Development of a Statistical Shape Model and Assessment of Anatomical Shape Variations in the Hemipelvis

Veldhuizen, Willemina A. van; Wel, Hylke van der; Kuipers, H.; Kraeima, Joep; Duis, Kaj ten; Wolterink, Jelmer M.; Vries, Jean Paul de; Schuurmann, Richte C. L.; IJpma, Frank F. A.

doi:10.3390/jcm12113767

Cited by 3 publications

(1 citation statement)

References 34 publications

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“…These results were consistent with the SSM in the current study, accounting for variation in the femoral capsular attachments. Studies of pelvis morphology have not found variation in the acetabular geometry (i.e., version and inclination) among the common modes of pelvis variability [58,59]. The current SSM likewise observes minimal variation in acetabular inclination among the dominant shape modes and decreased diameter of the acetabular rim coupled with decreased acetabular version as part of mode 4 (Figure 5 and Table 1).…”

Section: Discussionmentioning

confidence: 44%

Instantaneous Generation of Subject-Specific Finite Element Models of the Hip Capsule

Anantha-Krishnan,

Myers,

Fitzpatrick

et al. 2023

Bioengineering

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Subject-specific hip capsule models could offer insights into impingement and dislocation risk when coupled with computer-aided surgery, but model calibration is time-consuming using traditional techniques. This study developed a framework for instantaneously generating subject-specific finite element (FE) capsule representations from regression models trained with a probabilistic approach. A validated FE model of the implanted hip capsule was evaluated probabilistically to generate a training dataset relating capsule geometry and material properties to hip laxity. Multivariate regression models were trained using 90% of trials to predict capsule properties based on hip laxity and attachment site information. The regression models were validated using the remaining 10% of the training set by comparing differences in hip laxity between the original trials and the regression-derived capsules. Root mean square errors (RMSEs) in laxity predictions ranged from 1.8° to 2.3°, depending on the type of laxity used in the training set. The RMSE, when predicting the laxity measured from five cadaveric specimens with total hip arthroplasty, was 4.5°. Model generation time was reduced from days to milliseconds. The results demonstrated the potential of regression-based training to instantaneously generate subject-specific FE models and have implications for integrating subject-specific capsule models into surgical planning software.

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Section: Discussionmentioning

confidence: 44%

Instantaneous Generation of Subject-Specific Finite Element Models of the Hip Capsule

Anantha-Krishnan,

Myers,

Fitzpatrick

et al. 2023

Bioengineering

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Automatic virtual reconstruction of acetabular fractures using a statistical shape model

van Veldhuizen,

van Noortwijk,

Meesters

et al. 2024

Eur J Trauma Emerg Surg

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Purpose Automatic virtual reconstruction of complex fractures would be helpful for pre-operative surgical planning. We developed a statistical shape model (SSM) which contains data of 200 intact 3D hemipelves. It allows for quantification of shape differences and is able to reconstruct abnormal shaped pelvises. We applied our SSM to reconstruct elementary and associate type acetabular fractures and assessed the reconstruction performance of the SSM, by comparing the reconstructed shape with the intact contralateral hemipelvis. Methods In this retrospective diagnostic imaging study, we used our SSM to virtually reconstruct fractured hemipelves of eighty-three patients with an acetabular fracture. A root mean square error (RMSE) was computed between the reconstructed shape and intact contralateral shape for the whole hemipelvis and for regions relevant for plate-fitting. These plate-fitting relevant regions were defined as: (1) Iliopectineal line length and radius; (2) ischial body line length and radius; (3) acetabular diameter, (4) quadrilateral slope and (5) weight-bearing acetabular dome. Results The median RMSE of the whole hemipelvis of the elementary type fractures was 2.2 (1.7–2.5) mm versus 3.2 (2.2–3.9) mm for the associate type fractures (p < 0.001). The median RMSE for the plate-fitting regions of elementary type fractures was 1.7 (1.4–2.1) mm versus 2.7 (2.0–4.1) mm for associate type fractures (p < 0.001). Conclusion Using a statistical shape model allows for accurate virtual reconstructions of elementary and associate type acetabular fractures within a clinically acceptable range, especially within regions important for plate-fitting. SSM-based reconstructions can serve as a valuable tool for pre-operative planning in clinical practice, when a template of the contralateral hemipelvis is unavailable.

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Clinical Workflow Algorithm for Preoperative Planning, Reduction and Stabilization of Complex Acetabular Fractures with the Support of Three-Dimensional Technologies

Solyom,

Moldovan,

Moldovan

et al. 2024

JCM

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Background: Treatment of pelvic injuries poses serious problems for surgeons due to the difficulties of the associated injuries. The objective of this research is to create a clinical workflow that integrates three-dimensional technologies in preoperative planning and performing surgery for the reduction and stabilization of associated acetabular fractures. Methods: The research methodology consisted of integrating the stages of virtual preoperative planning, physical preoperative planning, and performing the surgical intervention in a newly developed clinical workflow. The proposed model was validated in practice in a pilot surgical intervention. Results: On a complex pelvic injury case of a patient with an associated both-column acetabular fracture (AO/OTA-62C1g), we presented the results obtained in the six stages of the clinical workflow: acquisition of three-dimensional (3D) images, creation of the virtual model of the pelvis, creation of the physical model of the pelvis, preoperative physical simulation, orthopedic surgery, and imaging validation of the intervention. The life-size 3D model was fabricated based on computed tomography imagistics. To create the virtual model, the images were imported into Invesalius (version 3.1.1, CTI, Brazil), after which they were processed with MeshLab (version 2023.12, ISTI—CNR, Italy) and FreeCAD (version 0.21.2, LGPL, FSF, Boston, MA, USA). The physical model was printed in 21 h and 37 min using Ultimaker Cura software (version 5.7.2), on an Ultimaker 2+ printing machine through a Fused Deposition Modeling process. Using the physical model, osteosynthesis plate dimensions and fixation screw trajectories were tested to reduce the risk of neurovascular injury, after which they were adjusted and resterilized, which enhanced preoperative decision-making. Conclusions: The life-size physical model improved anatomical appreciation and preoperative planning, enabling accurate surgical simulation. The tools created demonstrated remarkable accuracy and cost-effectiveness that support the advancement and efficiency of clinical practice.

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Development of a Statistical Shape Model and Assessment of Anatomical Shape Variations in the Hemipelvis

Cited by 3 publications

References 34 publications

Instantaneous Generation of Subject-Specific Finite Element Models of the Hip Capsule

Instantaneous Generation of Subject-Specific Finite Element Models of the Hip Capsule

Automatic virtual reconstruction of acetabular fractures using a statistical shape model

Clinical Workflow Algorithm for Preoperative Planning, Reduction and Stabilization of Complex Acetabular Fractures with the Support of Three-Dimensional Technologies

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