Application and evaluation of biomechanical models and scores for the planning of total hip arthroplasty

Abstract

Intimate knowledge of the biomechanics of a given individual hip joint provides a potential advantage during the planning of total hip arthroplasty, and would thus have a positive influence over the outcome of such an intervention. In current clinical practise, the surgical planning is based solely on the status of the individual hip and its radiographic appearance. However, additional information could be gathered from the radiography to be used as input data for biomechanical models aimed at calculating the resultant force FR within the hip joint. An investigation of the biomechanical models by Pauwels, Debrunner and Iglič was performed, where the magnitude of FR calculated by the models showed a favourable comparison to the in-vivo data from instrumented prostheses by Bergmann. The Blumentritt model returned abnormally high results. The computational results showed large variations for FR orientation, which tends to depend more on the model used than on patient-specific parameters. Furthermore, a discrepancy was found between the data gathered from instrumented prostheses and the Standing Human Model within the 'AnyBody Modeling System™' software by AnyBody Tech. Additionally, the variations in inter-rater and intra-rater errors made while localizing radiographic landmarks were analysed with respect to their influence on Babisch-Layher-Blumentritt (BLB)-scoring using the Blumentritt hip model.

Patient-specific musculoskeletal modeling of the hip joint for preoperative planning of total hip arthroplasty: A validation study based on in vivo measurements

“…Musculoskeletal models (MSM) are a common method to study the mechanics of joints [ 13 ], and a patient-specific adapted MSM offers the possibility to approximate the individual HJF for activities of daily living [ 14 ]. Presently, the implementation of MSM into the preoperative planning process is still difficult, because, among other reasons, the validation of MSM is a challenging task [ 15 , 16 ].…”

Evaluierung von biomechanischen Modellen zur Therapieplanung für die Hüftendoprothesenversorgung – direkter Vergleich zwischen Berechnungsergebnissen und In-vivo-Messungen

“…Bei der präoperativen Planung sollte möglichst durch eine Berücksichtigung von patientenindividuellen Anforderungen, Wahl und Implantation von Komponenten versucht werden, sich dem biomechanischen Optimum anzunähern [27]. Hierbei würde ein valides biomechanisches Modell eine Hilfestellung bieten [28][29][30]. Eine (präoperative) Berechnung, bspw.…”

“…Grundsätzlich findet durch die mathematische Modellbildung eine simplifizierte Approximation der Realität statt. Schwierigkeiten bei der Validierung der Modellansichten sind zusätzliche, nachteilige Problematiken, die mit diesem Ansatz einhergehen [28,39]. Die meisten verwendeten Modelle zur Berechnung der resultierenden Hüftgelenkskraft R behandeln die Belastung als ebenes statisches Problem in der Frontalebene [10][11][12][13][14][15][40][41][42][43][44].…”

Biomechanical Models of the Hip – a Validation Study Based on 10 CT-Datasets

“…In the context of developing a planning module for computer-assisted THA, the models of Pauwels, Debrunner, Blumentritt and Iglič were investigated in earlier studies (Eschweiler et al, 2012). However, it has been shown that the models of Blumentritt and Iglič yielded contradictory results in comparison to others as well as compared to the in-vivo measurements (Eschweiler et al, 2012). Blumentritt's model computed R too high, and Iglič's revealed a lack of patient-specific adaption.…”

“…R and Ɵ can be computed by using patient-specific biomechanical models with adapted geometrical and anthropometrical parameters taken from standardized acquired clinical X-ray images. In the context of developing a planning module for computer-assisted THA, the models of Pauwels, Debrunner, Blumentritt and Iglič were investigated in earlier studies (Eschweiler et al, 2012). However, it has been shown that the models of Blumentritt and Iglič yielded contradictory results in comparison to others as well as compared to the in-vivo measurements (Eschweiler et al, 2012).…”