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Towards an app to estimate patient-specific perioperative femur fracture risk

Towards an app to estimate patient-specific perioperative femur fracture risk


Title: Towards an app to estimate patient-specific perioperative femur fracture risk
Author: Esposito, L.
Minutolo, V.
Gargiulo, P.
Jonsson, H.
Gislason, M. K.
Fraldi, M.
Date: 2020-09-01
Language: English
Scope:
University/Institute: Landspitali - The National University Hospital of Iceland
Department: Department of Engineering
Other departments
Faculty of Medicine
Surgical Services
Series: Applied Sciences (Switzerland); 10(18)
ISSN: 2076-3417
DOI: https://doi.org/10.3390/APP10186409
Subject: Bone elastic-plastic behavior; Intra-operative femur fracture risk; Total hip arthroplasty; Arthroplasty, Replacement, Hip; Decision Making; Bone elastic-plastic behavior; Intra-operative femur fracture risk; Total hip arthroplasty; Arthroplasty, Replacement, Hip; Decision Making; Materials Science (all); Instrumentation; Engineering (all); Process Chemistry and Technology; Computer Science Applications; Fluid Flow and Transfer Processes
URI: https://hdl.handle.net/20.500.11815/3410

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Citation:

Esposito , L , Minutolo , V , Gargiulo , P , Jonsson , H , Gislason , M K & Fraldi , M 2020 , ' Towards an app to estimate patient-specific perioperative femur fracture risk ' , Applied Sciences (Switzerland) , vol. 10 , no. 18 , 6409 . https://doi.org/10.3390/APP10186409

Abstract:

Total Hip Arthroplasty has been one of the most successful surgical procedure in terms of patient outcomes and satisfaction. However, due to increase in life expectancy and the related incidence of age-dependent bone diseases, a growing number of cases of intra-operative fractures lead to revision surgery with high rates of morbidity and mortality. Surgeons choose the type of the implant, either cemented or cementless prosthesis, on the basis of the age, the quality of the bone and the general medical conditions of the patients. Generally, no quantitative measures are available to assess the intra-operative fracture risk. Consequently, the decision-making process is mainly based on surgical operators' expertise and qualitative information obtained from imaging. Motivated by this scenario, we here propose a mechanical-supported strategy to assist surgeons in their decisions, by giving intelligible maps of the risk fracture which take into account the interplay between the actual mechanical strength distribution inside the bone tissue and its response to the forces exerted by the implant. In the presented study, we produce charts and patient-specific synthetic "traffic-light" indicators of fracture risk, by making use of ad hoc analytical solutions to predict the stress levels in the bone by means of Computed Tomography-based mechanical and geometrical parameters of the patient. We felt that if implemented in a friendly software or proposed as an app, the strategy could constitute a practical tool to help the medical decision-making process, in particular with respect to the choice of adopting cemented or cementless implant.

Description:

This research was funded by the Università degli Studi della Campania “L.Vanvitelli”, grant Programma VALERE: “VAnviteLli pEr la RicErca”, DDG N. 516—24 May2018. Publisher Copyright: © 2020 by the authors.

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