System and method to select a prosthesis based on proximal femur morphology

Abstract

Methods and systems for selecting an appropriate prosthesis for a prospective implant recipient are discussed. For example, a method for selecting an appropriate prosthesis can include, accessing anatomical image data, receiving an indication of a plurality of landmark locations within the image data, constructing a femoral canal axial indication within the image data, producing a plurality of lateral anatomic structural measurements, and selecting the appropriate prosthesis to fit the prospective implant recipient. The anatomical image data can include sufficient detail to allow measurement of internal and external geometry of a proximal femur. The plurality of lateral anatomic structural measurements can include measurements along, and perpendicular to, the femoral canal axial indication that run along a femoral canal within the anatomical image data. The prosthesis can be selected based, at least in part, on the plurality of lateral anatomic structural measurements.

1 - 20 . (canceled) 
     
     
         21 . A method for selecting a prosthesis from a set of available prostheses, the method comprising:
 accessing anatomical image data including data representing a proximal end of a femur of a patient;   determining, based on analysis of the anatomical image data, a femoral canal axial indication along a femoral canal based at least in part on anatomical landmark locations found within the anatomical image data;   performing a plurality of automated edge detection based measurements long a length of the femoral canal axial indication within the anatomical image data to generate a plurality of lateral anatomic structural measurements; and   selecting, based at least in part on the plurality of lateral anatomic structural measurements along the femoral canal axial indication, a prosthesis from the set of available prostheses to best fit the femur of the patient.   
     
     
         22 . The method of  claim 21 , wherein the performing the plurality of automated edge detection based measurements includes, for each measurement, detecting a change in contrast within the anatomical image data representing a change in bone density. 
     
     
         23 . The method of  claim 21 , wherein determining the femoral canal axial indication includes receiving indication of the landmark locations from user selection of at least one of:
 a midpoint of an isthmus within the femur;   a medial aspect of a lesser trochanter of the femur; and   a midpoint of a proximal metaphysis within the femur.   
     
     
         24 . The method of  claim 23 , wherein receiving indication of the landmark locations further includes receiving coordinates within the anatomical image data based on centering a circular region of interest over a femoral head of the femur within the anatomical image data. 
     
     
         25 . The method of  claim 21 , further comprising calculating, based at least in part on the plurality of lateral anatomic structural measurements, a canal flare index (CFI) and a cortical index (CI). 
     
     
         26 . The method of  claim 25 , wherein the selecting the prosthesis is further based on the CFI and the CI calculated from the plurality of lateral anatomic structural measurements. 
     
     
         27 . The method of  claim 21 , further comprising calculating, based at least in part on the plurality of lateral anatomic structural measurements, a medial flare index (MFI) and a lateral flare index (LFI). 
     
     
         28 . The method of  claim 27 , wherein the selecting the prosthesis is further based on the MFI and the LFI calculated from the plurality of lateral anatomic structural measurements. 
     
     
         29 . The method of  claim 21 , wherein the selecting the prosthesis includes calculating a bow in the femur based at least in part on the plurality of lateral anatomic structural measurements and the femoral canal axial indication. 
     
     
         30 . A system for selecting a prosthesis from a set of available prostheses, the system comprising:
 a computer including at least one processor and a memory device, the memory device including instructions that, when executed by the at least one processor, cause the computer to perform operations comprising:   
       accessing anatomical image data including data representing a proximal end of a femur of a patient;
 determining, based on analysis of the anatomical image data, a femoral canal axial indication along a femoral canal based at least in part on anatomical landmark locations found within the anatomical image data; 
 performing a plurality of automated edge detection based measurements long a length of the femoral canal axial indication within the anatomical image data to generate a plurality of lateral anatomic structural measurements; and
 selecting, based at least in part on the plurality of lateral anatomic structural measurements along the femoral canal axial indication, a prosthesis from the set of available prostheses to best fit the femur of the patient. 
 
 
     
     
         31 . The system of  claim 30 , wherein the instructions that cause the computer to perform the plurality of automated edge detection based measurements include instructions that cause the computer to, for each measurement, detect a change in contrast within the anatomical image data representing a change in bone density and using a threshold to select an edge. 
     
     
         32 . The system of  claim 30 , wherein the instructions that cause the computer to determine the femoral canal axial indication includes instructions to cause the computer to receive selection of the landmark locations from user selection of at least one of:
 a midpoint of an isthmus within the femur;   a medial aspect of a lesser trochanter of the femur; and   a midpoint of a proximal metaphysis within the femur.   
     
     
         33 . The system of  claim 30 , wherein the instructions that cause the computer to receive selection of the landmark locations further include instructions that cause the computer to receive input centering a circular region of interest over a femoral head of the femur within the anatomical image data. 
     
     
         34 . The system of  claim 30 , wherein the instructions further include instructions that cause the computer to calculate, based at least in part on the plurality of anatomic structural measurements, a canal flare index (CFI) and a cortical index (CI); and
 wherein the instructions that cause the computer to select the prosthesis further include instructions that cause the computer to select the prosthesis based at least in part on the CFI and the CI calculated from the plurality of anatomic structural measurements.   
     
     
         35 . The system of  claim 30 , wherein the instructions further include instructions that cause the computer to calculate, based at least in part on the plurality of anatomic structural measurements, a medial flare index (MFI) and a lateral flare index (LFI); and
 wherein the instructions that cause the computer to select the prosthesis further include instructions that cause the computer to select the prosthesis based at least in part on the MFI and the LFI calculated from the plurality of anatomic structural measurements.   
     
     
         36 . A machine-readable storage device including instructions that, when executed by a machine, cause the machine to select a prosthesis from a set of available prostheses using operations comprising:
 accessing anatomical image data including data representing a proximal end of a femur of a patient;   determining, based on analysis of the anatomical image data, a femoral canal axial indication along a femoral canal based at least in part on anatomical landmark locations found within the anatomical image data;   performing a plurality of automated edge detection based measurements long a length of the femoral canal axial indication within the anatomical image data to generate a plurality of lateral anatomic structural measurements; and   selecting, based at least in part on the plurality of lateral anatomic structural measurements along the femoral canal axial indication; a prosthesis from the set of available prostheses to best fit the femur of the patient.   
     
     
         37 . The machine-readable storage device of  claim 36 , wherein instructions to perform the plurality of automated edge detection based measurements include instructions to cause the machine to perform, for each measurement, detecting a change in contrast within the anatomical image data representing a change in bone density. 
     
     
         38 . The machine-readable storage device of  claim 36 , further including instructions that cause the machine to use operations including:
 calculating a second plurality of anatomical structural measurements within the first anatomical image, the second plurality of anatomical structural measurements associated with a femoral head of the femur;   accessing a second anatomical image of the portion of the target implant recipient, the second anatomical image depicting a lateral view of external and internal geometry of the proximal end of the femur of the target implant recipient;   calculating a third plurality of anatomical structural measurements within the second anatomical image, the third plurality of anatomical structural measurements associated with the femoral head of the femur; and   calculating a version of the femoral head based at least in part on the second plurality of anatomical structural measurements and the third plurality of anatomical structural measurements.   
     
     
         39 . The machine-readable storage device of  claim 36 , wherein the instructions further include instructions that cause the machine to:
 produce a fourth plurality of anatomical structural measurements along, and substantially perpendicular to, a femoral canal axial indication within the second anatomical image;   calculate, based at least in part on the first plurality of anatomical structural measurements and the fourth plurality of anatomical structural measurements, a canal flare index (CFI) and a cortical index (CI); and   wherein the instructions that cause the machine to select the prosthesis further include instructions that cause the machine to select the prosthesis based at least in part on the CFI and the CI.   
     
     
         40 . The machine-readable storage device of  claim 36 , wherein the instructions further include instructions that cause the machine to perform further operations comprising:
 calculating, based at least in part on the plurality of lateral anatomic structural measurements, a canal flare index (CFI) and a cortical index (CI); and   
       selecting the prosthesis further based on the CFI and the CI calculated from the plurality of lateral anatomic structural measurements.