Wysocki Matthew A, Lewis Steven A, Doyle Scott T
Department of Pathology and Anatomical Sciences, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY 14203-1121, USA.
Bioengineering (Basel). 2023 Jan 17;10(2):123. doi: 10.3390/bioengineering10020123.
There are still numerous problems with modern joint replacement prostheses, which negatively influence patient health and recovery. For example, it is especially important to avoid failures and complications following hip arthroplasty because the loss of hip joint function is commonly associated with increased demand on the healthcare system, reoperation, loss of independence, physical disability, and death. The current study uses hip arthroplasty as a model system to present a new strategy of computationally generating patient-specific statistical reconstructions of complete healthy anatomical structures from computed tomography (CT) scans of damaged anatomical structures. The 3D model morphological data were evaluated from damaged femurs repaired with prosthetic devices and the respective damaged femurs that had been restored using statistical reconstruction. The results from all morphological measurements (i.e., maximum femoral length, Hausdorff distance, femoral neck anteversion, length of rotational center divergence, and angle of inclination) indicated that the values of femurs repaired with traditional prostheses did not fall within the +/-3 standard deviations of the respective patient-specific healthy anatomical structures. These results demonstrate that there are quantitative differences in the morphology of femurs repaired with traditional prostheses and the morphology of patient-specific statistical reconstructions. This approach of generating patient-specific statistical reconstructions of healthy anatomical structures might help to inform prosthetic designs so that new prostheses more closely resemble natural healthy morphology and preserve biomechanical function. Additionally, the patient-specific statistical reconstructions of healthy anatomical structures might be valuable for surgeons in that prosthetic devices could be selected and positioned to more accurately restore natural biomechanical function. All in all, this contribution establishes the novel approach of generating patient-specific statistical reconstructions of healthy anatomical structures from the CT scans of individuals' damaged anatomical structures to improve treatments and patient outcomes.
现代关节置换假体仍然存在许多问题，这些问题对患者的健康和康复产生负面影响。例如，避免髋关节置换术后的失败和并发症尤为重要，因为髋关节功能丧失通常与医疗系统需求增加、再次手术、失去独立性、身体残疾和死亡相关。当前的研究以髋关节置换术作为模型系统，提出了一种新策略，即根据受损解剖结构的计算机断层扫描（CT）图像，通过计算生成特定患者的完整健康解剖结构的统计重建模型。从使用假体装置修复的受损股骨以及使用统计重建方法修复的相应受损股骨中评估3D模型形态学数据。所有形态学测量结果（即股骨最大长度、豪斯多夫距离、股骨颈前倾角、旋转中心发散长度和倾斜角度）表明，使用传统假体修复的股骨的值不在相应特定患者健康解剖结构的±3个标准差范围内。这些结果表明，使用传统假体修复的股骨形态与特定患者的统计重建形态存在定量差异。这种生成特定患者健康解剖结构统计重建模型的方法可能有助于为假体设计提供参考，使新的假体更接近自然健康形态并保留生物力学功能。此外，特定患者健康解剖结构的统计重建模型对于外科医生可能很有价值，因为可以选择和定位假体装置，以更准确地恢复自然生物力学功能。总而言之，本研究建立了一种新方法，即根据个体受损解剖结构的CT扫描生成特定患者健康解剖结构的统计重建模型，以改善治疗效果和患者预后。
