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Statistical atlas-based morphological variation analysis of the asian humerus: Towards consistent allometric implant positioning

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International Journal of Computer Assisted Radiology and Surgery Aims and scope Submit manuscript

Abstract

Purpose

Positioning existing humeral implants into Asian patients poses significant challenges due to the inconsistent statistical shapes between Western population and Asian population. Current humeral orthopedic fixation devices and implants have a generic shape and are not designed for Asian patients who exhibit different sizes and shapes compared to their Western counterparts for which present day designs have been based on. To address this problem, it is necessary to develop Asian-specific implants that accommodate the morphology of Asian humeri. Existing morphological studies of humeri in Asian populations are rare and most previous analyses are either based on the manual measurement of dry bones or the use of dual energy X-ray absorptiometry scans. The purpose of this pilot morphological study is to explore the characteristics of Asian humeri using statistical atlas-based analysis.

Methods

Forty-four CT scans of normal upper limbs were obtained from the National University Hospital, Singapore and used to construct statistical humerus atlases. The atlases were subsequently used to study the morphology of the humeri in an Asian population. Humeral shapes of different patient clusters were analyzed based on statistical shape models. Comparison between different clusters was conducted with regard to centerline, length, width and surface curvature.

Results

The statistical humerus atlases reflected the mean shape and modes of variation of humeri in an Asian population. Analyses based on these atlases indicated that curvature and shape of the internal humeral canal were similar in males and females while humeral length and width were greater in males. Most importantly, surface curvatures were explicitly different between clusters.

Conclusion

Morphologic analysis based on statistical atlases is novel and useful to characterize the Asian humerus. The humerus demonstrates gender-specific morphology. This unique approach provides information that is useful to the clinician and biomedical engineer, not only in the modification of current or design of future humeral implants, but also in the precise dynamic positioning of Asian-specific humeral implants to Asian patients. Our findings support the need for further development of humeral implants, curvilinear robotics, and the questioning of whether gender-specific devices are necessary.

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Acknowledgments

This work is supported by Singapore Academic Research Fund under Grants R397000139133 and R397000157112 and NUS Cross Faculty Research Grant R-397-000-177-133 (Statistical Shape Analysis for Development of Humerus Implants that Suits the Asian Population) awarded to Dr. Hongliang Ren. Also, we would like to thank Dr. Emmanuel Audenaert from Ghent University Hospital for sharing the algorithm on rigid registration and also for the fruitful discussions.

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Authors and Affiliations

  1. Department of Biomedical Engineering, National University of Singapore, Singapore, Singapore

    K. Wu, B. Zhou & H. Ren

  2. Department of Orthopaedic Surgery, National University Health System, Singapore, Singapore

    K. L. Wong, D. P. Murphy & Z. J. Daruwalla

  3. Department of Diagnostic Imaging, National University Health System, Singapore, Singapore

    S. J. K. Ng & S. T. Quek

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  1. K. Wu
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  2. K. L. Wong
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  5. B. Zhou
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  7. Z. J. Daruwalla
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  8. H. Ren
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Correspondence to H. Ren.

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Wu, K., Wong, K.L., Ng, S.J.K. et al. Statistical atlas-based morphological variation analysis of the asian humerus: Towards consistent allometric implant positioning. Int J CARS 10, 317–327 (2015). https://doi.org/10.1007/s11548-014-1084-y

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  • DOI: https://doi.org/10.1007/s11548-014-1084-y

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