Period ◽  
Joint Replacement Surgery ◽  
Replacement Surgery ◽  
Increased Risk ◽  
Patients At Risk ◽  
Total Knee ◽  
Arthroplasty Procedure

Background. Patients undergoing joint replacement remain at increased risk for venous thromboembolism (VTE) compared to other types of surgery, regardless of thromboprophylactic regimen. The pathophysiologic processes rendering this group of patients at risk for VTE are multifactorial. Procedure-specific and patient-specific exposures play a role in the postoperative development of VTE, including the development of anti-phospholipid antibodies (aPL). Methods. We measured three aPL (anti-cardiolipin, anti-β2 glycoprotein, and lupus anticoagulant) in 123 subjects undergoing total knee or hip arthroplasty to describe the presence of these antibodies preoperatively and to describe the rate of postoperative seroconversion among those people who were negative preoperatively. Postoperative antibodies were measured at day 7, 14, and 21. Results. The prevalence of aPL antibodies in the preoperative period was 44%, positive subjects were more likely to be smokers (P=0.05) and were less likely to have undergone a previous arthroplasty procedure (P=0.002). Subjects seroconverted in a 21 day postoperative period at a rate of 79%. Conclusions. These pilot data suggest that the prevalence of aPL in this population both preoperatively and postoperatively is higher than previously expected. Further studies are needed to describe aPL in a larger population and to establish their clinical significance in populations undergoing joint replacement surgeries.

BIOMECHANICAL MECHANISMS FOR DAMAGE: RETRIEVAL ANALYSIS AND COMPUTATIONAL WEAR PREDICTIONS IN TOTAL KNEE REPLACEMENTS

2005 ◽  
Vol 05 (03) ◽  
pp. 469-475 ◽  
Author(s):  
MELINDA K. HARMAN ◽  
SCOTT A. BANKS ◽  
BENJAMIN J. FREGLY ◽  
W. GREGORY SAWYER ◽  
W. ANDREW HODGE
Keyword(s):  
Total Knee Replacement ◽  
Knee Replacement ◽  
Articular Surface ◽  
Knee Kinematics ◽  
Dynamic Contact ◽  
Cartilage Degeneration ◽  
Patient Specific ◽  
Knee Prostheses ◽  
Joint Biomechanics ◽  
Total Knee

Damage patterns on the articular surface of the proximal tibia, including cartilage degeneration in osteoarthritic knees and damage of polyethylene knee prostheses after total knee replacement, provide information related to knee joint biomechanics and damage mechanisms at the articular surface. This study reports articular damage patterns and knee kinematics assessed in the knees of older subjects, before and after total knee replacement. The damage patterns are used to evaluate computational dynamic contact and tribological models that predict polyethylene damage in a patient-specific total knee replacement model.

scholarly journals Does Computer-Assisted Femur First THR Improve Musculoskeletal Loading Conditions?

2015 ◽  
Vol 2015 ◽  
pp. 1-16 ◽  
Author(s):  
Tim A. Weber ◽  
Sebastian Dendorfer ◽  
Joachim Grifka ◽  
Gijsbertus J. Verkerke ◽  
Tobias Renkawitz
Keyword(s):  
Gait Analysis ◽  
Early Stage ◽  
Reaction Force ◽  
Minimal Invasive ◽  
Patient Specific ◽  
Computer Assisted ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Force Magnitude ◽  
Musculoskeletal Models

We have developed a novel, computer-assisted operation method for minimal-invasive total hip replacement (THR) following the concept of “femur first/combined anteversion,” which incorporates various aspects of performing a functional optimization of the prosthetic stem and cup position (CAS FF). The purpose of this study is to assess whether the hip joint reaction forces and patient’s gait parameters are being improved by CAS FF in relation to conventional THR (CON). We enrolled 60 patients (28 CAS FF/32 CON) and invited them for gait analysis at three time points (preoperatively, postop six months, and postop 12 months). Data retrieved from gait analysis was processed using patient-specific musculoskeletal models. The target parameters were hip reaction force magnitude (hrf), symmetries, and orientation with respect to the cup. Hrf in the CAS FF group were closer to a young healthy normal. Phase-shift symmetry showed an increase in the CAS FF group. Hrf orientation in the CAS FF group was closer to optimum, though no edge or rim-loading occurred in the CON group as well. The CAS FF group showed an improved hrf orientation in an early stage and a trend to an improved long-term outcome.

Total Hospital Costs and Readmission Rate of Patient-Specific Instrument in Total Knee Arthroplasty Patients

2020 ◽  
Author(s):  
Stephen Thomas ◽  
Ankur Patel ◽  
Corey Patrick ◽  
Gary Delhougne
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Hospital Cost ◽  
Readmission Rate ◽  
Hospital Costs ◽  
Patient Specific ◽  
P Value ◽  
Total Hospital Cost ◽  
Total Hospital ◽  
Total Knee

AbstractDespite advancements in surgical technique and component design, implant loosening, stiffness, and instability remain leading causes of total knee arthroplasty (TKA) failure. Patient-specific instruments (PSI) aid in surgical precision and in implant positioning and ultimately reduce readmissions and revisions in TKA. The objective of the study was to evaluate total hospital cost and readmission rate at 30, 60, 90, and 365 days in PSI-guided TKA patients. We retrospectively reviewed patients who underwent a primary TKA for osteoarthritis from the Premier Perspective Database between 2014 and 2017 Q2. TKA with PSI patients were identified using appropriate keywords from billing records and compared against patients without PSI. Patients were excluded if they were < 21 years of age; outpatient hospital discharges; evidence of revision TKA; bilateral TKA in same discharge or different discharges. 1:1 propensity score matching was used to control patients, hospital, and clinical characteristics. Generalized Estimating Equation model with appropriate distribution and link function were used to estimate hospital related cost while logistic regression models were used to estimate 30, 60, and 90 days and 1-year readmission rate. The study matched 3,358 TKAs with PSI with TKA without PSI patients. Mean total hospital costs were statistically significantly (p < 0.0001) lower for TKA with PSI ($14,910; 95% confidence interval [CI]: $14,735–$15,087) than TKA without PSI patients ($16,018; 95% CI: $15,826–$16,212). TKA with PSI patients were 31% (odds ratio [OR]: 0.69; 95% CI: 0.51–0.95; p-value = 0.0218) less likely to be readmitted at 30 days; 35% (OR: 0.65; 95% CI: 0.50–0.86; p-value = 0.0022) less likely to be readmitted at 60 days; 32% (OR: 0.68; 95% CI: 0.53–0.88; p-value = 0.0031) less likely to be readmitted at 90 days; 28% (OR: 0.72; 95% CI: 0.60–0.86; p-value = 0.0004) less likely to be readmitted at 365 days than TKA without PSI patients. Hospitals and health care professionals can use retrospective real-world data to make informed decisions on using PSI to reduce hospital cost and readmission rate, and improve outcomes in TKA patients.

scholarly journals Quality Control in 3D Printing: Accuracy Analysis of 3D-Printed Models of Patient-Specific Anatomy

Materials ◽  
2021 ◽  
Vol 14 (4) ◽  
pp. 1021
Author(s):  
Bernhard Dorweiler ◽  
Pia Elisabeth Baqué ◽  
Rayan Chaban ◽  
Ahmed Ghazy ◽  
Oroa Salem
Keyword(s):  
Wall Thickness ◽  
Large Scale ◽  
Fused Deposition Modeling ◽  
Vascular Anatomy ◽  
3D Models ◽  
Patient Specific ◽  
Stl File ◽  
Fused Deposition ◽  
3D Printed ◽  
The Mean

As comparative data on the precision of 3D-printed anatomical models are sparse, the aim of this study was to evaluate the accuracy of 3D-printed models of vascular anatomy generated by two commonly used printing technologies. Thirty-five 3D models of large (aortic, wall thickness of 2 mm, n = 30) and small (coronary, wall thickness of 1.25 mm, n = 5) vessels printed with fused deposition modeling (FDM) (rigid, n = 20) and PolyJet (flexible, n = 15) technology were subjected to high-resolution CT scans. From the resulting DICOM (Digital Imaging and Communications in Medicine) dataset, an STL file was generated and wall thickness as well as surface congruency were compared with the original STL file using dedicated 3D engineering software. The mean wall thickness for the large-scale aortic models was 2.11 µm (+5%), and 1.26 µm (+0.8%) for the coronary models, resulting in an overall mean wall thickness of +5% for all 35 3D models when compared to the original STL file. The mean surface deviation was found to be +120 µm for all models, with +100 µm for the aortic and +180 µm for the coronary 3D models, respectively. Both printing technologies were found to conform with the currently set standards of accuracy (<1 mm), demonstrating that accurate 3D models of large and small vessel anatomy can be generated by both FDM and PolyJet printing technology using rigid and flexible polymers.

scholarly journals Complex wall modeling for hemodynamic simulations of intracranial aneurysms based on histologic images

2021 ◽  
Vol 16 (4) ◽  
pp. 597-607
Author(s):  
Annika Niemann ◽  
Samuel Voß ◽  
Riikka Tulamo ◽  
Simon Weigand ◽  
Bernhard Preim ◽  
...  
Keyword(s):  
Wall Thickness ◽  
Vessel Wall ◽  
Intracranial Aneurysms ◽  
Geometric Model ◽  
Image Data ◽  
Outer Wall ◽  
3D Models ◽  
Patient Specific ◽  
Intracranial Vessel ◽  
Hemodynamic Simulations

Abstract Purpose For the evaluation and rupture risk assessment of intracranial aneurysms, clinical, morphological and hemodynamic parameters are analyzed. The reliability of intracranial hemodynamic simulations strongly depends on the underlying models. Due to the missing information about the intracranial vessel wall, the patient-specific wall thickness is often neglected as well as the specific physiological and pathological properties of the vessel wall. Methods In this work, we present a model for structural simulations with patient-specific wall thickness including different tissue types based on postmortem histologic image data. Images of histologic 2D slices from intracranial aneurysms were manually segmented in nine tissue classes. After virtual inflation, they were combined into 3D models. This approach yields multiple 3D models of the inner and outer wall and different tissue parts as a prerequisite for subsequent simulations. Result We presented a pipeline to generate 3D models of aneurysms with respect to the different tissue textures occurring in the wall. First experiments show that including the variance of the tissue in the structural simulation affect the simulation result. Especially at the interfaces between neighboring tissue classes, the larger influence of stiffer components on the stability equilibrium became obvious. Conclusion The presented approach enables the creation of a geometric model with differentiated wall tissue. This information can be used for different applications, like hemodynamic simulations, to increase the modeling accuracy.

scholarly journals The Design and Simulation of a 16-Sensors Plantar Pressure Insole Layout for Different Applications: From Sports to Clinics, a Pilot Study

Sensors ◽  
2021 ◽  
Vol 21 (4) ◽  
pp. 1450
Author(s):  
Alfredo Ciniglio ◽  
Annamaria Guiotto ◽  
Fabiola Spolaor ◽  
Zimi Sawacha
Keyword(s):  
Pressure Distribution ◽  
Plantar Pressure ◽  
Center Of Pressure ◽  
Reaction Force ◽  
Weight Lifting ◽  
Lower Limbs ◽  
Plantar Pressure Distribution ◽  
Drop Landing ◽  
Mean Pressure ◽  
Footwear Design

The quantification of plantar pressure distribution is widely done in the diagnosis of lower limbs deformities, gait analysis, footwear design, and sport applications. To date, a number of pressure insole layouts have been proposed, with different configurations according to their applications. The goal of this study is to assess the validity of a 16-sensors (1.5 × 1.5 cm) pressure insole to detect plantar pressure distribution during different tasks in the clinic and sport domains. The data of 39 healthy adults, acquired with a Pedar-X® system (Novel GmbH, Munich, Germany) during walking, weight lifting, and drop landing, were used to simulate the insole. The sensors were distributed by considering the location of the peak pressure on all trials: 4 on the hindfoot, 3 on the midfoot, and 9 on the forefoot. The following variables were computed with both systems and compared by estimating the Root Mean Square Error (RMSE): Peak/Mean Pressure, Ground Reaction Force (GRF), Center of Pressure (COP), the distance between COP and the origin, the Contact Area. The lowest (0.61%) and highest (82.4%) RMSE values were detected during gait on the medial-lateral COP and the GRF, respectively. This approach could be used for testing different layouts on various applications prior to production.

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