Total hip arthroplasty purposes to replace a hip joint damaged by an artificial hip joint. However, the developed products that already exist in the market lead to the mismatch between the hip implant equipment and the patient’s bone morphometric. Besides causing complications, the mismatch also continues to the dislocation effects, fracture, osteolysis, and thigh pain. This paper aims to design a customized hip implant based on real patient data, particularly for Indonesian patient, limited to the acetabular components and stem parts. The computed images were analyzed to estimate the patient proximal femur morphometric; those are the femoral head diameter, neck-shaft angle, mediolateral width, anteroposterior width, neck length and neck width. The experiment has succeeded in designing the acetabular shell with the thickness of 3 mm, the acetabular liner with the thickness of 6 mm, the femoral head between 22.4 to 24.8 mm, the short stem in both the right for 110.656 mm and left femur bone for 111.49 mm; that fit the patient's femur bone. Overall, the proposed steps in designing the customized hip implant in this work, based on image analysis on medical imaging data, can be a standard to be applied for other patient-needs hip arthroplasty implants.
Total Hip Replacement Implant Designing and its Computational Analysis using ...IRJET Journal
This document discusses the design and computational analysis of a total hip replacement implant using finite element analysis (FEA). Researchers designed a patient-specific implant based on CT scans of femur bones. They used Mimics software to extract 3D models of femurs from CT data and measure dimensions. AutoCAD was used to design the implant based on the dimensions. FEA was performed using ANSYS on implant designs made of different materials to analyze mechanical strength and stability. Models with and without pores were analyzed to study how pores may improve osseointegration. The goal is to create implants tailored to individual patients' anatomy to increase compatibility and implant life.
Additive Manufacturing and Testing of a Prosthetic Foot Ankle Jointijtsrd
Ankle replacement is a fairly new concept and is one of the popular treatments of ankle fractures and arthritis. This project focuses on modelling and 3D Printing of a prosthetic talocrural joint. The standard sizes of tibia which is the larger bone of lower leg and talus being lower part of the ankle joint, are observed and modeled accordingly by using CATIA with standard dimensions. The prototype is made with PLA plastic using an FDM Fused Deposition Modelling 3D printer. The analytical tests carried on ANSYS by applying human weight on the tibial surface and physical tests are conducted on Universal testing machine. The compression force is applied on the prototype and observed till failure. Results obtained are compared for static position of the foot, of both analytical and physical outcomes. Yogesh Avula | Adi Seshan Mula | Vishal Onnala | Kartheek Merugu ""Additive Manufacturing and Testing of a Prosthetic Foot Ankle Joint"" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-3 | Issue-3 , April 2019, URL: https://www.ijtsrd.com/papers/ijtsrd23216.pdf
Paper URL: https://www.ijtsrd.com/engineering/bio-mechanicaland-biomedical-engineering/23216/additive-manufacturing-and-testing-of-a-prosthetic-foot-ankle-joint/yogesh-avula
Functional outcome of Arthroscopic reconstruction of single bundle anterior c...iosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
1) The document describes a study comparing computer-assisted mandibular reconstruction using vascularized iliac crest bone grafts to conventional reconstruction techniques.
2) With computer-assisted planning, a surgical guide was designed based on CT scans and used to precisely shape and position the bone graft. This method aimed to reduce operating time and bone removal compared to conventional techniques.
3) Results found that with computer-assisted planning, the bone graft fit perfectly into the mandibular defect with less adjustment needed. Operating time and bone removed were also reduced compared to conventional techniques. Patients reported higher satisfaction with their appearance.
This document presents a study analyzing stress levels in various materials used in total knee replacements under static conditions. A 3D model of a knee prosthesis was created in SolidWorks. Finite element analysis was then performed in ABAQUS to calculate stress, contact pressure, and deformation in different biomaterials. The materials analyzed for the femoral component included 316L stainless steel, cobalt-chromium alloy, titanium alloy, porous tantalum, and zirconia. Ultra-high molecular weight polyethylene was used for the tibial component. An analytic hierarchy process was used to determine the best femoral material considering factors like stress levels, strain, density, and osseointegration. The results indicated titanium alloy experienced the highest stress and strain
Modelling and static analysis of femur bone by using different implant materialsIOSR Journals
Femur is leg bone of the human body Undergoing more deformation. Biomechanics is the theory of
how tissues, cells, muscles, bones, organs and the motion of them and how their form and function are
regulated by basic mechanical properties. The aim of this study is to create a model of real proximal human
femur bone and the behavior of femur bone is analyzed in ANSYS under physiological load conditions.
A finite element model of bones is generated by using CT scan data are being widely used to make
realistic investigations on the mechanical behavior of bone structures. . Orthopedic implantation is done in case
of failure. Before implantation it is necessary to analyze the perfectness in case of its material property, size and
shape, surface treatment, load resistance and chances of failure. Analysis is done for the stresses formed in
different femur implant materials under static loading condition using ANSYS software.
Analysis is done on different materials like structural steel, and Ti-6Al-4V implant materials. Since
each femur carries 1/2 the body weight , analysis is done for 550kg,650kg, 750kg load, including the cases of
patient carrying certain weight. And based on the analysis it can be concluded that, while comparing these two
implant materials Ti-6Al-4V gave less deformation on static load conditions. TI-6AL4V is a low density
material, which has excellent bio compatible and mechanical properties, it is ideal for the use of an implant in surgeries. Finally the success of implantation depends on implant material and size, implantation method and
its handling by the patient
Lumbar disk 3D modeling from limited number of MRI axial slices IJECEIAES
This paper studies the problem of clinical MRI analysis in the field of lumbar intervertebral disk herniation diagnosis. It discusses the possibility of assisting radiologists in reading the patient's MRI images by constructing a 3D model for the region of interest using simple computer vision methods. We use axial MRI slices of the lumbar area. The proposed framework works with a very small number of MRI slices and goes through three main stages. Namely, the region of interest extraction and enhancement, inter-slice interpolation, and 3D model construction. We use the Marching Cubes algorithm to construct the 3D model of the region of interest. The validation of our 3D models is based on a radiologist's analysis of the models. We tested the proposed 3D model construction on 83 cases and We have a 95% accuracy according to the radiologist evaluation. This study shows that 3D model construction can greatly ease the task of the radiologist which enhances the working experience. This leads eventually to a more accurate and easy diagnosis process.
The document describes a study that used COMSOL Multiphysics software to create an approximate bone model and apply different pressures to analyze von-mises stress and displacement. An approximate bone model was constructed in COMSOL using geometric shapes. Pressures of 25Pa and 50Pa were applied and the von-mises stress and displacement were observed. The results for the approximate bone model were similar to those of an actual bone model, showing this method can be used to monitor bone diseases by simulating stresses on bone.
Total Hip Replacement Implant Designing and its Computational Analysis using ...IRJET Journal
This document discusses the design and computational analysis of a total hip replacement implant using finite element analysis (FEA). Researchers designed a patient-specific implant based on CT scans of femur bones. They used Mimics software to extract 3D models of femurs from CT data and measure dimensions. AutoCAD was used to design the implant based on the dimensions. FEA was performed using ANSYS on implant designs made of different materials to analyze mechanical strength and stability. Models with and without pores were analyzed to study how pores may improve osseointegration. The goal is to create implants tailored to individual patients' anatomy to increase compatibility and implant life.
Additive Manufacturing and Testing of a Prosthetic Foot Ankle Jointijtsrd
Ankle replacement is a fairly new concept and is one of the popular treatments of ankle fractures and arthritis. This project focuses on modelling and 3D Printing of a prosthetic talocrural joint. The standard sizes of tibia which is the larger bone of lower leg and talus being lower part of the ankle joint, are observed and modeled accordingly by using CATIA with standard dimensions. The prototype is made with PLA plastic using an FDM Fused Deposition Modelling 3D printer. The analytical tests carried on ANSYS by applying human weight on the tibial surface and physical tests are conducted on Universal testing machine. The compression force is applied on the prototype and observed till failure. Results obtained are compared for static position of the foot, of both analytical and physical outcomes. Yogesh Avula | Adi Seshan Mula | Vishal Onnala | Kartheek Merugu ""Additive Manufacturing and Testing of a Prosthetic Foot Ankle Joint"" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-3 | Issue-3 , April 2019, URL: https://www.ijtsrd.com/papers/ijtsrd23216.pdf
Paper URL: https://www.ijtsrd.com/engineering/bio-mechanicaland-biomedical-engineering/23216/additive-manufacturing-and-testing-of-a-prosthetic-foot-ankle-joint/yogesh-avula
Functional outcome of Arthroscopic reconstruction of single bundle anterior c...iosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
1) The document describes a study comparing computer-assisted mandibular reconstruction using vascularized iliac crest bone grafts to conventional reconstruction techniques.
2) With computer-assisted planning, a surgical guide was designed based on CT scans and used to precisely shape and position the bone graft. This method aimed to reduce operating time and bone removal compared to conventional techniques.
3) Results found that with computer-assisted planning, the bone graft fit perfectly into the mandibular defect with less adjustment needed. Operating time and bone removed were also reduced compared to conventional techniques. Patients reported higher satisfaction with their appearance.
This document presents a study analyzing stress levels in various materials used in total knee replacements under static conditions. A 3D model of a knee prosthesis was created in SolidWorks. Finite element analysis was then performed in ABAQUS to calculate stress, contact pressure, and deformation in different biomaterials. The materials analyzed for the femoral component included 316L stainless steel, cobalt-chromium alloy, titanium alloy, porous tantalum, and zirconia. Ultra-high molecular weight polyethylene was used for the tibial component. An analytic hierarchy process was used to determine the best femoral material considering factors like stress levels, strain, density, and osseointegration. The results indicated titanium alloy experienced the highest stress and strain
Modelling and static analysis of femur bone by using different implant materialsIOSR Journals
Femur is leg bone of the human body Undergoing more deformation. Biomechanics is the theory of
how tissues, cells, muscles, bones, organs and the motion of them and how their form and function are
regulated by basic mechanical properties. The aim of this study is to create a model of real proximal human
femur bone and the behavior of femur bone is analyzed in ANSYS under physiological load conditions.
A finite element model of bones is generated by using CT scan data are being widely used to make
realistic investigations on the mechanical behavior of bone structures. . Orthopedic implantation is done in case
of failure. Before implantation it is necessary to analyze the perfectness in case of its material property, size and
shape, surface treatment, load resistance and chances of failure. Analysis is done for the stresses formed in
different femur implant materials under static loading condition using ANSYS software.
Analysis is done on different materials like structural steel, and Ti-6Al-4V implant materials. Since
each femur carries 1/2 the body weight , analysis is done for 550kg,650kg, 750kg load, including the cases of
patient carrying certain weight. And based on the analysis it can be concluded that, while comparing these two
implant materials Ti-6Al-4V gave less deformation on static load conditions. TI-6AL4V is a low density
material, which has excellent bio compatible and mechanical properties, it is ideal for the use of an implant in surgeries. Finally the success of implantation depends on implant material and size, implantation method and
its handling by the patient
Lumbar disk 3D modeling from limited number of MRI axial slices IJECEIAES
This paper studies the problem of clinical MRI analysis in the field of lumbar intervertebral disk herniation diagnosis. It discusses the possibility of assisting radiologists in reading the patient's MRI images by constructing a 3D model for the region of interest using simple computer vision methods. We use axial MRI slices of the lumbar area. The proposed framework works with a very small number of MRI slices and goes through three main stages. Namely, the region of interest extraction and enhancement, inter-slice interpolation, and 3D model construction. We use the Marching Cubes algorithm to construct the 3D model of the region of interest. The validation of our 3D models is based on a radiologist's analysis of the models. We tested the proposed 3D model construction on 83 cases and We have a 95% accuracy according to the radiologist evaluation. This study shows that 3D model construction can greatly ease the task of the radiologist which enhances the working experience. This leads eventually to a more accurate and easy diagnosis process.
The document describes a study that used COMSOL Multiphysics software to create an approximate bone model and apply different pressures to analyze von-mises stress and displacement. An approximate bone model was constructed in COMSOL using geometric shapes. Pressures of 25Pa and 50Pa were applied and the von-mises stress and displacement were observed. The results for the approximate bone model were similar to those of an actual bone model, showing this method can be used to monitor bone diseases by simulating stresses on bone.
An Automated Pelvic Bone Geometrical Feature Measurement Utilities on Ct Scan...IOSR Journals
This document discusses an automated system for measuring geometric features of the pelvic bone from CT scan images. The system uses patch statistical shape models and a multilevel measurement utility to determine pelvic orientation based on image calibration. It aims to help orthopedic surgeons locate damage areas and landmarks more accurately, especially for obese patients where manual palpation is difficult. The system involves experts to analyze statistical values generated from the measurements to inform treatment decisions.
Wavelets in Medical Image Processing On Hip Arthroplasty and De-Noising, Segm...IOSR Journals
This document discusses the use of wavelet transforms for medical image processing, specifically for hip arthroplasty. It provides background on wavelet transforms and how they can be used for tasks like de-noising and segmentation. The document then describes the key parameters measured in hip arthroplasty, including parameters from anterior-posterior and anterior-lateral x-rays both before and after prosthesis insertion. It also discusses using the DICOM standard to organize medical image data and extracting information from DICOM files.
This document discusses the 3D modeling of the knee joint using CT/MRI scan data and MIMICS software for the purpose of designing a custom knee implant. Key steps included segmenting the distal femur and proximal tibia from images, creating a 3D surface model, and designing a knee implant using reverse engineering that precisely matches the patient's bone geometry. The custom implant was found to mimic the natural curvature of the knee joint better than standard implants, allowing for more natural motion. Accuracy was improved over previous CAD models by using medical images and accounting for variability in bone density across different regions.
Finite Element Analysis of Osteosynthesis Miniplate for the Reconstruction of...UniversitasGadjahMada
In the last two decades, the use of osteosynthesis miniplate has been growing to aid the healing process and reconstruction of fractured mandibular bone. In principle, the plate is used to provide stable fixation of the fractured bone tissue during the healing process and reconstruction. Based on earlier studies, it is noted that arrangements and geometry of the osteosynthesis miniplate played a critical role in determining the stability of the fractured mandibular bone, as well as the miniplate. In this research, a simulation with finite element method (FEM) was carried out to investigate the influence of the number of holes in an osteosynthesis miniplate on the stability of fractured mandibular bone and the corresponding miniplate after the implantation. For this purpose, a set of osteosynthesis miniplate with three different configurations was taken for simulation using a three-dimensional (3D) model of mandibular bone generated from the patient through computed tomography (CT). The result of the simulation showed that all the miniplates with three configurations tested were stable enough to prevent movement of fractured mandibular bone. Moreover, fixation with a pair of miniplates having four screw holes demonstrated the desired result; as indicated by the lowest value of displacement, pressure on the bone surface and pressure on the miniplate.
The document describes a study that measured the morphology of patellae from southern Chinese volunteers using 3D models reconstructed from CT scans. The following key points were found:
1. Male patellae were significantly larger than female patellae in height, width, thickness and other metrics.
2. There were no statistically significant differences between left and right patellae within each gender.
3. Comparisons to previous Western studies found the southern Chinese patellae tended to be thinner and smaller.
4. Measurements between height, width, thickness and other metrics were highly correlated within each patella.
This document describes the process of creating a 3D CAD model of the human knee joint from CT scan data using reverse engineering and Mimics software. Key points:
- CT scan data of a 25-year-old male's knee was used to generate DICOM images, which were then imported into Mimics.
- Mimics software uses density segmentation to distinguish bone, soft tissues, and other structures based on pixel intensity in the images.
- Each bone segment was reconstructed separately through manual editing of density masks generated by Mimics.
- The final 3D model exported from Mimics in STL file format can be used for applications like surgical simulation and implant design where an accurate knee model is needed
Vertebra osteoporosis detection based on bone density using Index-Singh stati...TELKOMNIKA JOURNAL
Osteoporosis is a progressive decrease in bone density so that the bones become brittle and broken. Bones are composed of minerals such as calcium and phosphate, so the bones become hard and solid. Many people do not realize that osteoporosis is a silent disease. Therefore, early detection of osteoporosis is very important. Detection of osteoporosis can be done by utilizing x-ray images of the vertebra. In this research the detection of bone density using blended statistical methods and Index-Singh. The x-ray sample used in this research was 50 images of osteoporosis patients. The result of the area calculation yields the highest white pixel is 7,983 pixels and the lowest white pixel is 5,410 pixels. Based on the results of these calculations, a statistical grouping is conducted into 6 Index-Singh. The range of statistical values is 5,410–6,266 pixels grouped into Index-Singh 1, range of data 6,323–6,512 pixels grouped into Index-Singh 2, the data range 6,520-6,747 pixels grouped into Index-Singh 3, data range 6,778-6,998 pixels grouped into Index-Singh 4, data range 7,001-7,219 pixels grouped into Index-Singh 5, and data range 7,338-7,983 pixels grouped into Index-Singh 6. Overall, the results of testing the osteoporosis detection system have been successful and can be used as an early detection system for osteoporosis. This assistance system has a detection accuracy of 76% compared to doctor's justification.
Management of OA knee by osteotomies around the knee.docxSanthosh Raj
1. Dr. Santhosh Raj BK is conducting a study to evaluate the functional outcomes and cartilage regeneration for patients with medial compartment osteoarthritis of the knee joint following osteotomies.
2. The study will assess patients' functionality before and after distal femoral osteotomy or high tibial osteotomy using various scales. MRI and arthroscopy will also be used to examine cartilage status and regeneration.
3. During surgery, patients will receive platelet-rich plasma injections into damaged cartilage areas in addition to osteotomies and other procedures like ACL reconstruction or meniscal repair. Post-operative rehabilitation protocols will be followed.
This finite element analysis compared the stress distribution of two implant-supported prosthesis systems - one with implants placed in a straight line (straight system) and one with angled implants creating an offset (angled system). Both systems had three implants supporting a metal-ceramic prosthesis in the posterior mandible. Vertical and horizontal loads were applied. The results found that the peak stresses occurred at the neck of the mesial implant in the straight system and the distal implant in the angled system, but the values were similar between systems. There was no significant difference found in stress concentration between the two systems.
Biomechanical study, 3 d modeling and kinematic analysis of shoulder joint 2-3-4IAEME Publication
This document discusses a biomechanical study, 3D modeling, and kinematic analysis of the shoulder joint. It begins with an introduction to shoulder anatomy, including the clavicle, scapula, and humerus bones. It then reviews previous related studies on shoulder modeling. The paper describes 3D scanning and CAD modeling of the shoulder bones. A finite element analysis is performed on the meshed shoulder model to analyze von Mises stresses during flexion and extension motions. The modeling includes defining material properties of bones and muscles for the analysis.
Low-cost and open-source anthropomorphic prosthetics hand using linear actuatorsTELKOMNIKA JOURNAL
A robust, low cost, open-source, and low power consumption in the research of prosthetics hand is essential. The purpose of this study is to develop a low-cost, open-source anthropomorphic prosthetics hand using linear actuator based on electromyography (EMG) signal control. The main advantages of this proposed method are the low-cost, lightweight and simplicity of controlling the prosthetic hand using only single channel. This is achieved by evaluating the DC motor and exploring number of locations of the EMG signal. The development of prosthetics hand consists of 3D anthropomorphic hand design, active electrodes, microcontroller, and linear actuator. The active electrodes recorded the EMG signal from extensor carpi radialis longus. The built-in EMG amplifier on the electrode amplified the EMG signal. Further, the A/D converter in the Arduino microcontroller converted the analog signal into digital. A filtering process consisted of bandpass and notch filter was performed before it used as a control signal. The linear actuator controlled each finger for flexion and extension motion. In the assessment of the design, the prosthetic hand capable of grasping ten objects. In this study, the cost and weight of the prosthetics hand are 471.99 US$ and 0.531 kg, respectively. This study has demonstrated the design of low cost and opensource of prosthetics hand with reasonable cost and lightweight. Furthermore, this development could be applied to amputee subjects.
Osteoporosis Detection Using Deep LearningIJMTST Journal
Osteoporosis is a bone disorder which occurs due to low bone mass, degradation of bone micro-architecture
and high susceptibility to fracture. It is a major health concern across the world, especially in elderly people.
Osteoporosis can cause spinal or hip fractures that may lead to socio-economic burden and high morbidity.
Therefore, there is a need for the early diagnosis of osteoporosis and predicting the presence of the fracture.
We introduce a Convolutional Neural Network model to effectively diagnose osteoporosis in bone radiography
data. Automated diagnosis from digital radiographs is very challenging since the scans of healthy and
osteoporotic subjects show little or no visual differences. In this paper, we have proposed a model to separate
healthy from osteoporotic subjects using high dimensional textural feature representations computed from
radiography images. CNN can help us bring the use of structural MRI measurements of bone quality into
clinical practice for the detection of Osteoporosis as it gives high accuracy.
This document summarizes a study that performed a 3D finite element analysis of the human femur bone. The analysis used a 3D CAD model of the femur obtained from medical scans. The model was meshed and material properties were assigned to different bone tissues. Nonlinear analyses were conducted to simulate loads on the femur during normal activities. Results were compared to previous studies to validate the model. The study found that cancellous bone tissue reduces stresses in the femur, with its absence causing stresses almost double the amount.
Non linear 3 d finite element analysis of the femur boneeSAT Journals
Abstract In this paper a 3D stress analysis on the human femur is carried out with a view of understanding the stress and strain distributions coming into picture during normal day to day activities of a normal human being. This work was based on the third generation standard femur CAD model being provided by Rizzoli Orthopedic Institute. By locating salient geometric features on the CAD model with the VHP (Visible Human Project) femur model, material properties at four crucial locations were calculated and assigned to the current model and carried out a nonlinear analysis using a general purpose finite element software ABAQUS. Simulation of Marten’s study revealed that the highest stress formed in the absence of the cancellous tissue is almost double the value of stress formed with cancellous tissue. A comparative study was made with the Lotz’s model by taking into consideration two different sections near the head and neck of the femur. An exhaustive number of finite element analyses were carried out on the femur model, to simulate the actual scenario. Index Terms: Fracture, Cortex, Cancellous, femur bone, finite element
This document discusses several studies that have used machine learning and deep learning techniques to detect and predict osteoarthritis of the knee. It first provides an abstract that outlines common symptoms of knee osteoarthritis and describes the data set used, which includes knee X-ray information. It then summarizes several related works that have employed techniques like convolutional neural networks, clustering algorithms, and artificial neural networks to predict osteoarthritis severity, classify osteoarthritis stages, and determine the likelihood of requiring total knee replacement surgery based on radiographic and symptom data. The document concludes by mentioning a study that used a deep learning approach to predict cartilage degradation using MRI images of knees.
Image Analysis of Periapical Radiograph for Bone Mineral Density Prediction IJECEIAES
Osteoporosis is a systemic skeletal disease. Parameter from any bone site in the body has possibility to be developed as a predictor of osteoporosis. The alteration in the mandible trabecular bone is visible in periapical radiographs. The aim of this study was to correlate the area parameter and the integrated density of periapical radiograph with bone mineral density. Image analysis of periapical radiograph i.e. measurement of area parameter and integrated density was done on Region of Interest (ROI) by using canny edge detection method. Result of this study showed that the area parameter has asignificant (α<0.05) negative correlation with the bone mass density (BMD) of the lumbar spine (r = -0.371) and T-score of the lumbar spine (r = -0.383). The linear regression test showed that the area parameter only can be used to predict T-score of the lumbar spine (F=5.822, α<0.05). The integrated density showed a significant (α < 0.05) negative correlation with T-score of hip (r = -0.332) and T-score of lumbar spine (r = -0.377). It can be concluded that the area parameter can be used as one of input parameters for computeraided system of osteoporosis early detection by using periapical radiograph.
Comparison of X-ray and DXA for Evaluating OsteoporosisRSIS International
Osteoporosis is a thinning of the bone that leads to fracture with minimum force. It affects postmenopausal women and elderly of both genders. Bone Mineral Density (BMD) is one of the parameter related to bone strength. Dual Energy X-ray Absorptiometry (DXA) is currently considered as the “gold standard” for measuring BMD.To evaluate osteoporosis in postmenopausal women using low-cost digital hip radiograph in comparison with DXA as a gold standard; i) To evaluate the morphometry of proximal femur using digital radiograph in the diagnosing osteoporosis in Indian women. ii) To evaluate the morphometry of metacarpal using digital radiograph in the diagnosing osteoporosis in Indian women. iii) To evaluate the loss of trabeculae in the proximal femur using Singh’s index in Indian women. iv) To estimate of volumetric trabeculae at Neck of the Femur in the Evaluation of Osteoporosis. v) To calculate the energy at neck of the proximal femur using image processing technique.A free medical screening camp for osteoporosis was conducted at SRM Medical College and Research Institute. A total number of 50 (n=50) Indian women, 18 healthy pre menopausal women (n=18, 36.3 ± 8.7 years) and 32 post menopausal women (n=32, 58 ± 9.1 years) whose age ranged from 20- 85 years were included. A standard digital radiograph of the right hip was obtained in all study Indian women using a digital x-ray machine. The results obtained by DXA found that 20% and 34% of the Indian women were having osteoporosis and osteopenia respectively. The mean values of ratio of femoral length to femoral width (BC/DE), thickness of the medial Shaft Cortex (SC), width of the Acetabular bone (AW), lesser trochanter thickness of the Medial cortex (NC), and ratio of hip axis length to femoral width (AC/DE) were lesser in the osteoporotic Indian women than in normal Indian women. These values were found to be decreased by - 29%, -23%, -17%, -15%, and -10% respectively, when comparing to normal Indian women. The mean values of metacarpal index of all the five were decreased in osteoporotic patients by cortical thickness (D-d) and relative cortical thickness (D-d)/D was -31% -30.7% respectively, when comparing to normal Indian women. The femur neck and total hip BMD and Singh’s index were lesser by 41.6% and 33.7%,40% (p<0.01) respectively in osteoporotic post-menopausal women, comparing to normal post-menopausal women. The mean values of area and the volume of the proximal neck were decreased -20% and -21% in the osteoporotic Indian women than in normal Indian women.
An Expandable Prosthesis with Dual Cage-and-Plate Function in a Single Device...Erwin Chiquete, MD, PhD
Juan J. Ramı´rez, Erwin Chiquete, Juan J. Ramı´rez, Jr., Ernesto Go´mez-Limo´n, and Juan M. Ramı´rez
An expandable vertebral body prosthesis with dual cage-and-plate function in a single
device (JR prosthesis) was designed to test the hypothesis that this modular system can
provide the biomechanical requirements for immediate and durable spine stabilization
after corpectomy. Cadaver assays were performed with a stainless steal device to test fixation
and adequacy to the human spine anatomy. Then, 14 patients with vertebral tumors
(eight metastatic) underwent corpectomy and vertebral body replacement with a titaniummade
JR prosthesis. All patients had neurological deficit, severe pain and spine instability
prior to surgery. Mean pain score before surgery on a visual analog scale decreased from
7.6e3.0 points after operation ( p 5 0.002). All patients achieved at least one grade of
improvement in the Frankel score ( p 5 0.003), excepting the three patients with Frankel
grade A before surgery. Two patients with renal cell carcinoma died during the following
4 days after surgery. The remaining patients attained a painless and stable spine immediately,
which was maintained for long periods (mean follow-up: 25.4 months). No significant
infections or implant failures were registered. A nonfatal case of inferior vena cava
surgical injury was observed (repaired during surgery without further complications). In
conclusion, the JR prosthesis stabilizes the spine immediately after surgery and for the
rest of the patients’ life. To our knowledge, this is the first report on the clinical experience
of any expandable vertebral body prosthesis with dual cage-and-plate function in
a single device.
The document describes a study that aimed to reconstruct the 3D structure of the tibial nerve through micro-CT imaging. Tibial nerve samples were stained with calcium chloride and scanned with micro-CT to obtain 2D images. The nerve bundle contours were then extracted from these images using an automated algorithm. This allowed for the successful construction of a 3D model of the tibial nerve bundles. The 3D reconstruction provides detailed visualization of the nerve's internal structure and geometry. This technique is an improvement over previous methods and lays the foundation for further research on peripheral nerve anatomy and repair.
For discussion #1 if you have any questions ask I will ask the pro.docxlmelaine
For discussion #1 if you have any questions ask I will ask the professor. Use your best judgement as if you in the class must apa format 12 pt font reference slide in text citations. This is the only guidance there is. I would imagine you would just pull the information itself from the papers you already wrote and copy and paste along with citations. Due by Saturday December 7, 2019 at 10 am EST.
For Discussion #2 must be answered thoroughly. Must be APA format, answer thoroughly, must have at least 1-2 verifiable legitimate sources per discussion post and reflection discussion, must have in-text citations in each post and reflection. 250+ words needed per discussion and reflection post answering thoroughly. Due Thursday November 21, 2019. By 10 PM EST. . Plagiarism Free. Due by Saturday December 7, 2019 at 10 am
Discussion #1
Prepare a brief Power Point or equivalent visual presentation that summarized your capstone paper.
Be certain to highlight:
· Issue
· Analysis Summary
· Recommendations
Discussion #2
Module 5 contains a reading entitled 'Barriers to Change". Describe the key obstacle to implementing your recommendations in the issue study.
Please use this link:
https://www.linkedin.com/pulse/barriers-organizational-change-nnamdi-okeke-ph-d-
You must start a thread before you can read and reply to other threads
RESEARCH ARTICLE
Cervical Spine Injuries: A Whole-Body
Musculoskeletal Model for the Analysis of
Spinal Loading
Dario Cazzola
1*, Timothy P. Holsgrove2,3, Ezio Preatoni1, Harinderjit S. Gill2,
Grant Trewartha
1
1 Department for Health, University of Bath, Bath, United Kingdom, 2 Centre for Orthopaedic Biomechanics,
Department of Mechanical Engineering, University of Bath, Bath, United Kingdom, 3 College of Engineering,
Mathematics & Physical Sciences, University of Exeter, Exeter, United Kingdom
* [email protected]
Abstract
Cervical spine trauma from sport or traffic collisions can have devastating consequences
for individuals and a high societal cost. The precise mechanisms of such injuries are still
unknown as investigation is hampered by the difficulty in experimentally replicating the con-
ditions under which these injuries occur. We harness the benefits of computer simulation to
report on the creation and validation of i) a generic musculoskeletal model (MASI) for the
analyses of cervical spine loading in healthy subjects, and ii) a population-specific version of
the model (Rugby Model), for investigating cervical spine injury mechanisms during rugby
activities. The musculoskeletal models were created in OpenSim, and validated against in
vivo data of a healthy subject and a rugby player performing neck and upper limb move-
ments. The novel aspects of the Rugby Model comprise i) population-specific inertial proper-
ties and muscle parameters representing rugby forward players, and ii) a custom scapula-
clavicular joint that allows the application of multiple external loads. We confirm the utili ...
Redefining brain tumor segmentation: a cutting-edge convolutional neural netw...IJECEIAES
Medical image analysis has witnessed significant advancements with deep learning techniques. In the domain of brain tumor segmentation, the ability to
precisely delineate tumor boundaries from magnetic resonance imaging (MRI)
scans holds profound implications for diagnosis. This study presents an ensemble convolutional neural network (CNN) with transfer learning, integrating
the state-of-the-art Deeplabv3+ architecture with the ResNet18 backbone. The
model is rigorously trained and evaluated, exhibiting remarkable performance
metrics, including an impressive global accuracy of 99.286%, a high-class accuracy of 82.191%, a mean intersection over union (IoU) of 79.900%, a weighted
IoU of 98.620%, and a Boundary F1 (BF) score of 83.303%. Notably, a detailed comparative analysis with existing methods showcases the superiority of
our proposed model. These findings underscore the model’s competence in precise brain tumor localization, underscoring its potential to revolutionize medical
image analysis and enhance healthcare outcomes. This research paves the way
for future exploration and optimization of advanced CNN models in medical
imaging, emphasizing addressing false positives and resource efficiency.
Embedded machine learning-based road conditions and driving behavior monitoringIJECEIAES
Car accident rates have increased in recent years, resulting in losses in human lives, properties, and other financial costs. An embedded machine learning-based system is developed to address this critical issue. The system can monitor road conditions, detect driving patterns, and identify aggressive driving behaviors. The system is based on neural networks trained on a comprehensive dataset of driving events, driving styles, and road conditions. The system effectively detects potential risks and helps mitigate the frequency and impact of accidents. The primary goal is to ensure the safety of drivers and vehicles. Collecting data involved gathering information on three key road events: normal street and normal drive, speed bumps, circular yellow speed bumps, and three aggressive driving actions: sudden start, sudden stop, and sudden entry. The gathered data is processed and analyzed using a machine learning system designed for limited power and memory devices. The developed system resulted in 91.9% accuracy, 93.6% precision, and 92% recall. The achieved inference time on an Arduino Nano 33 BLE Sense with a 32-bit CPU running at 64 MHz is 34 ms and requires 2.6 kB peak RAM and 139.9 kB program flash memory, making it suitable for resource-constrained embedded systems.
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This document discusses the 3D modeling of the knee joint using CT/MRI scan data and MIMICS software for the purpose of designing a custom knee implant. Key steps included segmenting the distal femur and proximal tibia from images, creating a 3D surface model, and designing a knee implant using reverse engineering that precisely matches the patient's bone geometry. The custom implant was found to mimic the natural curvature of the knee joint better than standard implants, allowing for more natural motion. Accuracy was improved over previous CAD models by using medical images and accounting for variability in bone density across different regions.
Finite Element Analysis of Osteosynthesis Miniplate for the Reconstruction of...UniversitasGadjahMada
In the last two decades, the use of osteosynthesis miniplate has been growing to aid the healing process and reconstruction of fractured mandibular bone. In principle, the plate is used to provide stable fixation of the fractured bone tissue during the healing process and reconstruction. Based on earlier studies, it is noted that arrangements and geometry of the osteosynthesis miniplate played a critical role in determining the stability of the fractured mandibular bone, as well as the miniplate. In this research, a simulation with finite element method (FEM) was carried out to investigate the influence of the number of holes in an osteosynthesis miniplate on the stability of fractured mandibular bone and the corresponding miniplate after the implantation. For this purpose, a set of osteosynthesis miniplate with three different configurations was taken for simulation using a three-dimensional (3D) model of mandibular bone generated from the patient through computed tomography (CT). The result of the simulation showed that all the miniplates with three configurations tested were stable enough to prevent movement of fractured mandibular bone. Moreover, fixation with a pair of miniplates having four screw holes demonstrated the desired result; as indicated by the lowest value of displacement, pressure on the bone surface and pressure on the miniplate.
The document describes a study that measured the morphology of patellae from southern Chinese volunteers using 3D models reconstructed from CT scans. The following key points were found:
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Vertebra osteoporosis detection based on bone density using Index-Singh stati...TELKOMNIKA JOURNAL
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Management of OA knee by osteotomies around the knee.docxSanthosh Raj
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This finite element analysis compared the stress distribution of two implant-supported prosthesis systems - one with implants placed in a straight line (straight system) and one with angled implants creating an offset (angled system). Both systems had three implants supporting a metal-ceramic prosthesis in the posterior mandible. Vertical and horizontal loads were applied. The results found that the peak stresses occurred at the neck of the mesial implant in the straight system and the distal implant in the angled system, but the values were similar between systems. There was no significant difference found in stress concentration between the two systems.
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Osteoporosis Detection Using Deep LearningIJMTST Journal
Osteoporosis is a bone disorder which occurs due to low bone mass, degradation of bone micro-architecture
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Therefore, there is a need for the early diagnosis of osteoporosis and predicting the presence of the fracture.
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Image Analysis of Periapical Radiograph for Bone Mineral Density Prediction IJECEIAES
Osteoporosis is a systemic skeletal disease. Parameter from any bone site in the body has possibility to be developed as a predictor of osteoporosis. The alteration in the mandible trabecular bone is visible in periapical radiographs. The aim of this study was to correlate the area parameter and the integrated density of periapical radiograph with bone mineral density. Image analysis of periapical radiograph i.e. measurement of area parameter and integrated density was done on Region of Interest (ROI) by using canny edge detection method. Result of this study showed that the area parameter has asignificant (α<0.05) negative correlation with the bone mass density (BMD) of the lumbar spine (r = -0.371) and T-score of the lumbar spine (r = -0.383). The linear regression test showed that the area parameter only can be used to predict T-score of the lumbar spine (F=5.822, α<0.05). The integrated density showed a significant (α < 0.05) negative correlation with T-score of hip (r = -0.332) and T-score of lumbar spine (r = -0.377). It can be concluded that the area parameter can be used as one of input parameters for computeraided system of osteoporosis early detection by using periapical radiograph.
Comparison of X-ray and DXA for Evaluating OsteoporosisRSIS International
Osteoporosis is a thinning of the bone that leads to fracture with minimum force. It affects postmenopausal women and elderly of both genders. Bone Mineral Density (BMD) is one of the parameter related to bone strength. Dual Energy X-ray Absorptiometry (DXA) is currently considered as the “gold standard” for measuring BMD.To evaluate osteoporosis in postmenopausal women using low-cost digital hip radiograph in comparison with DXA as a gold standard; i) To evaluate the morphometry of proximal femur using digital radiograph in the diagnosing osteoporosis in Indian women. ii) To evaluate the morphometry of metacarpal using digital radiograph in the diagnosing osteoporosis in Indian women. iii) To evaluate the loss of trabeculae in the proximal femur using Singh’s index in Indian women. iv) To estimate of volumetric trabeculae at Neck of the Femur in the Evaluation of Osteoporosis. v) To calculate the energy at neck of the proximal femur using image processing technique.A free medical screening camp for osteoporosis was conducted at SRM Medical College and Research Institute. A total number of 50 (n=50) Indian women, 18 healthy pre menopausal women (n=18, 36.3 ± 8.7 years) and 32 post menopausal women (n=32, 58 ± 9.1 years) whose age ranged from 20- 85 years were included. A standard digital radiograph of the right hip was obtained in all study Indian women using a digital x-ray machine. The results obtained by DXA found that 20% and 34% of the Indian women were having osteoporosis and osteopenia respectively. The mean values of ratio of femoral length to femoral width (BC/DE), thickness of the medial Shaft Cortex (SC), width of the Acetabular bone (AW), lesser trochanter thickness of the Medial cortex (NC), and ratio of hip axis length to femoral width (AC/DE) were lesser in the osteoporotic Indian women than in normal Indian women. These values were found to be decreased by - 29%, -23%, -17%, -15%, and -10% respectively, when comparing to normal Indian women. The mean values of metacarpal index of all the five were decreased in osteoporotic patients by cortical thickness (D-d) and relative cortical thickness (D-d)/D was -31% -30.7% respectively, when comparing to normal Indian women. The femur neck and total hip BMD and Singh’s index were lesser by 41.6% and 33.7%,40% (p<0.01) respectively in osteoporotic post-menopausal women, comparing to normal post-menopausal women. The mean values of area and the volume of the proximal neck were decreased -20% and -21% in the osteoporotic Indian women than in normal Indian women.
An Expandable Prosthesis with Dual Cage-and-Plate Function in a Single Device...Erwin Chiquete, MD, PhD
Juan J. Ramı´rez, Erwin Chiquete, Juan J. Ramı´rez, Jr., Ernesto Go´mez-Limo´n, and Juan M. Ramı´rez
An expandable vertebral body prosthesis with dual cage-and-plate function in a single
device (JR prosthesis) was designed to test the hypothesis that this modular system can
provide the biomechanical requirements for immediate and durable spine stabilization
after corpectomy. Cadaver assays were performed with a stainless steal device to test fixation
and adequacy to the human spine anatomy. Then, 14 patients with vertebral tumors
(eight metastatic) underwent corpectomy and vertebral body replacement with a titaniummade
JR prosthesis. All patients had neurological deficit, severe pain and spine instability
prior to surgery. Mean pain score before surgery on a visual analog scale decreased from
7.6e3.0 points after operation ( p 5 0.002). All patients achieved at least one grade of
improvement in the Frankel score ( p 5 0.003), excepting the three patients with Frankel
grade A before surgery. Two patients with renal cell carcinoma died during the following
4 days after surgery. The remaining patients attained a painless and stable spine immediately,
which was maintained for long periods (mean follow-up: 25.4 months). No significant
infections or implant failures were registered. A nonfatal case of inferior vena cava
surgical injury was observed (repaired during surgery without further complications). In
conclusion, the JR prosthesis stabilizes the spine immediately after surgery and for the
rest of the patients’ life. To our knowledge, this is the first report on the clinical experience
of any expandable vertebral body prosthesis with dual cage-and-plate function in
a single device.
The document describes a study that aimed to reconstruct the 3D structure of the tibial nerve through micro-CT imaging. Tibial nerve samples were stained with calcium chloride and scanned with micro-CT to obtain 2D images. The nerve bundle contours were then extracted from these images using an automated algorithm. This allowed for the successful construction of a 3D model of the tibial nerve bundles. The 3D reconstruction provides detailed visualization of the nerve's internal structure and geometry. This technique is an improvement over previous methods and lays the foundation for further research on peripheral nerve anatomy and repair.
For discussion #1 if you have any questions ask I will ask the pro.docxlmelaine
For discussion #1 if you have any questions ask I will ask the professor. Use your best judgement as if you in the class must apa format 12 pt font reference slide in text citations. This is the only guidance there is. I would imagine you would just pull the information itself from the papers you already wrote and copy and paste along with citations. Due by Saturday December 7, 2019 at 10 am EST.
For Discussion #2 must be answered thoroughly. Must be APA format, answer thoroughly, must have at least 1-2 verifiable legitimate sources per discussion post and reflection discussion, must have in-text citations in each post and reflection. 250+ words needed per discussion and reflection post answering thoroughly. Due Thursday November 21, 2019. By 10 PM EST. . Plagiarism Free. Due by Saturday December 7, 2019 at 10 am
Discussion #1
Prepare a brief Power Point or equivalent visual presentation that summarized your capstone paper.
Be certain to highlight:
· Issue
· Analysis Summary
· Recommendations
Discussion #2
Module 5 contains a reading entitled 'Barriers to Change". Describe the key obstacle to implementing your recommendations in the issue study.
Please use this link:
https://www.linkedin.com/pulse/barriers-organizational-change-nnamdi-okeke-ph-d-
You must start a thread before you can read and reply to other threads
RESEARCH ARTICLE
Cervical Spine Injuries: A Whole-Body
Musculoskeletal Model for the Analysis of
Spinal Loading
Dario Cazzola
1*, Timothy P. Holsgrove2,3, Ezio Preatoni1, Harinderjit S. Gill2,
Grant Trewartha
1
1 Department for Health, University of Bath, Bath, United Kingdom, 2 Centre for Orthopaedic Biomechanics,
Department of Mechanical Engineering, University of Bath, Bath, United Kingdom, 3 College of Engineering,
Mathematics & Physical Sciences, University of Exeter, Exeter, United Kingdom
* [email protected]
Abstract
Cervical spine trauma from sport or traffic collisions can have devastating consequences
for individuals and a high societal cost. The precise mechanisms of such injuries are still
unknown as investigation is hampered by the difficulty in experimentally replicating the con-
ditions under which these injuries occur. We harness the benefits of computer simulation to
report on the creation and validation of i) a generic musculoskeletal model (MASI) for the
analyses of cervical spine loading in healthy subjects, and ii) a population-specific version of
the model (Rugby Model), for investigating cervical spine injury mechanisms during rugby
activities. The musculoskeletal models were created in OpenSim, and validated against in
vivo data of a healthy subject and a rugby player performing neck and upper limb move-
ments. The novel aspects of the Rugby Model comprise i) population-specific inertial proper-
ties and muscle parameters representing rugby forward players, and ii) a custom scapula-
clavicular joint that allows the application of multiple external loads. We confirm the utili ...
Similar to Computed tomography image analysis for Indonesian total hip arthroplasty designs (20)
Redefining brain tumor segmentation: a cutting-edge convolutional neural netw...IJECEIAES
Medical image analysis has witnessed significant advancements with deep learning techniques. In the domain of brain tumor segmentation, the ability to
precisely delineate tumor boundaries from magnetic resonance imaging (MRI)
scans holds profound implications for diagnosis. This study presents an ensemble convolutional neural network (CNN) with transfer learning, integrating
the state-of-the-art Deeplabv3+ architecture with the ResNet18 backbone. The
model is rigorously trained and evaluated, exhibiting remarkable performance
metrics, including an impressive global accuracy of 99.286%, a high-class accuracy of 82.191%, a mean intersection over union (IoU) of 79.900%, a weighted
IoU of 98.620%, and a Boundary F1 (BF) score of 83.303%. Notably, a detailed comparative analysis with existing methods showcases the superiority of
our proposed model. These findings underscore the model’s competence in precise brain tumor localization, underscoring its potential to revolutionize medical
image analysis and enhance healthcare outcomes. This research paves the way
for future exploration and optimization of advanced CNN models in medical
imaging, emphasizing addressing false positives and resource efficiency.
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As demand for smaller, quicker, and more powerful devices rises, Moore's law is strictly followed. The industry has worked hard to make little devices that boost productivity. The goal is to optimize device density. Scientists are reducing connection delays to improve circuit performance. This helped them understand three-dimensional integrated circuit (3D IC) concepts, which stack active devices and create vertical connections to diminish latency and lower interconnects. Electrical involvement is a big worry with 3D integrates circuits. Researchers have developed and tested through silicon via (TSV) and substrates to decrease electrical wave involvement. This study illustrates a novel noise coupling reduction method using several electrical involvement models. A 22% drop in electrical involvement from wave-carrying to victim TSVs introduces this new paradigm and improves system performance even at higher THz frequencies.
Electric vehicle and photovoltaic advanced roles in enhancing the financial p...IJECEIAES
Climate change's impact on the planet forced the United Nations and governments to promote green energies and electric transportation. The deployments of photovoltaic (PV) and electric vehicle (EV) systems gained stronger momentum due to their numerous advantages over fossil fuel types. The advantages go beyond sustainability to reach financial support and stability. The work in this paper introduces the hybrid system between PV and EV to support industrial and commercial plants. This paper covers the theoretical framework of the proposed hybrid system including the required equation to complete the cost analysis when PV and EV are present. In addition, the proposed design diagram which sets the priorities and requirements of the system is presented. The proposed approach allows setup to advance their power stability, especially during power outages. The presented information supports researchers and plant owners to complete the necessary analysis while promoting the deployment of clean energy. The result of a case study that represents a dairy milk farmer supports the theoretical works and highlights its advanced benefits to existing plants. The short return on investment of the proposed approach supports the paper's novelty approach for the sustainable electrical system. In addition, the proposed system allows for an isolated power setup without the need for a transmission line which enhances the safety of the electrical network
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Fossil fuel consumption increased quickly, contributing to climate change
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and they succeeded in playing a noticeable role in reducing climate change.
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examine the role of women in addressing the climate change. The analysis's
findings discussed the relevant to the sustainable development goals (SDGs),
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highlight how women have influenced policies and actions related to climate
change, point out areas of research deficiency and recommendations on how
to increase role of the women in addressing the climate change and
achieving sustainability. To achieve more successful results, this initiative
aims to highlight the significance of gender equality and encourage
inclusivity in climate change decision-making processes.
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Computed tomography image analysis for Indonesian total hip arthroplasty designs
1. International Journal of Electrical and Computer Engineering (IJECE)
Vol. 12, No. 6, December 2022, pp. 6123~6131
ISSN: 2088-8708, DOI: 10.11591/ijece.v12i6.pp6123-6131 6123
Journal homepage: http://ijece.iaescore.com
Computed tomography image analysis for Indonesian total hip
arthroplasty designs
Talitha Asmaria1
, Dita Ayu Mayasari2
, Alfensa Dinda Gestara Febrananda2
, Nadiya Nurul2
,
Ahmad Jabir Rahyussalim3,4
, Ika Kartika1
1
Research Center for Metallurgy, National Research and Innovation Agency, South Tangerang, Indonesia
2
Department of Biomedical Engineering, University of Dian Nuswantoro, Semarang, Indonesia
3
Faculty of Medicine, University of Indonesia, Jakarta, Indonesia
3
Department of Orthopedic, Cipto Mangunkusumo Hospital, Jakarta, Indonesia
Article Info ABSTRACT
Article history:
Received Jul 21, 2021
Revised Jun 11, 2022
Accepted Jul 7, 2022
Total hip arthroplasty purposes to replace a hip joint damaged by an artificial
hip joint. However, the developed products that already exist in the market
lead to the mismatch between the hip implant equipment and the patient’s
bone morphometric. Besides causing complications, the mismatch also
continues to the dislocation effects, fracture, osteolysis, and thigh pain. This
paper aims to design a customized hip implant based on real patient data,
particularly for Indonesian patient, limited to the acetabular components and
stem parts. The computed images were analyzed to estimate the patient
proximal femur morphometric; those are the femoral head diameter,
neck-shaft angle, mediolateral width, anteroposterior width, neck length and
neck width. The experiment has succeeded in designing the acetabular shell
with the thickness of 3 mm, the acetabular liner with the thickness of 6 mm,
the femoral head between 22.4 to 24.8 mm, the short stem in both the right
for 110.656 mm and left femur bone for 111.49 mm; that fit the patient's
femur bone. Overall, the proposed steps in designing the customized hip
implant in this work, based on image analysis on medical imaging data, can
be a standard to be applied for other patient-needs hip arthroplasty implants.
Keywords:
Acetabular components
Computed tomography
Patient-specific implant
Stem design
Total hip arthroplasty
This is an open access article under the CC BY-SA license.
Corresponding Author:
Talitha Asmaria
Research Center for Metallurgy, National Research and Innovation Agency
Building 473, Research Center for Metallurgy, Puspiptek Area, South Tangerang, Banten 15314, Indonesia
Email: talitha.asmaria@brin.go.id
1. INTRODUCTION
Total hip arthroplasty (THA) is an orthopaedical surgery procedure to replace the acetabulum
cartilage with an artificial metal shell. The head and neck of the femur are replaced by a prosthesis in the
form of a rod and a ball made of metal [1]. It is one of the most cost-effective operations and the most
successful operation compared to surgeries in other orthopedic fields [2]. The hip implants mainly consist of
two components: acetabular components and femoral stem. The first reported hip implant was generated by
Philip Wiles in 1938 using a metal-on-metal bearing [3]. Based on research by McKee, the hip implant using
a metal-on-metal approach faced problems of loosening and subsequent mechanical failure [3]. Investigations
about finding the most effective hip implant design and materials have always been conducted to manage the
issues. The study of the femoral stem is vital to appraise clinical success due to its compatibility within the
proximal femur [4]. Nowadays, there is a wide range of hip implant designs differing in geometric features
and configurations to closely mimic a patient’s hip geometry [5], [6]. On the latest cutting-edge implant
design technology, computed tomography scanning (CT-Scan) or magnetic resonance imaging (MRI) images
2. ISSN: 2088-8708
Int J Elec & Comp Eng, Vol. 12, No. 6, December 2022: 6123-6131
6124
are used to define the best measurement for implant design, including hip and knee [7], [8]. Particularly in
the Indonesian case, a previous study has succeeded measuring the three-dimensional (3D) morphometry of
proximal femur to design the best-fit femoral stem for the Indonesian population [9]. However, in that work,
it only focused on giving the proposed dimension of proximal femur component with no hip implant design
result for the Indonesian data.
THA offers new hope for the osteoarthritis (OA) patient, in particular for the recovery process, the
functional restoration, quality of life improvement in a better condition [10]. As the main cause of joint
movement disorders, OA has affected more than 30 million people in the United States (US) and about 41 of
a thousand people per year in the United Kingdom (UK) [11]. In 2018, Indonesia had a 7.3% prevalence rate
of joint disease, continuing to increase. OA is the most common joint disease in Indonesia [12]. The high
number of OA sufferers worldwide causes a substantial increase in THA procedures. A lot of health
companies manufacture hip prostheses to meet the needs of THA in global demand. THA is also used for
people who suffer from a fracture of the neck femur, congenital abnormalities, tumor, joint damage, and
other hip joint diseases [13]. However, the companies that produce the hip prosthesis of hip implants
currently only use the proximal femur parameter of western society to reference the dimensions [9].
According to the world population review (WPR), the countries that are included in the western community
category (WCC) are countries in the continent of Europe, America, and Australia [14]. Research reveals that
the size of the proximal femur in Indonesian society is smaller than in western civilization after conducting a
comparison experiment of the proximal femur size using multinational data [9]. Femoral morphology and
size are different between men and women [15]. Because there is a variation of femur proximal measures, not
all hip implants in the market are suitable with bone morphometry. If the size of the applied hip prosthesis or
the hip implant does not match the patient’s body morphometry, it will cause discomfort to the patient. The
mismatch between the hip implant and bone morphometry leads to dislocation, fracture, osteolysis, and other
complications. Therefore, composing the THA design that is adapted to bone morphometry is essential.
This work aims to design a customized hip implant based on femoral proximal Indonesian female
morphometry measurement using the latest correlated literacy [9]. In 2019, Tuong [16] summarized from
several previous works that femur geometrical parameters of the Vietnamese population are different from
Asian people, those are Thai, Malay, Indian, and Japanese. All those works employed very complex methods
from generating medical imaging data, creating it into 3D models of the femur bone, measuring the femur
geometrical parameters, designing the implant, and finding it very time-consuming. Besides that, the image
processing steps in the reverse engineering of femur bone may be leaving inaccuracies. The 3D
reconstruction of femur bone can be replaced using multiplanar reconstruction to simplify the process, and it
is more accurate for measuring the bone morphometry [17]. Furthermore, the literacy of patient-specific hip
implant design for Indonesian people, particularly for women, is very limited. The plan will significantly
contribute to the scientific recommendation regarding the implant design in the most suitable THA based on
bone morphometry of the Indonesian people.
2. RESEARCH METHOD
The research method consists of two main stages: data acquisition and parameters measurement.
The data was acquired from a CT-Scan 128 slice dual source belonging to the Cipto Mangunkusumo Hospital
Jakarta with the permission of the radiologist and the orthopedist. The equipment can perform organ
reconstruction in 3D with a very short examination time and provides a high-resolution picture. The data is a
type of CT pelvis or lower abdomen. It consists of 374 images loaded in the multiplanar reconstruction
feature in Radiant Dicom with a free 30-days trial. The patient is female, has a weight of 61 kg, a height of
165 cm, and 49 years old. In this work, we apply five parameters that are used for designing the hip implant;
those are femoral head diameter (FHD), mediolateral width (MLW), anteroposterior width (APW), neck shaft
angle (NSA), neck length (NL), and neck width (NW). Figure 1 shows the FHD measurement. FHD is
measured from the edge of the femoral head bone to another edge [18]. The MLW and APW are calculated
on an axial plane horizontally and vertically and consist of 3 types. Figure 2 shows the three types are 20 mm
above the lesser trochanter, 20 mm below the lesser trochanter, and 40 mm below the lesser trochanter.
Figure 3 exhibits the APW and MLW for all three types in the right and left femurs [9]. APW1 and MLW1
for right femur are in Figure 3(a) and left femur are in Figure 3(b). APW2 and MLW2 for right femur are in
Figure 3(c) and left femur are in Figure 3(d). APW3 and MLW3 for right femur are in Figure 3(e) and left
femur are in Figure 3(f). NSA is the angle between the femoral head and passing through the shaft. NL is the
length between the femoral head center and the femoral axis. NW is the width of the femoral neck measured
horizontally. The neck width is also measured to estimate the acetabular head. Figures 4 displays the NSA in
Figure 4(a), NL, and NW measurements in Figure 4(b) [18]. Parameter measurement results will be discussed
as the main considerations for designing the implants. In this study, we used Autodesk Inventor Professional.
3. Int J Elec & Comp Eng ISSN: 2088-8708
Computed tomography image analysis for Indonesian total hip arthroplasty designs (Talitha Asmaria)
6125
Figure 1. FHD measurement
Figure 2. MLW and APW measurements
(a) (b) (c)
(d) (e) (f)
Figure 3. MLW1 and APW1 measurement on the (a) right femur and (b) left femur, MLW2 and APW2
measurement on the (c) right femur and (d) left femur, and MLW3 and APW3 measurement on the (e) right
femur and (f) left femur
4. ISSN: 2088-8708
Int J Elec & Comp Eng, Vol. 12, No. 6, December 2022: 6123-6131
6126
(a) (b)
Figure 4. Measurement on the right and left femur for the (a) NSA and (b) NL and NW
3. RESULTS AND DISCUSSION
According to the measurement results in this study as seen in Table 1, compared to several
measurements in other different ethnic groups, as shown in Table 2, the Indonesian data has several smaller
numbers of the proximal femur in almost available parameter measurements than Indian, Swiss, France, Thai,
and American [19]–[23]. The femur proximal measurement results will be fundamental to design the
acetabular components and stem. The most appropriate size for the design of acetabular components is
following the patient’s femoral head diameter [19].
Table 1. The measurement of Indonesian woman’s proximal femur
Variable Right Left Mean
Femoral head diameter 42.8 mm 40.4 mm 41.6 mm
Mediolateral Width 1 43.0 mm 40.0 mm 41.5 mm
Mediolateral Width 2 11.0 mm 11.0 mm 11.0 mm
Mediolateral Width 3 7.0 mm 9.6 mm 8.3 mm
Anterioposterior Width 1 26.6 mm 25.3 mm 25.95 mm
Anteroposterior Width 2 11.2 mm 11.2 mm 11.2 mm
Anteroposterior Width 3 9.47 mm 9.47 mm 9.47 mm
Neck Shaft Angle 119.4° 124.7° 122.05°
Neck Length
Neck Width
37.9 mm
23.1 mm
34.9 mm
23.1 mm
34.6 mm
23.1 mm
Table 2. Comparison of proximal femur measurement reported in different studies (n= number of specimens)
Parameter Indonesian
(n=2)
Indian [20]
(n=400 and 98)
Mean+SD
Swiss [21]
(n=32)
Mean+SD
Western [22]
(n=75)
Mean+SD
Thai [23]
(n=240)
Mean+SD
American [24]
(n=120)
Mean+SD
Femoral head diameter (mm) 41.6 41.0 2.70 46.29+4.02 45.53+3.40 43.1+3.44 45.88+3.61
Neck Shaft Angle (°) 122.05 132.62+5.50 126.35+4.29 123.65+4.29 127.45+5.00 122.52+ 3.09
Neck Length/Width (mm) 34.6/23.1 28.59+2.92 - - 44.91+3.94 25.21 4.76
Table 3 shows the calculation for acetabular components [25], [26]. The thickness of 3 mm will be
very suitable for acetabular shell because it has higher stiffness than the 4 mm thickness [25]. A thickness of
6 mm was applied for the acetabular liner based on the recommendation to prevent the fracture [26]. In this
study, the size of the femoral head is in the classification of the small femoral head size, which is not less
than 22 mm and does not exceed 28 mm [27]. Figure 5 shows the left acetabular components configuration in
Figure 5(a) and the right one in Figure 5(b), whereby 1 and 3 are acetabular shell and femoral head with
metal and 2 is acetabular liner with polymer. Compared with the previous studies, when the acetabular
component exceeds the size of the patient's femoral head, it may lead to fracture [13]. Dislocation may occur
if the acetabular component is smaller than the size of the patient's femoral head. The acetabular components
design has been adjusted to the femoral head patient’s morphometry.
FHD, MLW, APW, and NSA are the main considerations in stem design [18]. Table 4 shows all
estimations in the femoral stem design. Figure 6 for the left femur and Figure 7 for the right femur illustrate
detailed dimensions and points to assist the design estimation. The NSA and NL are functioning to estimate
and reduce the area’s torque during the load cycle [4]. The femoral stem width varies depending on the
mediolateral width size [28]. Estimation of the slope angle between the stem and the neck on the femoral
5. Int J Elec & Comp Eng ISSN: 2088-8708
Computed tomography image analysis for Indonesian total hip arthroplasty designs (Talitha Asmaria)
6127
stem is considered by measuring the NSA [4]. The femoral stem’s NL is considered by calculating the femur
bone’s NL [4]. A femoral stem’s length can be categorized into two types, a conventional stem with more
than 120 mm and short stem with less than 120 mm [29], [30]. Those two studies conclude that the short stem
has more clinical success and provides reliable long-term results. The risk of intraoperative fracture and stem
loosening tends to be smaller than other types [31]. The short stem does not require a lot of bone to be drilled
so that the remaining available bone will provide an opportunity for further revision surgery [29]. In this
work, the stem length (point A to point I in Figures 6 and 7) is drawn less than 12 cm and has been justifying
the bone patient’s morphometry. The femoral stem length in this work is comprised of the line from A-I-J-K-
I. The letter A is a point where the line of intersection between the y-axis and the NSA.
Table 3. The calculation for acetabular components
Component Right Left Notes
Acetabular Shell DAS = DL − ∆xAS
DAS = 42,8 − (3 + 3)
DAS = 42,8 − 6
DAS = 36,8
DAS = DL − ∆xAS
DAS = 40,4 − (3 + 3)
DAS = 40,4 − 6
DAS = 34,4
DAS=Inside diameter of acetabular shell
DL=Outside diameter of acetabular shell
Δx=X1+X2
X=Thickness
AS= Acetabular shell
AL=Acetabular liner
DAL=Inside diameter of acetabular liner
FH=Femoral head
DFH=Inside diameter of femoral head
Acetabular Liner DAL = DAS − ∆xAL
DAL = 36,8 − (6 + 6)
DAL = 36,8 − 12
DAL = 24,8
DAL = DAS − ∆xAL
DAL = 34,4 − (6 + 6)
DAL = 34,4 − 12
DAL = 22,4
Femoral Head DFH = DL − (∆xAS + ∆xAL)
DFH = 42,8 − (6 + 12)
DFH = 42,8 − 18
DFH = 24,8
DFH = DL − (∆xAS + ∆xAL)
DFH = 40,4 − (6 + 12)
DFH = 40,4 − 18
DFH = 22,4
(a)
(b)
Figure 5. Design of acetabular components for (a) left femur and (b) right femur. 1, 2, and 3 indicate
acetabular shell, acetabular liner, and femoral head
The lesser trochanter is located in the H letter. The MLW1 is 20 mm above parallel to the H letter.
The MLW 2 is 40 mm below the lesser trochanter. The distance of I to J will be a representative distance
between MLW1 and MLW2. The MLW3 is 20 mm below the MLW2. The distance of J-K is a concept of
distance between MLW2 and MLW3. In the APW parameter, the minimum number that has been obtained is
9.47 mm. The APW has the main attention to estimating the femoral stem thickness. The femoral stem
cannot properly fit into the bone cavity if the femoral stem thickness is greater than the minimum size of
APW [18]. Here, we apply a thickness of 8 mm to allow the stem to enter the bone. Rawal et al. [18] have
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been proposed the dimension of the femoral stem for the Indian population. If we look at the proposed extent
of the Indian women population, Indian has slightly higher numbers in all proximal femur morphometry
parameters. The proposed dimension was three types of stem lengths: 120 mm, 125 mm, and 130 mm [18].
Compared with our design, in which the size stems are 110.656 mm for the right implant and 111.49 mm for
the left implant, our plan has a shorter dimension than the Indian. Based on the created hip implant design,
the design is close to the patient’s proximal femur morphometry. As the first literacy to design the THA
based on the real patient’s CT, particularly in the Indonesian race, this paper expects being a main reference
in the patient-specific or customized hip implant design based on medical images such as CT-scan and
magnetic resonance imaging (MRI). Since we intend to understand the need for a special patient that will not
match general commercial hip implants, the measured data in this study is limited to only one case. The
number of specimens should be increased to have a more comprehensive study in a specific clan.
Table 4. Femoral stem design estimation
Variable Right Left Determination
H-B (mm) 43 40 Based on MLW 1 parameter measurement
G-C (mm) 11 11 Based on MLW 2 parameter measurement
F-D (mm) 7 9.6 Based on MLW 3 parameter measurement
I-J (mm) 60 60 The distance between MLW 1 and MLW 2
J-K (mm) 20 20 The distance between MLW 2 and MLW 3
K-E (mm) 20 20 The distance between MLW 3 and the edge of femoral stem
A-E (mm) 110.656 111.49 Femoral stem length
I-L (mm) 37.9 34.9 Based on Neck Length parameter measurement
< LIE (o
) 119.4 124.7 Based on Neck Shaft Angle parameter measurement
Thickness
(mm)
8 8 Based on minimum APW parameter: 9.47 mm. There is a 1.47 mm gap between
implant and bone to provide a place for bone ingrowth
Figure 6. Stem design for the left femur consists of detailed dimensions and variables for the design
estimation
In the hip implant’s manufacturing process, the material selection will be the main factor in an
implant application’s success after a proper design. The latest trend of hip implant manufactures four types
material, which are metal-on-polyethylene (MoP), metal-on-metal (MoM), ceramic-on-ceramic (CoC), and
ceramic-on-polyethylene (CoP) [32]. But recently, hybrid combinations of several types were introduced
[32]. There are several considerations for choosing the best material, such as implant cost, patient age, and
the patient’s activity level. This experiment is limited to a rough surface with a very specific dimension.
Latest literacy reports that a detailed modification using uncemented, flat, and tapered stems can achieve
osteointegration for distal profile [33]. The manufacture of the optimal THA design, adapted to the
biocompatible material, will allow the clinical trial, such as preliminary investigation on the cadaver. Using a
patient need dimension for the THA components combined with the latest trends for both acetabular and stem
will complete the THA study.
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Figure 7. Stem design for the right femur consists of detailed dimensions and variables for the design
estimation
4. CONCLUSION
A hip implant design has been created based on the proximal femur morphometric of the Indonesian
woman patient CT data. From all measured parameters, the hip implants have been designed with these
specifications: the right and left stem length of 110.656 mm and 111.49 mm; the acetabular shell with the
inside diameter of 36.8 mm for right and 34.4 mm for left with each thickness of 3 mm, the acetabular liner
with the inside diameter of 24.8 mm for the right and 22.4 for the left with the thickness of 6 mm, and
femoral head with a diameter of 24.8 mm for right and 22.4 mm for left. The design can be a major
recommendation regarding the most suitable hip implant based on the patient’s bone morphometry using
medical image analysis. Material selection and further modification will improve the progress after having a
fitting design.
ACKNOWLEDGEMENTS
The authors thank Indonesian Endowment Fund for Education for the funding of data CT-Scan
acquirement. Dr. Marcel Prasetyo, Sp. Rad(K) guided us to understand all measurement techniques. The
elements of ethics in publishing the medical images obtained from the external source, has been approved by
the authorized radiologist and the orthopedist from Cipto Mangunkusumo Hospital.
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BIOGRAPHIES OF AUTHORS
Talitha Asmaria received a bachelor of engineering in biomedical engineering
major in 2012 from Airlangga University, Surabaya, Indonesia. She has completed her MSc
degree in 2016 from biomedical engineering at the University of Bristol, United Kingdom.
She is currently an early career researcher in the Research Center for Metallurgy, National
Research and Innovation Agency, Indonesia, and a lecturer in the biomedical engineering
study program, International University of Liasion Indonesia. Her research interest is implant
planning, which includes design analysis, image processing, material development, and 3D
printing technology. She can be contacted at email: talitha.asmaria@brin.go.id.
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Dita Ayu Mayasari graduated with a biomedical engineering bachelor’s degree
at Airlangga University in 2014 and a master of biotechnology from the University of Gajah
Mada in 2016. She is working as a lecturer in the Department of Biomedical Engineering,
Dian Nuswantoro University, Indonesia. Her interest is in biomechanics, biomaterials and
tissue engineering. She can be contacted at email: mayasari.dita@dsn.dinus.ac.id.
Alfensa Dinda Gestara Febrananda is currently taking a bachelor’s degree in
Biomedical Engineering from Dian Nuswantoro University, Indonesia. She works as a
laboratory assistant in the biomedical engineering laboratory at Dian Nuswantoro University.
Her research interests are implants, surgery procedures, and the healthcare system. She can be
contacted at email: alfensadinda@gmail.com.
Nadiya Nurul is a third-grade bachelor student in Biomedical Engineering at
Dian Nuswantoro University, Indonesia. She also works as a laboratory assistant in the
biomedical engineering laboratory at Dian Nuswantoro University. Her research interest is
implant planning, including the design and implant materials. She can be contacted at email:
nadiyanurul1999@gmail.com.
Ahmad Jabir Rahyussalim received a Bachelor of Medical Education in 1996, a
specialist program equivalent to a master’s degree in orthopedics and traumatology in 2008,
and a doctoral degree in 2013 from the University of Indonesia. Dr. dr. Rahyussalim,
Sp.OT(K) is currently a lecturer and a consultant specialist in orthopedics and traumatology at
the Faculty of Medicine, University of Indonesia and Cipto Mangunkusumo Hospital,
Indonesia (FKUI-RSCM). His research interest is stem cells, biodegradable materials,
biomaterials, spine interventions, and orthopedics implants. He can be contacted at email:
rahyussalim71@ui.ac.id.
Ika Kartika received a bachelor of metallurgy engineering in 1996 from General
Achmad Yani University, a master’s degree in material engineering in 2006 from Institute
Technology of Bandung, and a doctoral degree in 2010 from Institute of Material Research,
Tohuku University. Dr. Ika Kartika is currently a senior researcher and the research group
coordinator of biocompatible material and biomedical application in the Research Center for
Metallurgy, National Research and Innovation Agency, Indonesia. Her research interest is
biodegradable magnesium alloys, biocompatible cobalt and titanium alloys, and implant
technology. She can be contacted at email: ikak001@brin.go.id.