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Objective:To investigate the effect of 3D-printed customized flanged cup in hip revision with severe acetabular bone defects.Methods:Since February 2017, 10 cases of 3D-printed customized flanged cups were used in hip revision with severe acetabular bone defects, including 2 cases of Paprosky type IIIA and 8 cases of Paprosky type IIIB. There were 5 males and 5 females, mean age 73.6±8.1 yrs (range, 62-87 yrs), 5 left and 5 right cases. The preoperative thin-layer CT scan was preformed to reverse reconstruct digital pelvis. Five cases of one-piece flanged cups and 5 cases of decomposed flanged cups, including 3 cases of composite one-piece cups were designed by computer. The surgery was performed strictly according to the plan.Postoperative follow-up was performed to evaluate the Harris score. Operation time,intraoperative bleeding and other complications such as vascular and nerve injury, postoperative infection, and dislocation were counted. Pelvic X-ray was used to assess the height and horizontal position of the center of rotation and the stability of the prosthesis.Results:The surgical procedure was successful, with an average operative time of 147.9±48.3 min (range, 96-212 min) and an average intraoperative bleeding of 730.4±262.6 ml (range, 500-1 300 ml). The mean time of final follow-up was 40.8±18.7 months (range, 16-70 months) after surgery. At the last follow-up, the average Harris score was 83.80±6.73, with 4 cases excellent, 5 cases good, and 1 case fair. The excellent and good rate was 90%. The last Harris score was significantly higher than that before operation 28.60±8.40 ( t=16.84, P<0.001). The height of affected hip joint rotation center decreased from 46.24±7.74 mm before operation to 15.54±2.54 mm after operation with significant difference ( t=14.61, P<0.001). It was slightly higher than the opposite side (13.81±1.48 mm), which had no significant difference ( t=1.83, P=0.100). The horizontal distance of affected hip joint rotation center increased from 33.79±5.27 mm before operation to 40.53±4.50 mm after operation with significant difference ( t=3.62, P=0.006). It had no significant difference ( t=1.28, P=0.232) compared with the opposite side (38.54±3.46 mm). All incisions were healed in one stage without infection, vascular or nerve injury. During the following-up, all prostheses were in satisfied position without loosening, dislocation or screw breaks. Conclusion:Digitally assisted 3D-printed flanged cups can be used in hip revision with severe acetabular bone defect. It can not only improve hip joint function, but also restore the acetabular rotation center and the prosthesis stability, which can achieve good early and mid-term effect.
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Finite Element Analysis (FEA) plays an important role in the biomechanical field. In this paper, we used FEA method in the area of ophthalmology. We generated an eyeball - extraocular muscles (EOMs) model and converted it to meet the need of FEA process. We exerted outside forces on the structure for nonlinear computation and achieved the distributions of displacement, stress and strain. The results corresponded with the basic theory of ophthalmology. We also put forward some related aspects for discussion and advanced studies.
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This article introduces a medical imaging and image processing knowledge center which serves as an e-learning platform based on network technology. This platform includes contents of medical imaging and medical image processing for the teaching activities, virtual reality tutoring system of human skeleton, medical image database, etc. The purpose of establishing this platform is to recruit and excavate information records which usually associated with the daily data exchanged in teaching and research activities. Then it will gradually form an open professional knowledge database. At present, this platform plays the role of knowledge community in the educational activities of BME program in Tsinghua University.
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Edge detection is an absolutely necessary step in medical image processing, and the use of differential operators to detect edge is one of the most common and effective methods. In this paper are analyzed the frequency features of the Roberts operator, Prewitt operator, Sobel operator and Laplacian operator from the viewpoint of frequency domain, and it is proposed that the frequency features of the differential operators should be considered when differential operator is being used and/or constructed. Because edge detection operator is sensitive to the edge type, the appropriate operator should be adopted in different edge type detection. Finally, the importance and necessity of selecting edge detection operator are validated in the MRI image edge processing.