Patient-specific design process and evaluation of a hip prosthesis femoral stem.

Abstract

There are several commercially available hip implant systems. However, for some cases, custom implant designed based on patient-specific anatomy can offer the patient the best available implant solution. Currently, there is a growing trend toward personalization of medical implants involving additive manufacturing into orthopedic medical implants' manufacturing. This article introduces a systematic design methodology of femoral stem prosthesis based on patient's computer tomography data. Finite element analysis is used to evaluate and compare the micromotion and stress distribution of the customized femoral component and a conventional stem. The proposed customized femoral stem achieved close geometrical fit and fill between femoral canal and stem surfaces. The customized stem demonstrated lower micromotion (peak: 21 μm) than conventional stem (peak: 34 μm). Stress results indicate up to 89% increase in load transfer by conventional stem than custom stem because the higher stiffness of patient-specific femoral stem proximally increases the custom stem shielding in Gruen's zone 7. Moreover, patient-specific femoral stem transfers the load widely in metaphyseal region. The customized femoral stem presented satisfactory results related to primary stability, but compromising proximo-medial load transfer due to increased stem cross-sectional area increased stem stiffness.