Automated design of bone-preserving, insertable, and shape-matching patient-specific acetabular components

Area of Science:

• Orthopedic Surgery
• Biomedical Engineering
• Computational Design

Background:

• Revision total hip arthroplasty (THA) faces challenges with large acetabular defects due to poor bone stock.
• Standard implants may not achieve adequate fixation without excessive bone removal in revision cases.

Purpose of the Study:

• To present a computational strategy for designing patient-specific implants for revision THA.
• To maximize bone-implant contact and minimize bone reaming for severe acetabular defects.

Main Methods:

• Developed an automated computational design strategy for patient-specific implants.
• Simulated implant performance against optimally fitted hemispherical implants using 15 severe pelvic defect models (Paprosky 2A-3B).
• Evaluated bone-implant contact area and reamed bone volume.

Main Results:

• Patient-specific implants increased bone-implant contact by a median of 63%.
• The proposed method reduced the volume of reamed bone stock by a median of 98%.
• The design strategy ensures component insertability while optimizing fixation.

Conclusions:

• The computational design strategy offers a promising approach for creating effective patient-specific implants for revision THA.
• This method can potentially reduce costs and operating times compared to existing patient-specific systems.
• The generated implants enhance bone preservation and fixation in complex acetabular reconstructions.