Skip to main content
Log in

Radiograph-based femur morphing method

  • Published:
Medical and Biological Engineering and Computing Aims and scope Submit manuscript

Abstract

Many applications in orthopaedic surgery require the creation of personalised design models that can serve as the basis for navigation in computer aided surgery systems or be used to create a personalised model to perform structural analysis during pre-operative planning or post-operative follow-up. The paper introduces a method for developing a three-dimensional (3D) patient-specific model of a femur bone from an antero-posterior radiograph. A generic femur was employed and was altered on the basis of bone boundaries visible on radiographs. Morphological errors were evaluated against 3D models obtained from computed tomography (CT) scans. When only the antero-posterior radiograph was used, the average radius estimation error was 4.8 mm, the average percentage area estimation error was 14%, and the average percentage estimation error for inertial moments was 15%. If both the medial-lateral and the anterior-posterior radiographs were used, these errors were 2.0 mm, 5% and 7%, respectively. The procedure described can be profitably employed whenever CT scans are not available, such as during a retrospective analysis, or when CT scans cannot be justified because of X-ray exposure and cost considerations.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  • Adam, F., Hammer, D. S., Pape, D., andKohn, D. (2002): ‘Femoral anatomy, computed tomography and computer-aided design of prosthetic implants’,Arch. Orthop. Trauma Surg.,122, pp. 262–268

    Google Scholar 

  • Bargar, M. D. (1989): ‘Shape the implant to the patient’,Clin. Orthop.,249, pp. 73–78

    Google Scholar 

  • Bert, J. M. (1996): ‘Custom total hip arthroplasty’,J. Arthroplasty,11, pp. 905–915

    Google Scholar 

  • Bianco, P. T., Bechtold, J. E., Kyle, R. F., andGustilo, R. B. (1989): ‘Synthetic composite femurs for use in evaluation of torsional stability of cementless femoral prosthesis’, inTorzilli, P. A., andFriedman, M. H. (Eds): ‘Proc. Biomechanics Symposium’, (AMD, A.S.M.E., New York, USA), pp 297–300

    Google Scholar 

  • Bignardi, C., Calderale, P. M., Giacosa, F., andIeropoli, O. (1995): ‘FEM analysis of bone-implant system by using videodensitometric measurements’, inPower, H., andHart, R. T. (Eds): Computer simulations in biomedicine’ (Computational Mechanics Publications, Southampton, UK), pp. 301–308

    Google Scholar 

  • Calderale, P. M., Cannas, M., Bignardi, C., Giacosa, F., Leonardi, F., Massè, A., andVivalda, P. (1993): ‘Biomechanical study of clinical results of orthopaedic implants by means of X-ray image observations’,Proc. 2nd Polish-Italian Seminar, Torino, Italy (Levrotto & Bella, Torino, Italy), pp. 107–114

    Google Scholar 

  • Culmann, C. (1866): ‘Die graphische Statik’,Auflage, Meyer und Zeller, Zurich

    Google Scholar 

  • Wolff, J. L. (1869): ‘Ueber die Bedeutung der Architectur der spongiösen Substanz’,Centralb. f. die med. Wissensch,54, pp. 849–851

    Google Scholar 

  • Eckrich, S. G., Noble, P. C., andTullos, H. S. (1994): ‘Effect of rotation on the radiographic appearance of the femoral canal’,J. Arthroplasty,9, pp. 419–426

    Article  Google Scholar 

  • Eggers, E. A., andMctighe, T. (1993): ‘Can plain X-rays generate reliable data for identification and fabrication of custom implants?’.Proc 6th Meeting Int. Soc. for the Study of Custom Prostheses, Amelia Island, Florida, pp. 6–14

  • Hayes, D. E. E., Taylor, J. K., Paul, H. A., andBargar, W. L. (1991): ‘Errors of radiographic estimation of fit and fill of cementless femoral components’,Trans. Orthop. Res. Soc.,16, pp. 533–540

    Google Scholar 

  • Husmann, O., Rubin, P. J., Leyvraz, P. F., De Roguin, B., and Argenson, J. N. (1997): ‘Three-dimensional morphology of the proximal femur’,J Arthroplasty,12, pp. 444–450

    Article  Google Scholar 

  • Iguchi, H., Hua, J., andWalker, P. S. (1996): ‘Accuracy of using radiographs for custom hip stem design’,J. Arthroplasty,11, pp. 312–321

    Article  Google Scholar 

  • Kaneuji, A., Matsumoto, T., Nishino, M., Miura, T., Sugimori, T., andTomita, K. (2000): ‘Three-dimensional morphological analysis of the proximal femoral canal, using computer-aided design systems, in Japanese patients with osteoarthrosis of the hip’,J. Orthop. Sci.,5, pp. 361–368

    Article  Google Scholar 

  • Kang, Y., Engelke, K., andKalender, W. A. (2003): ‘A new accurate and precise 3-D segmentation method for skeletal structures in volumetric CT data’,IEEE Trans. Med. Imag.,22, pp. 586–598

    Google Scholar 

  • Kerner, J., Huiskes, R., Van Lenthe, G. H., Weinans, H., Van Rietbergen, B., Engh, C. A., andAmis, A. A. (1999): ‘Correlation between pre-operative periprosthetic bone density and post-operative bone loss in THA can be explained by strain-adaptive remodelling’,J. Biomech.,32, pp. 695–703

    Article  Google Scholar 

  • Koch, J. C. (1917): ‘The laws of bone architecture-Part III’,Am. J. Anat.,21, pp. 215–298

    Article  Google Scholar 

  • Lengsfeld, M., Günther, D., Pressel, T., Leppek, R., Schmitt, J. andGriss, P. (2002): ‘Validation data for periprosthetic bone remodelling theories’,J. Biomech.,35, pp. 1553–1564

    Article  Google Scholar 

  • Mahaisavariya, B., Sitthiseripratip, K., Tongdee, T., Bohez, E. L., Vander Sloten, J., andOris, P. (2002): ‘Morphological study of the proximal femur: a new method of geometrical assessment using 3-dimensional reverse engineering’,Med. Eng. Phys.,24, pp. 617–622

    Article  Google Scholar 

  • Milton, J. S., andArnold, J. S. (1995): ‘Principles and applications for engineering and the computing sciences’, (McGraw-Hill, New York, USA, 1995)

    Google Scholar 

  • Noble, P. C., Alexander, J. W., Lindahl, L. I., Yew, D. T., Granberry, W. M., andTullos, H. S. (1988): ‘The anatomic basis of femoral component design’,Clin. Orthop. Rel. Res.,235, pp. 148–165

    Google Scholar 

  • Orlik, J., Zhurov, A., andMiddleton, J. (2003): ‘On the secondary stability of coated cementless hip replacement: parameters that affected interface strength’,Med Eng Phys.,25, pp. 825–831

    Article  Google Scholar 

  • Roux, W. (1895): ‘Gesammelte Abhandlungen uber die Entwicklungsmechanik der Organismen’, (W. Engelmann, Leipzig, 1895)

    Google Scholar 

  • Rubin, P. J., Leyvraz, P. F., Aubaniac, J. M., Argenson, J. N., Esteve, P., andDe Roguin, B. (1992): ‘The morphology of the proximal femur. A three-dimensional radiographic analysis’,J. Bone Joint Surg. Br.,74, pp. 28–32

    Google Scholar 

  • Song, Y., Beaupre, G. S., andGoodman, S. B. (1999): ‘Osseointegration of total hip arthroplasties: studies in humans and animals’,J. Long Term Eff. Med. Implants,9, pp. 77–112

    Google Scholar 

  • Sutherland, C. J., Bresina, S. J., andGayou, D. E. (1994): ‘Use of general purpose mechanical computer assisted engineering software in orthopaedic surgical planning: advantages and limitations’,Comput. Med. Imaging. Graph.,18, pp. 435–442

    Google Scholar 

  • Viceconti, M., Casali, M., Massari, B., Cristofolini, L., Bassini, S., andToni, A. (1996): ‘The ‘standardized femur program’. Proposal for a reference geometry to be used for the creation of finite element models of the femur’,J. Biomech.,29, pp. 1241–1250

    Article  Google Scholar 

  • Weinans, H., Sumner, D. R., Igloria, R., andNatarajan, R. N. (2000): ‘Sensitivity of periprosthetic stress-shielding to load and the bone density-modulus relationship in subject-specific finite element models’,J. Biomech.,33, pp. 809–817

    Article  Google Scholar 

  • Wissing, H., andBuddenbrock, B. (1993): ‘Determining rotational errors of the femur by axial computerized tomography in comparison with clinical and conventional radiologic determination’,Unfallchirurgie,19, pp. 145–157

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to E. M. Zanetti.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Zanetti, E.M., Crupi, V., Bignardi, C. et al. Radiograph-based femur morphing method. Med. Biol. Eng. Comput. 43, 181–188 (2005). https://doi.org/10.1007/BF02345952

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF02345952

Keywords

Navigation