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Bone-to-bone and implant-to-bone impingement : a novel graphical representation for hip replacement planning

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Palit, Arnab, King, Richard, Hart, Zoe, Gu, Yolanda, Pierrepont, James, Elliott, Mark T. and Williams, Mark A. (2020) Bone-to-bone and implant-to-bone impingement : a novel graphical representation for hip replacement planning. Annals of Biomedical Engineering, 48 . pp. 1354-1367. doi:10.1007/s10439-020-02451-x

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Official URL: http://dx.doi.org/10.1007/s10439-020-02451-x

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Abstract

Bone-to-bone impingement (BTBI) and implant-to-bone impingement (ITBI) risk assessment is generally performed intra-operatively by surgeons, which is entirely subjective and qualitative, and therefore, lead to sub-optimal results and recurrent dislocation in some cases. Therefore, a method was developed for identifying subject-specific BTBI and ITBI, and subsequently, visualising the impingement area on native bone anatomy to highlight where prominent bone should be resected. Activity definitions and subject-specific bone geometries, with planned implants were used as inputs for the method. The ITBI and BTBI boundary and area were automatically identified using ray intersection and region growing algorithm respectively to retain the same ‘conical clearance angle’ obtained to avoid prosthetic impingement (PI). The ITBI and BTBI area was then presented with different colours to highlight the risk of impingement, and importance of resection. A clinical study with five patients after 2 years of THA was performed to validate the method. The results supported the study hypothesis, in that the predicted highest risk area (red coloured zone) was completely/majorly resected during the surgery. Therefore, this method could potentially be used to examine the effect of different pre-operative plans and hip motions on BTBI, ITBI, and PI, and to guide bony resection during THA surgery.

Item Type: Journal Article
Subjects: R Medicine > RD Surgery
Divisions: Faculty of Science > WMG (Formerly the Warwick Manufacturing Group)
Library of Congress Subject Headings (LCSH): Total hip replacement, Hip joint -- Surgery , Prosthetists
Journal or Publication Title: Annals of Biomedical Engineering
Publisher: Springer
ISSN: 0090-6964
Official Date: April 2020
Dates:
DateEvent
April 2020Published
22 January 2020Available
6 January 2020Accepted
Volume: 48
Page Range: pp. 1354-1367
DOI: 10.1007/s10439-020-02451-x
Status: Peer Reviewed
Publication Status: Published
Access rights to Published version: Open Access
RIOXX Funder/Project Grant:
Project/Grant IDRIOXX Funder NameFunder ID
UNSPECIFIEDCorin Grouphttp://dx.doi.org/10.13039/100012341

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