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Open AccessArticle

Towards an App to Estimate Patient-Specific Perioperative Femur Fracture Risk

1
Department of Engineering, University of Campania “Luigi Vanvitelli”, 81031 Aversa, Italy
2
Institute for Biomedical and Neural Engineering, Reykjavik University, 101 Reykjavik, Iceland
3
Department of Science, Landspitali University Hospital, 101 Reykjavik, Iceland
4
Department of Orthopaedic Surgery, Landspitali University Hospital, University of Iceland, 101 Reykjavik, Iceland
5
Department of Structures for Engineering and Architecture, University of Napoli Federico II, 80125 Napoli, Italy
*
Author to whom correspondence should be addressed.
Appl. Sci. 2020, 10(18), 6409; https://doi.org/10.3390/app10186409
Received: 22 July 2020 / Revised: 1 September 2020 / Accepted: 10 September 2020 / Published: 14 September 2020
(This article belongs to the Special Issue Computational and Experimental Assessment in Structural Engineering)
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. View Full-Text
Keywords: total hip arthroplasty; intra-operative femur fracture risk; bone elastic-plastic behavior total hip arthroplasty; intra-operative femur fracture risk; bone elastic-plastic behavior
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Esposito, L.; Minutolo, V.; Gargiulo, P.; Jonsson, H., Jr.; Gislason, M.K.; Fraldi, M. Towards an App to Estimate Patient-Specific Perioperative Femur Fracture Risk. Appl. Sci. 2020, 10, 6409.

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