Femoral anatomy, computed tomography and computer-aided design of prosthetic implants

Precise digital data of the internal femoral anatomy are necessary to develop new prosthetic implants with computer-aided design (CAD) techniques. Thirty human cadaveric femurs of central European origin were analysed by high precision computed tomography (CT) using thin slice and high resolution imaging. The CT data were image processed with thresholding to obtain a reconstruction of the cortical bone geometry. The CT threshold for cortical bone was optimized by comparison with saw cuts of macerated femurs. For each specimen a three-dimensional (3D) model of the cortical femur was calculated by the CAD system based on the processed CT data. Virtual 3D models of the 30 femurs were used to adjust a hypothetical stem to the proximal femur anatomy by repeated virtual implantations. The CAD system allowed for evaluation of anatomical parameters after hip reconstruction, amount of bone removal, and cortical bone contact. The fit and fill of the stem could be tested before clinical application and implant-related problems could be corrected.