Towards a patient-specific estimation of intra-operative femoral fracture risk.

L Esposito, P Bifulco, P Gargiulo, M K Gíslason, M Cesarelli, L Iuppariello, H Jónsson, A Cutolo, M Fraldi

Journal: Computer methods in biomechanics and biomedical engineering 2019;21(12):663-672

PMID: 30370789

Abstract

Total Hip Arthroplasty requires pre-surgical evaluation between un-cemented and cemented prostheses. A Patient with intra-operative periprosthetic fracture and another with a successful outcome were recruited, and their finite element models were constructed by processing CT data, assuming elastic-plastic behavior of the bone as function of the local density. To resemble the insertion of the prosthesis into the femur, a fictitious thermal dilatation is applied to the broach volume. Strain-based fracture risk factor is estimated, depicting results in terms of the total mechanical strain expressed using a simple "traffic lights" color code to provide immediate, concise, and intelligible pre-operative information to surgeons.

Address: a Department of Structures for Engineering and Architecture (DiSt), Polytechnic School - College of Engineering , University of Naples Federico II , Naples , Italy.; b Department of Electric Engineering and Information Technologies (DIETI), Polytechnic School - College of Engineering , University of Naples Federico II , Naples , Italy.; c Institute for Biomedical and Neural Engineering, Department of Science , Landspítali University Hospital, University of Iceland , Reykjavik , Iceland.; d Department of Orthopaedic Sciences , Landspítali University Hospital, University of Iceland , Reykjavik , Iceland.; e Department of Chemical, Materials and Production Engineering (DIC-MAPI), Polytechnic School - College of Engineering , University of Naples Federico II , Naples , Italy.; f Interdisciplinary Research Centre for Biomaterials (CRIB) , University of Naples Federico II , Naples , Italy.

DOI: 10.1080/10255842.2018.1508570

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MeSH Terms: Arthroplasty, Replacement, Hip, Female, Femoral Fractures, Femur, Humans, Male, Risk Factors, Stress, Mechanical