Registration based assessment of femoral torsion for rotational osteotomies based on the contralateral anatomy

BACKGROUND Computer-assisted techniques for surgical treatment of femoral deformities have become increasingly important. In state-of-the-art 3D deformity assessments, the contralateral side is used as template for correction as it commonly represents normal anatomy. Contributing to this, an iterative closest point (ICP) algorithm is used for registration. However, the anatomical sections of the femur with idiosyncratic features, which allow for a consistent deformity assessment with ICP algorithms being unknown. Furthermore, if there is a side-to-side difference, this is not considered in error quantification. The aim of this study was to analyze the influence and value of the different sections of the femur in 3D assessment of femoral deformities based on the contralateral anatomy. MATERIAL AND METHODS 3D triangular surface models were created from CT of 100 paired femurs (50 cadavers) without pathological anatomy. The femurs were divided into sections of eponymous anatomy of a predefined percentage of the whole femoral length. A surface registration algorithm was applied to superimpose the ipsilateral on the contralateral side. We evaluated 3D femoral contralateral registration (FCR) errors, defined as difference in 3D rotation of the respective femoral section before and after registration to the contralateral side. To compare this method, we quantified the landmark-based femoral torsion (LB FT). This was defined as the intra-individual difference in overall femoral torsion using with a landmark-based method. RESULTS Contralateral rotational deviation ranged from 0° to 9.3° of the assessed femoral sections, depending on the section. Among the sections, the FCR error using the proximal diaphyseal area for registration was larger than any other sectional error. A combination of the lesser trochanter and the proximal diaphyseal area showed the smallest error. The LB FT error was significantly larger than any sectional error (p < 0.001). CONCLUSION We demonstrated that if the contralateral femur is used as reconstruction template, the built-in errors with the registration-based approach are smaller than the intraindividual difference of the femoral torsion between both sides. The errors are depending on the section and their idiosyncratic features used for registration. For rotational osteotomies a combination of the lesser trochanter and the proximal diaphyseal area sections seems to allow for a reconstruction with a minimal error

Three-dimensional modelling of the femur and humerus in adult male guinea pigs (guinea pig) with computed tomography and some biometric measurement values

Background: Guinea pig is a species belonging to the Caviidae family of the Rodentia order and is frequently used in experimental studies. Biomedical imaging methods are used in the diagnosis and treatment of many diseases in medicine. Among these methods, computed tomography (CT) is one of the most important imaging methods. In this study, it was aimed to perform the three-dimensional (3D) modelling of the CT images, obtained from the humerus and femur in the guinea pigs, via the MIMICS programme, and to make some biometric measurements regarding the bones over these models. Materials and methods: In the present study, 12 male adult guinea pigs were used. The soft tissue on the humerus and femur bones of the guinea pigs was removed. After this procedure, CT images at a 0.5 mm-thickness were obtained from the animals. The images were recorded in DICOM format. Then, the reconstruction process was performed from the images by using the 3D modeling programme MIMICS® 13.1. On the 3D model of the humerus and femur (right-left), volumes, surface areas and lengths as well as other biometric parameters were measured separately, and the values were recorded. In addition, measurements of the bones were made with the help of a digital calliper. Results: Among the parameters obtained from 3D models, a statistical difference was observed between the right and left cortical thicknesses of the femur from the measurements of calliper and the right and left humerus volumes (p &lt; 0.05); whereas, no statistical difference was found in other parameters of both measurements (p &gt; 0.05). Conclusions: It can be stated that CT and 3D modelling can be used for the measurement of some parameters in the long bones of the guinea pigs

Patient-specific modelling in orthopedics: from image to surgery

In orthopedic surgery, to decide upon intervention and how it can be optimized, surgeons usually rely on subjective analysis of medical images of the patient, obtained from computed tomography, magnetic resonance imaging, ultrasound or other techniques. Recent advancements in computational performance, image analysis and in silico modeling techniques have started to revolutionize clinical practice through the development of quantitative tools, including patient#specific models aiming at improving clinical diagnosis and surgical treatment. Anatomical and surgical landmarks as well as features extraction can be automated allowing for the creation of general or patient-specific models based on statistical shape models. Preoperative virtual planning and rapid prototyping tools allow the implementation of customized surgical solutions in real clinical environments. In the present chapter we discuss the applications of some of these techniques in orthopedics and present new computer-aided tools that can take us from image analysis to customized surgical treatment

Skeletal sexing standards of human remains in Turkey

The identification of victims involved in mass fatality incidents, as well as the identification of unknown individuals in criminal cases has become an increasingly important issue nowadays. Sex assessment represents a key point in forensic evaluations due to its significance in providing biological identity. Even though the availability of documented skeletal remains to forensic practitioners is a common practice in many countries, in Turkey, contemporary documented skeletal remains are not available for this purpose. For this reason, studies have been focused on living populations. Previous research has shown that modern technologies such as CT scanning present very promising potential in establishing new standards for contemporary populations. Therefore, the main aim of this project was to examine the application of the measurements taken from 3D CT images of the femur in order to assess sex, and to contribute to the establishment of discriminant function equations for the Turkish population for forensic applications. The accuracy and reproducibility of imaging methods in the assessment of the measurements taken from femora are essential when estimating sex. This research also concentrated on determining the accuracy and repeatability of CT measurements, using the femur. Prior to primary data collection, a preliminary study was performed in an effort to test the reliability of the femur measurements. The results of reliability analysis indicated no significant difference between the three observations of each measurement. Thus, the methodology employed in the current study appears reliable and reproducible. In addition, a validation study was conducted to determine the linear measurement accuracy of the 3D volume rendering models derived from a medical CT scanner and the influence of different reconstruction parameters. The differences between measurements obtained from dry bones and their 3D volume rendered models were also evaluated. The results from this study indicated that there were no statistically significant differences between measurements taken from different reconstruction parameters and measurements obtained from CT images and drybones. Using the CT data, volume-rendering function (VR), 3D Curved Multiplanar reconstruction (MPR), and Scout View on OsiriX were employed in order to compare the accuracy and reliability of each rendering method and to determine which technique is optimal for linear measurements. Overall, the measurements taken from the 3D Volume Rendering images had the highest intra-observer reliability when compared to the other two rendering methods. This research study produced data and interpretations that will inform on and improve population specific standards of sex assessment from three-dimensional postcranial osteometric landmarks. Additionally, this research is believed to provide value for a developing discipline of forensic anthropology, and integrate within the existing systems of criminal investigation and disaster victim identification practices in Turkey. A Turkish sample population, consisting of 300 adult hospital patients was examined via the interpretation of CT reconstructed images using the OsiriX software. The 3D reconstructions were then created using the volume-rendering function in OsiriX (v.5.6.). Following the 3D reconstruction, an image of each femur was segmented from the surrounding bones to ensure the correct usage of landmarks as accurately as possible. Thirteen measurements were acquired using a 3D viewer after being located and marked on each CT reconstructed femora. These thirteen anthropometric parameters were measured and analysed by basic descriptive statistics and discriminant analysis methods using the SPSS 21.0 software package. The intra-observer variation was assessed by obtaining the intraclass correlation coefficient in order to evaluate the accuracy of the linear measurements taken. Asymmetry was also tested. The results indicated that an accuracy of 92.3% was acquired from a combination of six of the measurements, and the Femur Vertical Diameter of Neck (FVDN) measurement was found to be the most dimorphic with 88.0% accuracy

Hip joint articular soft tissues of non-dinosaurian Dinosauromorpha and early Dinosauria: evolutionary and biomechanical implications for Saurischia

Dinosauromorphs evolved a wide diversity of hind limb skeletal morphologies, suggesting highly divergent articular soft tissue anatomies. However, poor preservation of articular soft tissues in fossils has hampered any follow-on functional inferences. We reconstruct the hip joint soft tissue anatomy of non-dinosaurian dinosauromorphs and early dinosaurs using osteological correlates derived from extant sauropsids and infer trends in character transitions along the theropod and sauropodomorph lineagues. Femora and pelves of 107 dinosauromorphs and outgroup taxa were digitized using 3D imaging techniques. Key transitions were estimated using maximum likelihood ancestral state reconstruction. The hips of dinosauromorphs possessed wide a disparity of soft tissue morphologies beyond the types and combinations exhibited by extant archosaurs. Early evolution of the dinosauriform hip joint was characterized by the retention of a prominent femoral hyaline cartilage cone in post-neonatal individuals, with the cartilage cone independently reduced within theropods and sauropodomorphs. The femur of Dinosauriformes possessed a fibrocartilage sleeve on the metaphysis, which surrounded a hyaline core. The acetabulum of Dinosauriformes possessed distinct labrum and antitrochanter structures. In sauropodomorphs, hip congruence was maintained by thick hyaline cartilage on the femoral head, whereas theropods relied on acetabular tissues such as ligaments and articular pads. In particular, the craniolaterally ossified hip capsule of non- Avetheropoda neotheropods permitted mostly parasagittal femoral movements. These data indicate that the dinosauromorph hip underwent mosaic evolution within the saurischian lineage and that sauropodomorphs and theropods underwent both convergence and divergence in articular soft tissues, correlated with transitions in body size, locomotor posture, and joint loading