I
nte
rna
t
io
na
l J
o
urna
l o
f
Rec
o
nfig
ura
ble a
nd
E
m
be
dd
e
d Sy
s
t
e
m
s
(
I
J
R
E
S)
Vo
l.
14
,
No
.
2
,
J
u
ly
20
25
,
p
p
.
575
~
5
8
6
I
SS
N:
2089
-
4864
,
DOI
:
1
0
.
1
1
5
9
1
/i
j
r
es
.
v
14
.
i
2
.
pp
5
7
5
-
586
575
J
o
ur
na
l ho
m
ep
a
g
e
:
h
ttp
:
//ij
r
es.ia
esco
r
e.
co
m
Desig
n and
str
uct
ura
l
m
o
de
lling
of
pa
tient
-
sp
ecifi
c 3
D
-
prin
ted
k
n
ee fe
m
ur and
t
i
bia
i
m
p
la
nts
B
o
lug
o
dd
u Sa
nd
ee
p
1
,
Sa
ra
v
a
na
n
Dha
nu
s
h
k
o
di
2
,
S
ud
ha
ka
r
K
u
m
a
ra
s
a
m
y
3
1
D
e
p
a
r
t
me
n
t
o
f
M
e
c
h
a
n
i
c
a
l
E
n
g
i
n
e
e
r
i
n
g
,
P
r
i
s
t
D
e
e
me
d
U
n
i
v
e
r
si
t
y
,
T
h
a
n
j
a
v
u
r
,
I
n
d
i
a
2
D
e
p
a
r
t
me
n
t
o
f
M
e
c
h
a
n
i
c
a
l
E
n
g
i
n
e
e
r
i
n
g
,
P
o
n
n
a
i
y
a
h
R
a
ma
j
a
y
a
m I
n
st
i
t
u
t
e
o
f
S
c
i
e
n
c
e
a
n
d
T
e
c
h
n
o
l
o
g
y
,
V
a
l
l
a
m,
I
n
d
i
a
3
D
e
p
a
r
t
me
n
t
o
f
M
e
c
h
a
n
i
c
a
l
E
n
g
i
n
e
e
r
i
n
g
,
U
n
i
v
e
r
si
t
y
M
a
l
a
y
si
a
P
a
h
a
n
g
,
P
a
h
a
n
g
,
M
a
l
a
y
si
a
Art
icle
I
nfo
AB
ST
RAC
T
A
r
ticle
his
to
r
y:
R
ec
eiv
ed
J
an
2
4
,
2
0
2
5
R
ev
i
s
ed
Ma
r
1
0
,
2
0
2
5
A
cc
ep
ted
J
u
n
1
0
,
2
0
2
5
A
rth
rit
is
is
a
d
e
g
e
n
e
ra
ti
v
e
jo
in
t
c
o
n
d
it
io
n
t
h
a
t
p
r
o
g
re
ss
iv
e
l
y
d
a
m
a
g
e
s
th
e
k
n
e
e
,
lea
d
in
g
t
o
p
a
in
,
stif
f
n
e
ss
,
a
n
d
li
m
it
e
d
m
o
b
il
it
y
.
T
o
a
ll
e
v
iate
th
e
se
s
y
m
p
to
m
s
a
n
d
re
sto
re
jo
i
n
t
f
u
n
c
ti
o
n
a
li
ty
,
to
tal
k
n
e
e
a
rth
ro
p
las
ty
(T
K
A
)
is
p
e
rf
o
r
m
e
d
.
T
h
is
p
ro
c
e
d
u
re
b
e
c
o
m
e
s
n
e
c
e
ss
a
r
y
d
u
e
to
e
it
h
e
r
su
d
d
e
n
trau
m
a
to
t
h
e
k
n
e
e
o
r
g
ra
d
u
a
l
w
e
a
r
a
n
d
tea
r
o
f
th
e
m
e
n
isc
u
s
a
n
d
c
a
rti
l
a
g
e
.
T
K
A
in
v
o
lv
e
s
m
e
ti
c
u
lo
u
s
p
lan
n
i
n
g
,
p
re
c
ise
b
o
n
e
c
u
tt
i
n
g
,
a
n
d
th
e
p
lac
e
m
e
n
t
o
f
p
ro
sth
e
t
ic
c
o
m
p
o
n
e
n
ts
m
a
d
e
f
r
o
m
h
ig
h
-
d
e
n
sity
p
o
ly
e
th
y
len
e
a
n
d
m
e
tal
a
ll
o
y
s.
Ho
we
v
e
r,
trad
it
io
n
a
l
m
e
th
o
d
s
c
re
a
ti
n
g
c
u
sto
m
ize
d
k
n
e
e
imp
lan
ts
a
re
e
x
p
e
n
siv
e
a
n
d
ti
m
e
-
in
ten
siv
e
.
T
h
is
stu
d
y
e
x
p
lo
re
s
th
e
c
h
a
ll
e
n
g
e
s
in
m
a
n
u
f
a
c
tu
rin
g
p
e
rso
n
a
li
z
e
d
k
n
e
e
im
p
lan
ts
f
o
r
T
K
A
a
n
d
e
v
a
lu
a
tes
th
e
p
o
ten
ti
a
l
o
f
th
re
e
-
d
im
e
n
sio
n
a
l
(
3
D)
p
ri
n
ti
n
g
tec
h
n
o
l
o
g
y
in
th
is
p
ro
c
e
ss
.
V
a
riatio
n
s
in
k
n
e
e
jo
in
t
a
n
a
to
m
y
a
c
ro
s
s
p
o
p
u
lati
o
n
s
c
o
m
p
li
c
a
te
su
rg
e
r
y
,
a
s
o
p
ti
m
a
l
o
u
tco
m
e
s
re
l
y
o
n
p
re
c
ise
a
li
g
n
m
e
n
t
a
n
d
i
m
p
lan
t
d
im
e
n
sio
n
s
.
A
p
re
o
p
e
ra
ti
v
e
c
o
m
p
u
ted
to
m
o
g
ra
p
h
y
(CT
)
sc
a
n
id
e
n
ti
f
ies
th
e
re
g
io
n
o
f
in
tere
st
(ROI),
su
c
h
a
s
th
e
k
n
e
e
j
o
in
t
.
T
h
e
sc
a
n
d
a
ta
is
t
h
e
n
p
r
o
c
e
ss
e
d
u
sin
g
c
o
m
p
u
ter
-
a
id
e
d
d
e
sig
n
(CA
D)
so
f
twa
re
to
g
e
n
e
ra
te
a
p
rin
ta
b
le
f
il
e
.
T
h
e
p
a
ti
e
n
t’s
CT
sc
a
n
d
a
ta
is
c
o
n
v
e
r
ted
in
t
o
a
sta
n
d
a
rd
tr
ian
g
u
latio
n
lan
g
u
a
g
e
(S
T
L
)
f
il
e
a
n
d
CA
D
m
o
d
e
ls
o
f
th
e
k
n
e
e
j
o
in
t.
Err
o
rs
su
c
h
a
s
o
v
e
rlap
p
in
g
tri
a
n
g
les
o
r
o
p
e
n
l
o
o
p
s
in
th
e
S
T
L
f
il
e
a
r
e
c
o
rre
c
t
e
d
,
a
n
d
u
n
w
a
n
ted
g
e
o
m
e
tri
e
s
n
e
a
r
th
e
ROI
a
re
re
m
o
v
e
d
.
Re
se
c
ti
o
n
tec
h
n
iq
u
e
s
a
re
a
p
p
li
e
d
to
c
re
a
te
C
A
D
m
o
d
e
ls
tailo
re
d
to
th
e
p
a
ti
e
n
t’s
b
o
n
e
m
o
rp
h
o
l
o
g
y
.
F
u
se
d
d
e
p
o
siti
o
n
m
o
d
e
li
n
g
(
F
DM)
is
t
h
e
n
u
se
d
t
o
p
ro
d
u
c
e
p
ro
t
o
ty
p
e
s
o
f
th
e
k
n
e
e
jo
in
t
a
n
d
im
p
lan
t
s.
De
sp
it
e
v
isi
b
le
lay
e
r
li
n
e
s
in
th
e
p
ri
n
ted
p
ro
to
ty
p
e
s,
c
h
a
ll
e
n
g
e
s e
n
c
o
u
n
tere
d
d
u
r
in
g
t
h
e
p
ro
c
e
ss
w
e
re
e
ffe
c
ti
v
e
l
y
re
so
lv
e
d
.
K
ey
w
o
r
d
s
:
Kn
ee
r
ep
lace
m
e
n
t
Min
i
m
u
m
j
o
in
t sp
ac
e
w
id
t
h
Ost
eo
ar
th
r
iti
s
P
ar
am
etr
ic
m
o
d
eli
n
g
T
h
r
ee
-
d
i
m
en
s
io
n
al
m
o
d
el
T
h
is i
s
a
n
o
p
e
n
a
c
c
e
ss
a
rticle
u
n
d
e
r th
e
CC B
Y
-
SA
li
c
e
n
se
.
C
o
r
r
e
s
p
o
nd
ing
A
uth
o
r
:
B
o
lu
g
o
d
d
u
San
d
ee
p
Dep
ar
t
m
en
t o
f
Me
ch
a
n
ical
E
n
g
in
ee
r
i
n
g
,
P
r
is
t D
ee
m
ed
Un
iv
er
s
it
y
T
h
an
j
av
u
r
,
T
am
il
N
ad
u
,
I
n
d
ia
E
m
ail:
s
a
n
d
ee
p
v
ar
m
a@
j
its
.
i
n
1.
I
NT
RO
D
UCT
I
O
N
Kn
ee
ar
t
h
r
itis
,
i
n
cl
u
d
in
g
o
s
t
eo
ar
th
r
itis
,
r
h
e
u
m
ato
id
ar
th
r
i
tis
,
an
d
p
o
s
t
-
tr
au
m
at
ic
ar
th
r
itis
,
is
a
co
m
m
o
n
co
n
d
itio
n
af
f
ec
ti
n
g
t
h
e
k
n
ee
j
o
in
t
[
1
]
.
Ov
er
th
e
last
f
o
u
r
d
ec
ad
es,
k
n
ee
r
ep
lace
m
en
t
s
u
r
g
er
ies
h
a
v
e
in
cr
ea
s
ed
g
lo
b
all
y
[
2
]
.
T
o
ta
l
k
n
ee
r
ep
lace
m
en
t
(
T
K
R
)
is
o
f
ten
r
eq
u
ir
ed
d
u
e
to
c
ar
tilag
e
an
d
b
o
n
e
d
eg
en
er
atio
n
,
j
o
in
t
s
w
ell
in
g
,
a
n
d
m
ild
s
y
n
o
v
ial
i
n
f
la
m
m
atio
n
ca
u
s
ed
b
y
o
s
teo
ar
t
h
r
itis
[
3
]
.
Desp
ite
its
s
u
cc
es
s
,
u
p
to
2
5
% o
f
T
KR
p
atien
ts
r
ep
o
r
t d
is
s
atis
f
ac
t
io
n
[
4
]
.
As
s
h
o
w
n
i
n
Fig
u
r
e
1
,
u
n
d
er
s
tan
d
in
g
k
n
ee
a
n
a
to
m
y
a
n
d
in
j
u
r
y
m
ec
h
a
n
i
s
m
s
is
cr
u
cia
l
f
o
r
ef
f
ec
ti
v
e
d
iag
n
o
s
i
s
a
n
d
tr
ea
t
m
e
n
t
[
5
]
.
T
h
e
k
n
ee
j
o
in
t
co
n
s
is
ts
o
f
th
e
f
e
m
u
r
(
t
h
i
g
h
b
o
n
e)
,
tib
ia
(
s
h
in
b
o
n
e)
,
an
d
t
h
e
k
n
ee
ca
p
(
p
atella)
.
T
h
ese
b
o
n
e
s
ar
e
co
v
er
ed
b
y
a
s
m
o
o
th
la
y
er
ca
lled
ar
ticu
lar
ca
r
tilag
e,
wh
ich
en
ab
les
s
m
o
o
t
h
Evaluation Warning : The document was created with Spire.PDF for Python.
I
SS
N
:
2
0
8
9
-
4864
I
n
t J
R
ec
o
n
f
i
g
u
r
ab
le
&
E
m
b
ed
d
ed
Sy
s
t
,
Vo
l.
14
,
No
.
2
,
J
u
l
y
20
25
:
575
-
5
8
6
576
m
o
v
e
m
e
n
t
w
it
h
i
n
t
h
e
j
o
in
t.
B
et
w
ee
n
t
h
e
f
e
m
u
r
a
n
d
tib
ia,
th
e
r
e
ar
e
C
-
s
h
ap
ed
s
tr
u
c
tu
r
es
ca
ll
ed
m
en
i
s
ci
t
h
at
ac
t
as
s
h
o
c
k
ab
s
o
r
b
er
s
f
o
r
th
e
k
n
ee
.
T
y
p
icall
y
,
t
h
e
k
n
ee
is
u
n
d
er
s
to
o
d
to
in
clu
d
e
th
e
tib
io
f
e
m
o
r
al
an
d
p
atello
f
e
m
o
r
al
j
o
in
ts
.
T
h
e
tib
io
f
e
m
o
r
al
j
o
in
t
is
d
iv
id
ed
in
to
m
ed
ial
an
d
later
al
s
ec
tio
n
s
.
W
h
ile
t
h
er
e
is
a
s
lig
h
t
d
if
f
er
e
n
ce
in
th
e
s
ize
o
f
th
e
later
al
an
d
m
ed
ial
co
n
d
y
les,
th
e
f
o
r
m
er
is
g
e
n
er
all
y
co
n
s
tan
t.
Du
r
in
g
f
le
x
io
n
,
th
e
f
e
m
o
r
al
a
n
d
tib
ial
co
n
d
y
les ca
n
s
lid
e
an
d
r
o
ll to
g
et
h
er
.
Fig
u
r
e
1
.
An
ato
m
y
o
f
t
h
e
k
n
ee
Dir
ec
t
k
n
ee
i
m
p
ac
ts
r
eq
u
ir
e
i
m
m
ed
iate
atte
n
tio
n
[
6
]
,
an
d
p
r
o
s
th
ese
s
h
av
e
a
r
ep
o
r
ted
1
0
-
y
ea
r
s
u
r
v
iv
a
l
r
ate
ex
ce
ed
in
g
9
5
%.
P
r
ec
is
io
n
in
b
o
n
e
cu
ts
a
n
d
p
r
o
s
th
etic
p
lace
m
e
n
t
is
k
e
y
to
s
u
cc
es
s
f
u
l
T
KR
o
u
tco
m
es
.
to
tal
k
n
ee
ar
th
r
o
p
last
y
(
T
KA)
ev
en
l
y
d
i
s
tr
ib
u
te
s
k
n
ee
j
o
i
n
t
lo
ad
to
r
ed
u
ce
p
o
ly
et
h
y
le
n
e
lin
er
w
ea
r
an
d
en
h
a
n
ce
p
r
o
s
th
e
s
is
d
u
r
ab
ilit
y
[
7
]
.
A
d
v
an
ce
s
in
th
r
ee
-
d
i
m
e
n
s
io
n
al
(
3
D)
p
r
in
ti
n
g
h
a
v
e
m
a
d
e
it
a
v
alu
ab
le
to
o
l
in
o
r
th
o
p
ed
ics,
aid
in
g
in
m
o
b
ilit
y
r
esto
r
atio
n
a
n
d
p
ain
r
e
d
u
cti
o
n
f
o
r
i
m
p
r
o
v
ed
p
atien
t
q
u
alit
y
o
f
li
f
e
[
8
]
.
Desp
ite
it
s
b
en
e
f
it
s
,
i
n
cr
ea
s
ed
ar
th
r
o
p
last
y
p
r
o
ce
d
u
r
es
lead
t
o
m
an
y
co
m
p
licatio
n
s
,
b
u
t
i
m
p
r
o
v
in
g
T
KA
w
i
th
7
5
%
to
8
9
%
p
atien
t
s
atis
f
ac
t
io
n
,
ar
o
u
n
d
5
0
%
r
ep
o
r
t
f
u
n
ct
io
n
al
li
m
itatio
n
s
o
r
in
f
ec
tio
n
s
.
A
d
d
itio
n
al
w
ea
r
f
r
o
m
tib
ial
b
ea
r
in
g
m
icr
o
-
m
o
t
io
n
an
d
u
ltra
-
h
ig
h
-
m
o
lec
u
lar
-
w
ei
g
h
t
p
o
l
y
et
h
y
le
n
e
(
UHM
W
P
E
)
im
p
ac
ts
f
u
r
t
h
er
co
n
tr
ib
u
te
to
ch
alle
n
g
es [
9
]
.
P
atien
t
-
s
p
ec
if
ic
i
n
s
tr
u
m
e
n
tat
i
o
n
(
P
SI)
in
T
KA
s
i
m
p
lifie
s
s
u
r
g
er
y
,
en
h
an
ce
s
cu
tti
n
g
ac
cu
r
ac
y
,
an
d
r
ed
u
ce
s
co
m
p
licat
io
n
s
.
I
t
also
d
ec
r
ea
s
es
in
s
tr
u
m
e
n
t
u
s
e,
s
h
o
r
ten
s
p
r
o
ce
d
u
r
es,
an
d
lo
w
e
r
s
co
s
ts
[
1
0
],
[
1
1
]
.
Usi
n
g
C
T
o
r
MRI
s
ca
n
s
,
3
D
p
r
in
ti
n
g
cr
ea
tes
a
n
ato
m
ica
ll
y
c
u
s
to
m
ized
c
u
tti
n
g
g
u
id
e
s
b
ased
o
n
d
etailed
m
o
d
el
s
o
f
th
e
p
atie
n
t
’
s
k
n
ee
,
en
ab
lin
g
p
r
ec
is
e
p
r
e
-
o
p
er
ativ
e
p
lan
n
i
n
g
.
S
u
r
g
eo
n
s
u
s
e
th
e
s
e
g
u
id
es,
m
ad
e
f
r
o
m
m
ater
ials
lik
e
n
y
lo
n
,
p
o
l
y
m
er
s
,
o
r
m
etals,
to
d
eter
m
i
n
e
k
e
y
s
u
r
g
ical
p
ar
a
m
eter
s
s
u
c
h
a
s
alig
n
m
e
n
t,
r
o
tatio
n
,
r
esectio
n
lev
el
s
,
an
d
co
m
p
o
n
en
t
s
izi
n
g
[
1
2
]
–
[
1
4
]
.
Du
r
in
g
s
u
r
g
er
y
,
P
SI
g
u
id
es
ass
i
s
t
in
b
o
n
e
cu
ts
an
d
p
in
p
o
s
itio
n
in
g
.
I
f
ad
j
u
s
t
m
e
n
t
s
ar
e
n
ee
d
ed
,
s
tan
d
ar
d
in
s
tr
u
m
e
n
t
s
ar
e
u
s
ed
.
P
r
o
d
u
cin
g
th
e
s
e
g
u
id
es
t
y
p
icall
y
tak
e
s
ab
o
u
t
th
r
ee
w
ee
k
s
[
1
5
]
.
P
r
o
p
e
r
s
o
f
t
ti
s
s
u
e
h
an
d
li
n
g
an
d
o
s
te
o
p
h
y
te
r
ete
n
tio
n
ar
e
cr
u
ci
al
f
o
r
g
u
id
e
p
lace
m
en
t.
MRI
-
b
ased
s
y
s
te
m
s
d
o
n
o
t r
eq
u
ir
e
ca
r
tilag
e
r
e
m
o
v
al,
w
h
ile
C
T
-
b
ased
s
y
s
te
m
s
d
o
.
T
h
is
r
esear
ch
ai
m
s
to
d
ev
e
lo
p
an
i
n
n
o
v
ati
v
e
k
n
ee
j
o
in
t
co
n
s
i
s
ti
n
g
o
f
f
e
m
u
r
b
o
n
e,
tib
ia
b
o
n
e,
an
d
k
n
ee
ca
p
(
p
atella)
u
s
in
g
3
D
-
p
r
in
ted
p
o
ly
lactic
ac
id
(
P
L
A
)
,
o
f
f
er
in
g
a
lig
h
t
w
eig
h
t,
u
s
er
-
f
r
ien
d
l
y
d
esi
g
n
f
o
r
p
atien
t
r
eh
ab
ilit
a
tio
n
.
T
h
e
s
t
u
d
y
e
x
a
m
i
n
es
t
h
e
p
er
f
o
r
m
a
n
ce
o
f
th
e
P
L
A
k
e
y
co
m
p
o
n
e
n
ts
u
n
d
er
s
tr
es
s
an
d
s
tr
ain
,
co
m
p
ar
i
n
g
t
h
e
ef
f
ec
t
iv
en
e
s
s
o
f
t
h
ese
t
w
o
co
m
m
er
ciall
y
a
v
ailab
le
m
ater
ials
.
A
d
v
an
ce
m
e
n
ts
i
n
3D
-
p
r
in
ted
p
o
l
y
m
er
co
m
p
o
n
e
n
ts
h
av
e
m
ad
e
th
e
m
s
u
itab
le
f
o
r
d
em
an
d
i
n
g
ap
p
licatio
n
s
,
w
i
th
r
ed
u
ce
d
p
r
in
tin
g
co
s
ts
m
a
k
i
n
g
t
h
e
m
a
v
iab
le
alt
er
n
ativ
e
to
tr
ad
itio
n
al
o
r
th
o
tic
s
.
E
ar
ly
p
r
o
to
t
y
p
es
w
er
e
b
u
l
k
y
d
u
e
to
li
m
ita
tio
n
s
in
o
ld
er
tech
n
o
lo
g
y
,
b
u
t
n
o
w
3
D
-
p
r
in
ted
b
r
ac
es
o
f
f
er
p
er
s
o
n
alize
d
,
co
m
f
o
r
tab
le,
an
d
f
u
n
ctio
n
al
s
o
l
u
tio
n
s
.
C
u
s
to
m
d
esi
g
n
s
en
s
u
r
e
a
p
r
ec
is
e
f
it
a
n
d
i
m
p
r
o
v
ed
p
atien
t
c
o
m
p
lia
n
ce
.
T
h
e
v
er
s
atili
t
y
o
f
3
D
p
r
in
tin
g
al
lo
w
s
f
o
r
co
m
p
le
x
g
eo
m
etr
ie
s
an
d
m
ater
ial
s
elec
tio
n
to
ac
h
iev
e
th
e
d
esire
d
p
r
o
p
e
r
ties
,
w
h
il
e
r
ap
id
p
r
o
to
ty
p
in
g
en
ab
les q
u
ic
k
m
o
d
i
f
icatio
n
s
[
1
6
]
–
[
2
3
]
.
Evaluation Warning : The document was created with Spire.PDF for Python.
I
n
t J
R
ec
o
n
f
i
g
u
r
ab
le
&
E
m
b
ed
d
ed
Sy
s
t
I
SS
N:
2089
-
4864
Desig
n
a
n
d
s
tr
u
ctu
r
a
l m
o
d
elli
n
g
o
f p
a
tien
t
-
s
p
ec
ific 3
D
-
p
r
in
t
ed
kn
ee
femu
r
a
n
d
tib
ia
… (
B
o
lu
g
o
d
d
u
S
a
n
d
ee
p
)
577
Me
d
ical
ap
p
licatio
n
s
r
eq
u
ir
e
s
p
ec
ialized
m
ater
ial
s
,
s
u
c
h
as
en
er
g
y
-
ab
s
o
r
b
in
g
,
i
m
p
ac
t
-
r
es
is
tan
t,
an
d
b
io
lo
g
icall
y
m
o
d
elin
g
co
m
p
o
n
en
t
s
.
R
ec
e
n
t
r
esear
c
h
f
o
cu
s
es
o
n
m
ed
icin
a
l
p
o
l
y
m
er
s
w
i
th
f
lex
ib
ilit
y
[
2
4
]
,
[
2
5
]
,
to
u
g
h
n
e
s
s
[
2
6
]
,
[
2
7
]
,
elec
tr
ical
co
n
d
u
cti
v
it
y
[
2
8
]
,
[
2
9
]
,
an
d
b
io
co
m
p
atib
ilit
y
[
3
0
]
,
[
3
1
]
.
Fatig
u
e
f
r
ac
t
u
r
es
ar
e
o
f
ten
d
u
e
to
in
ad
eq
u
ate
b
o
n
e
s
u
p
p
o
r
t,
co
m
m
o
n
l
y
f
r
o
m
o
s
teo
l
y
s
i
s
.
P
r
ec
is
e
co
m
p
o
n
en
t
p
o
s
itio
n
in
g
d
u
r
i
n
g
s
u
r
g
er
y
i
s
es
s
en
tial
[
3
2
]
.
Fra
ctu
r
es
t
y
p
icall
y
o
cc
u
r
at
th
e
b
ase
p
late
an
d
s
te
m
j
u
n
ctio
n
,
r
eq
u
ir
in
g
ca
r
ef
u
l
m
o
n
ito
r
i
n
g
f
o
r
s
u
b
s
id
en
ce
,
as
th
is
r
ar
e
f
ai
lu
r
e
is
d
i
f
f
icu
lt to
d
etec
t o
n
r
ad
io
g
r
ap
h
s
[
3
3
]
.
Ku
r
en
o
v
et
a
l.
[
3
4
]
,
th
e
s
u
r
g
ical
i
m
p
ac
t
o
f
3
D
-
p
r
in
ted
p
e
r
s
o
n
alize
d
b
o
n
e
p
lates
f
o
r
s
e
v
er
e
tib
ial
p
latea
u
f
r
ac
tu
r
e
s
.
J
eo
n
et
a
l
.
[
3
5
]
f
o
u
n
d
th
at
3
D
p
r
in
tin
g
-
as
s
is
ted
T
KA
r
esu
lted
in
b
etter
s
h
o
r
t
-
ter
m
o
u
tco
m
e
s
,
i
m
p
r
o
v
ed
s
u
r
g
ical
e
f
f
icien
c
y
,
an
d
en
h
a
n
ce
d
k
n
ee
f
u
n
ctio
n
co
m
p
ar
ed
to
co
n
v
e
n
tio
n
al
T
K
A
.
R
an
d
az
zo
et
a
l
.
[
3
6
]
th
e
h
u
m
a
n
k
n
ee
a
n
d
an
al
y
ze
d
b
i
o
m
ec
h
a
n
ical
p
r
o
p
er
ties
u
n
d
e
r
d
if
f
er
e
n
t
lo
ad
in
g
co
n
d
itio
n
s
.
Saij
o
et
a
l
.
[
3
7
]
P
r
o
/E
s
o
f
t
w
ar
e
f
o
r
3
D
k
n
e
e
p
r
o
s
th
esis
r
ec
o
n
s
tr
u
ctio
n
a
n
d
ev
al
u
ated
s
tr
ess
d
is
tr
ib
u
tio
n
w
it
h
f
in
ite
ele
m
e
n
t
a
n
al
y
s
i
s
(
A
NSY
S).
Hu
a
n
g
an
d
Z
h
a
n
g
[
3
8
]
d
is
co
v
er
ed
th
at
s
ca
n
n
i
n
g
s
p
ee
d
s
ig
n
i
f
ica
n
tl
y
af
f
ec
ted
t
h
e
te
n
s
i
le
s
tr
en
g
t
h
o
f
t
itan
iu
m
allo
y
i
m
p
lan
t
s
.
C
r
a
f
ts
et
a
l
.
[
3
9
]
f
o
u
n
d
th
at
th
e
T
ag
u
ch
i
m
et
h
o
d
r
ed
u
ce
d
b
u
ck
li
n
g
d
e
f
o
r
m
atio
n
i
n
tita
n
i
u
m
allo
y
b
r
ac
in
g
s
tr
u
ct
u
r
es.
C
h
ae
et
a
l
.
[
4
0
]
cu
s
to
m
ized
3D
-
p
r
in
ted
s
tai
n
les
s
s
teel
t
ib
ial
i
m
p
lan
ts
f
o
r
f
r
ac
tu
r
e
f
ix
at
io
n
w
it
h
s
u
r
g
ical
s
cr
e
w
s
.
W
illi
a
m
s
et
a
l
.
[
4
1
]
s
t
u
d
ied
t
o
u
g
h
n
e
s
s
,
co
m
b
in
i
n
g
s
tr
en
g
t
h
an
d
d
u
ct
ilit
y
,
u
s
i
n
g
to
u
g
h
p
o
l
y
u
r
et
h
a
n
e
to
cr
ea
te
a
3
D
-
p
r
in
ted
ten
s
ile
b
ar
w
ith
cr
o
s
s
h
atc
h
s
tr
u
ct
u
r
es
,
co
m
p
ar
in
g
p
h
y
s
ical
an
d
ch
e
m
ical
cr
o
s
s
-
li
n
k
i
n
g
m
et
h
o
d
s
.
A
d
v
a
n
ce
s
in
f
le
x
ib
l
e
m
ater
ial
s
n
o
w
allo
w
p
r
o
s
th
etics
to
b
e
c
u
s
to
m
ized
to
i
n
d
iv
id
u
al
p
h
y
s
io
lo
g
y
u
s
i
n
g
s
ca
n
n
in
g
a
n
d
f
itti
n
g
te
ch
n
o
lo
g
ies
[
4
2
]
.
I
n
o
n
e
s
t
u
d
y
,
3
D
m
ap
p
in
g
s
o
f
t
w
ar
e
cr
ea
t
ed
a
n
asal
co
n
to
u
r
,
p
r
in
ted
w
it
h
a
Stra
tas
y
s
P
o
l
y
J
et
p
r
in
ter
a
n
d
r
u
b
b
er
-
lik
e
T
an
g
o
P
lu
s
m
ater
ial.
Ster
eo
lit
h
o
g
r
ap
h
y
h
a
s
also
b
ee
n
u
s
ed
to
p
r
in
t
co
m
p
lex
p
atter
n
s
o
n
f
lex
ib
le
m
ater
ial
s
[
4
3
]
.
B
i
o
co
m
p
atib
ilit
y
is
ess
e
n
tia
l
f
o
r
m
ater
ials
i
n
p
r
in
ted
o
b
j
ec
ts
th
at
i
n
ter
ac
t
w
it
h
th
e
b
o
d
y
,
en
s
u
r
i
n
g
t
h
e
y
d
o
n
't
ca
u
s
e
h
ar
m
.
Stra
t
a
s
y
s
ME
D6
1
0
,
an
ac
r
y
l
ic
-
b
ase
d
p
o
ly
m
er
,
is
u
s
ed
to
cr
ea
te
ti
s
s
u
e
s
ca
f
f
o
ld
s
w
it
h
co
m
p
le
x
t
o
p
o
lo
g
ies.
I
t
m
ee
t
s
k
e
y
b
io
co
m
p
a
tib
ilit
y
cr
iter
ia,
in
cl
u
d
in
g
b
io
d
eg
r
ad
ab
ilit
y
,
n
o
n
-
c
y
to
to
x
icit
y
,
a
n
d
tis
s
u
e
s
ti
m
u
latio
n
[
4
4
]
.
Fro
m
th
e
ab
o
v
e
liter
atu
r
e
s
u
r
v
e
y
d
is
cu
s
s
i
o
n
s
,
cu
r
r
en
t
k
n
ee
im
p
lan
t
m
o
d
eli
n
g
an
d
m
o
ld
in
g
m
et
h
o
d
s
,
esp
ec
iall
y
f
o
r
tib
ial
p
r
o
s
th
ese
s
,
h
av
e
s
e
v
er
al
li
m
ita
tio
n
s
.
T
h
is
p
ap
er
f
o
cu
s
es
o
n
th
e
m
o
d
elin
g
ap
p
r
o
ac
h
an
d
FDM
tech
n
iq
u
e
f
o
r
p
er
s
o
n
ali
ze
d
p
atien
t
-
s
p
ec
i
f
ic
3
D
-
p
r
in
te
d
k
n
ee
f
e
m
u
r
an
d
tib
ia
i
m
p
la
n
ts
.
Th
e
k
n
ee
j
o
in
t
co
n
s
is
ts
o
f
t
h
e
f
e
m
u
r
,
tib
ia,
an
d
p
atella,
w
it
h
ar
ticu
lar
ca
r
tilag
e
en
ab
li
n
g
s
m
o
o
t
h
m
o
v
e
m
e
n
t.
C
-
s
h
ap
ed
m
en
is
ci
b
et
w
ee
n
t
h
e
f
e
m
u
r
a
n
d
tib
ia
s
er
v
e
as
s
h
o
c
k
ab
s
o
r
b
er
s
.
T
h
e
k
n
ee
h
as
t
w
o
m
ai
n
co
m
p
o
n
e
n
ts
:
th
e
tib
io
f
e
m
o
r
al
an
d
p
atello
f
e
m
o
r
al
jo
in
ts
.
T
h
e
tib
io
f
e
m
o
r
al
j
o
i
n
t
is
d
iv
id
ed
in
to
m
ed
ial
an
d
later
al
s
ec
tio
n
s
,
w
it
h
a
s
lig
h
t size
d
i
f
f
er
en
ce
b
et
w
ee
n
th
e
co
n
d
y
les.
As
s
h
o
w
n
i
n
Fig
u
r
e
2
,
in
T
K
R
s
u
r
g
er
y
,
d
is
ea
s
ed
b
o
n
e
an
d
ca
r
tilag
e
ar
e
r
em
o
v
ed
,
an
d
th
e
f
e
m
u
r
an
d
tib
ia
ar
e
r
esh
ap
ed
t
o
f
it
th
e
p
r
o
s
th
es
i
s
co
m
p
o
n
e
n
ts
.
T
h
e
p
r
o
s
th
e
s
is
i
n
clu
d
e
s
f
e
m
o
r
al,
tib
ial
,
an
d
p
atellar
p
ar
ts
.
I
n
T
KR
s
u
r
g
er
y
,
d
is
ea
s
ed
b
o
n
e
an
d
ca
r
tilag
e
ar
e
r
e
m
o
v
ed
.
T
h
e
d
is
tal
f
e
m
u
r
an
d
p
r
o
x
i
m
al
tib
ia
ar
e
cu
t
an
d
r
esh
ap
ed
to
ac
co
m
m
o
d
ate
th
e
f
e
m
o
r
al
co
m
p
o
n
e
n
t
an
d
tib
ial
tr
ay
o
f
th
e
p
r
o
s
t
h
e
s
i
s
.
T
h
e
th
r
ee
m
ai
n
co
m
p
o
n
e
n
t
s
ar
e
th
e
f
e
m
o
r
al,
tib
ial,
an
d
p
atellar
co
m
p
o
n
e
n
ts
.
As
s
h
o
w
n
i
n
Fi
g
u
r
e
2
,
th
e
tib
ial
an
d
p
atellar
co
m
p
o
n
e
n
t
s
ca
n
b
e
m
ad
e
o
f
s
o
lid
p
o
l
y
et
h
y
len
e
o
r
h
a
v
e
a
m
e
tal
b
ac
k
in
g
t
h
at
s
u
p
p
o
r
ts
a
p
o
l
y
et
h
y
len
e
ar
ticu
lati
n
g
s
u
r
f
ac
e.
T
KA
is
o
f
ten
p
er
f
o
r
m
ed
w
h
e
n
th
e
ca
r
tilag
e
is
d
a
m
ag
ed
,
th
e
j
o
in
t
is
m
i
s
ali
g
n
ed
,
an
d
w
o
r
n
ca
r
tilag
e
s
u
r
f
ac
es
n
ee
d
r
ep
lace
m
en
t
w
i
t
h
ar
tific
ial
co
m
p
o
n
e
n
ts
[
4
5
]
.
T
h
e
p
r
i
m
ar
y
g
o
al
o
f
T
KA
i
s
to
r
eso
lv
e
m
ec
h
a
n
ical
p
r
o
b
lem
s
i
n
th
e
j
o
in
t,
r
ath
er
th
an
tr
ea
t
t
h
e
u
n
d
er
l
y
i
n
g
d
is
ea
s
e.
Fo
r
in
d
iv
id
u
al
s
w
it
h
s
e
v
er
e
j
o
in
t
d
am
a
g
e,
ar
th
r
o
p
last
y
m
a
y
b
e
t
h
e
o
n
l
y
a
v
ailab
le
tr
ea
t
m
e
n
t [
4
6
]
.
Ma
n
ag
in
g
ex
ce
s
s
w
eig
h
t
ca
n
f
u
r
th
er
en
h
a
n
ce
p
o
s
t
-
s
u
r
g
er
y
o
u
tco
m
e
s
[
4
7
]
.
I
n
3
1
%
o
f
c
ases
,
T
KA
r
esu
lted
in
w
eig
h
t
lo
s
s
,
i
m
p
r
o
v
ed
B
MI
,
an
d
b
etter
f
u
n
ctio
n
ali
t
y
[
4
8
]
.
Am
o
n
g
7
8
1
r
ev
is
io
n
T
KA
p
atien
ts
,
co
m
m
o
n
f
ail
u
r
e
ca
u
s
es
in
c
lu
d
ed
l
o
o
s
en
in
g
(
3
9
.
9
%),
in
f
e
ctio
n
(
2
7
.
4
%),
in
s
tab
ilit
y
(
7
.
5
%),
p
e
r
ip
r
o
s
th
etic
f
r
ac
tu
r
e
(
4
.
7
%),
an
d
ar
th
r
o
f
ib
r
o
s
is
(
4
.
5
%).
Fig
u
r
e
2
.
C
o
m
p
o
n
e
n
ts
o
f
T
KA
Evaluation Warning : The document was created with Spire.PDF for Python.
I
SS
N
:
2
0
8
9
-
4864
I
n
t J
R
ec
o
n
f
i
g
u
r
ab
le
&
E
m
b
ed
d
ed
Sy
s
t
,
Vo
l.
14
,
No
.
2
,
J
u
l
y
20
25
:
575
-
5
8
6
578
2.
P
RO
P
O
SE
D
WO
RK
:
M
AT
E
RIA
L
S A
ND
M
E
T
H
O
DS
T
h
e
m
ater
ia
ls
u
s
ed
ar
e
3
D
p
r
in
tin
g
m
ater
ial
t
h
r
o
u
g
h
a
m
ater
ial
e
x
tr
u
s
io
n
p
r
o
ce
s
s
i
n
ad
d
itiv
e
m
an
u
f
ac
t
u
r
in
g
(
A
M)
th
at
cr
e
ates
o
b
j
ec
ts
b
y
d
ep
o
s
itin
g
m
a
ter
ial
th
r
o
u
g
h
a
n
o
zz
le,
la
y
er
b
y
la
y
er
,
b
ased
o
n
co
m
p
u
ter
-
a
id
ed
d
esig
n
(
C
AD)
d
ata
[
4
9
]
,
[
5
0
]
.
I
t
is
esp
ec
iall
y
u
s
ef
u
l
in
b
io
m
ed
ical
d
ev
ices
an
d
tis
s
u
e
en
g
i
n
ee
r
i
n
g
(
T
E
)
f
o
r
p
r
o
d
u
cin
g
c
u
s
to
m
,
p
atien
t
-
s
p
ec
if
ic
p
a
r
ts
[
5
1
]
,
[
5
2
]
.
Fu
s
ed
d
ep
o
s
itio
n
m
o
d
eli
n
g
(
FD
M)
is
a
t
y
p
e
o
f
ad
d
itiv
e
tech
n
o
lo
g
y
w
h
er
e
m
ater
ial
i
s
m
elted
a
n
d
ex
tr
u
d
ed
to
f
o
r
m
s
h
ap
e
s
,
b
u
ild
in
g
la
y
er
s
o
n
e
at
a
ti
m
e
[
5
3
]
.
Fro
m
th
e
ab
o
v
e
liter
at
u
r
e
s
u
r
v
e
y
,
w
e
h
a
v
e
o
b
s
er
v
ed
th
at
th
e
3
D
m
o
d
elin
g
o
f
h
u
m
an
b
o
n
es
h
a
s
b
ec
o
m
e
a
tr
an
s
f
o
r
m
at
iv
e
to
o
l
in
m
ed
ical
r
esear
ch
an
d
ed
u
ca
tio
n
,
w
it
h
m
ater
ia
ls
li
k
e
P
L
A
a
n
d
r
ec
y
c
led
p
o
ly
et
h
y
len
e
ter
ep
h
t
h
al
ate
(
r
P
E
T
)
em
er
g
in
g
a
s
p
o
p
u
lar
c
h
o
ices
d
u
e
to
t
h
eir
u
n
iq
u
e
p
r
o
p
er
ties
.
B
elo
w
i
s
a
d
etailed
ex
p
lo
r
atio
n
o
f
h
o
w
t
h
ese
m
ater
ial
s
ar
e
f
ab
r
icate
d
an
d
p
r
ac
ticall
y
m
o
d
eled
f
o
r
b
o
n
e
r
ep
licas.
T
h
e
p
r
o
p
er
ties
o
f
b
o
n
e
m
o
d
eli
n
g
o
f
P
L
A
ar
e:
d
er
iv
ed
f
r
o
m
r
e
n
e
w
ab
le
r
eso
u
r
ce
s
l
ik
e
co
r
n
s
tar
ch
o
r
s
u
g
ar
ca
n
e;
b
io
d
eg
r
ad
ab
le,
en
v
ir
o
n
m
en
tal
l
y
f
r
ie
n
d
l
y
,
an
d
ea
s
y
to
p
r
in
t;
an
d
o
f
f
er
s
g
o
o
d
r
ig
id
ity
,
h
ig
h
d
i
m
en
s
io
n
al
ac
cu
r
ac
y
,
an
d
s
m
o
o
th
s
u
r
f
ac
e
f
in
i
s
h
es,
m
a
k
i
n
g
it
s
u
itab
le
f
o
r
r
ep
licatin
g
b
o
n
e
s
tr
u
ct
u
r
es.
An
d
f
o
r
r
P
E
T
a
r
e:
m
ad
e
f
r
o
m
r
ec
y
cled
p
last
ic,
s
u
ch
as
u
s
ed
b
ev
er
ag
e
b
o
ttles
;
s
tr
o
n
g
,
d
u
r
ab
le,
an
d
less
b
r
ittl
e
co
m
p
ar
ed
to
P
L
A;
an
d
p
r
o
v
id
es
a
s
u
s
ta
in
ab
le
alter
n
ati
v
e
w
it
h
h
i
g
h
s
tr
en
g
t
h
an
d
to
u
g
h
n
e
s
s
,
w
it
h
th
e
s
i
m
ilar
m
ec
h
an
ical
p
r
o
p
er
ties
to
b
o
n
e.
T
h
e
P
L
A
f
ab
r
icatio
n
p
r
o
ce
s
s
in
v
o
l
v
es
P
L
A
g
r
an
u
les
t
h
at
a
r
e
p
r
o
d
u
ce
d
th
r
o
u
g
h
p
o
l
y
m
er
izatio
n
o
f
lactic
ac
id
d
er
iv
ed
f
r
o
m
b
io
m
ass
.
T
h
e
g
r
an
u
le
s
ar
e
m
elted
an
d
ex
tr
u
d
ed
in
to
f
i
la
m
e
n
t
f
o
r
m
,
r
ea
d
y
f
o
r
u
s
e
i
n
3
D
p
r
in
ter
s
,
an
d
f
ila
m
e
n
ts
co
m
e
in
v
ar
io
u
s
d
ia
m
eter
s
(
e.
g
.
,
1
.
7
5
m
m
o
r
2
.
8
5
m
m
)
a
n
d
co
l
o
r
s
f
o
r
cu
s
to
m
ized
ap
p
licatio
n
s
.
T
h
e
r
P
E
T
f
ab
r
i
ca
tio
n
p
r
o
ce
s
s
is
:
P
E
T
w
aste
is
co
llected
,
clea
n
ed
,
an
d
s
h
r
ed
d
ed
in
to
f
la
k
es
;
th
ese
f
la
k
es
u
n
d
er
g
o
ex
tr
u
s
io
n
to
p
r
o
d
u
ce
r
ec
y
cled
P
E
T
f
ila
m
en
ts
;
a
n
d
f
ila
m
en
ts
ar
e
p
r
o
ce
s
s
ed
to
m
a
in
ta
i
n
co
n
s
is
ten
t q
u
a
lit
y
,
e
n
s
u
r
i
n
g
p
r
in
tab
ilit
y
an
d
s
tr
en
g
th
.
T
h
e
p
r
o
ce
s
s
in
m
o
d
eli
n
g
h
u
m
an
b
o
n
e
s
u
s
in
g
P
L
A
a
n
d
r
P
E
T
,
h
as
a
p
r
e
-
p
r
o
ce
s
s
in
g
s
t
ag
e
w
h
er
e
z
h
ig
h
-
r
eso
l
u
tio
n
C
T
s
ca
n
o
r
MRI
o
f
t
h
e
h
u
m
an
b
o
n
e
is
o
b
ta
in
ed
,
th
e
i
m
a
g
i
n
g
d
ata
i
s
p
r
o
ce
s
s
ed
u
s
in
g
C
A
D
s
o
f
t
w
ar
e
to
cr
ea
te
a
3
D
m
o
d
el,
a
n
d
th
e
m
o
d
el
is
co
n
v
er
ted
in
to
a
s
tan
d
ar
d
tess
ellatio
n
la
n
g
u
a
g
e
(
ST
L
)
f
ile,
w
h
ic
h
is
u
s
ed
f
o
r
3
D
p
r
in
tin
g
.
I
n
3
D
p
r
in
tin
g
s
ta
g
e
th
e
p
r
in
ti
n
g
s
e
tu
p
is
p
er
f
o
r
m
ed
t
h
r
o
u
g
h
P
L
A
o
r
r
P
E
T
f
ila
m
e
n
t
i
s
lo
ad
ed
in
to
a
n
F
D
M
3
D
p
r
in
ter
a
n
d
p
r
in
ter
p
ar
am
eter
(
te
m
p
er
at
u
r
e
,
s
p
ee
d
,
an
d
la
y
er
h
e
ig
h
t)
ar
e
ad
j
u
s
ted
b
ased
o
n
th
e
m
ater
i
al.
I
n
th
e
n
ex
t
s
tag
e
p
r
in
ti
n
g
p
r
o
ce
s
s
is
p
er
f
o
r
m
ed
th
r
o
u
g
h
:
f
o
r
P
L
A
,
p
r
in
t
te
m
p
er
atu
r
es
r
a
n
g
e
b
et
w
ee
n
1
9
0
-
220
°C
,
r
P
E
T
r
eq
u
ir
es
s
lig
h
t
l
y
h
i
g
h
er
te
m
p
er
at
u
r
es
(
2
3
0
-
260
°C
)
,
an
d
th
e
m
o
d
el
i
s
p
r
in
ted
la
y
er
b
y
la
y
er
to
r
ep
licate
th
e
b
o
n
e
s
tr
u
ctu
r
e
,
w
it
h
s
u
p
p
o
r
t stru
ctu
r
e
s
ad
d
ed
as n
ee
d
ed
.
I
n
th
e
p
o
s
t
-
p
r
o
ce
s
s
i
n
g
an
d
f
i
n
i
s
h
i
n
g
s
ta
g
e
,
s
u
p
p
o
r
ts
ar
e
r
em
o
v
ed
,
an
d
th
e
m
o
d
el
is
s
a
n
d
ed
to
ac
h
iev
e
a
s
m
o
o
th
f
in
i
s
h
.
P
L
A
m
o
d
els
m
a
y
u
n
d
er
g
o
an
n
ea
li
n
g
f
o
r
in
cr
ea
s
ed
s
t
r
en
g
t
h
an
d
h
ea
t
r
e
s
is
ta
n
ce
,
an
d
r
P
E
T
m
o
d
el
s
ca
n
b
e
tr
ea
ted
w
i
th
c
o
atin
g
s
f
o
r
en
h
a
n
ce
d
d
u
r
ab
ilit
y
an
d
s
u
r
f
ac
e
te
x
t
u
r
e.
B
y
le
v
er
ag
i
n
g
th
e
u
n
iq
u
e
p
r
o
p
er
ties
o
f
P
L
A
an
d
r
P
E
T
,
3
D
m
o
d
elin
g
o
f
h
u
m
an
b
o
n
es
ca
n
b
e
tailo
r
ed
f
o
r
d
iv
er
s
e
ap
p
licatio
n
s
,
f
r
o
m
ed
u
ca
tio
n
t
o
m
ed
ical
r
esear
c
h
,
co
m
b
i
n
i
n
g
p
r
ec
is
io
n
,
p
r
ac
ticalit
y
,
an
d
e
n
v
ir
o
n
m
e
n
tal
co
n
s
ci
o
u
s
n
e
s
s
.
Var
io
u
s
s
o
f
t
w
ar
e
to
o
ls
ar
e
u
s
ed
f
o
r
d
iag
n
o
s
i
n
g
d
is
ea
s
es
an
d
in
j
u
r
ies.
3
D
Sli
ce
r
,
an
o
p
en
-
s
o
u
r
ce
p
r
o
g
r
am
,
e
m
p
lo
y
s
v
o
lu
m
e
r
en
d
er
in
g
to
d
is
p
la
y
3
D
i
m
a
g
es.
Fig
u
r
e
3
ill
u
s
t
r
ate
s
t
h
e
d
eg
r
ad
atio
n
an
d
r
ec
o
v
er
y
o
f
j
o
in
t
s
p
ac
e
d
u
e
to
ca
r
tila
g
e
an
d
m
en
is
c
u
s
d
a
m
ag
e
[
5
4
],
[
5
5
]
.
T
h
e
tib
ial
i
m
p
la
n
t
o
p
ti
m
i
za
tio
n
(
to
p
o
lo
g
ical
o
p
tim
izatio
n
)
w
a
s
d
o
n
e
u
s
i
n
g
f
i
n
ite
ele
m
e
n
t
a
n
al
y
s
i
s
a
n
d
MA
T
L
A
B
s
o
f
t
w
ar
e.
T
h
e
tail
o
r
ed
im
p
la
n
t
m
o
d
el
w
a
s
i
m
p
o
r
ted
in
to
A
NSI
S
an
d
MA
T
L
A
B
s
i
m
u
lat
io
n
m
ec
h
a
n
ical
f
o
r
s
tr
ess
an
al
y
s
is
an
d
p
ar
am
e
ter
ad
j
u
s
t
m
e
n
t.
T
h
e
3
D
tib
ial
m
o
d
el
w
as
i
m
p
o
r
ted
in
to
MA
T
L
A
B
s
i
m
u
lat
io
n
p
r
o
f
ess
io
n
a
l
an
d
tr
an
s
f
er
r
ed
to
MA
T
L
A
B
s
i
m
u
latio
n
m
ec
h
a
n
ical
f
o
r
f
in
ite
ele
m
e
n
t
an
al
y
s
i
s
.
T
h
e
m
o
d
el
w
a
s
p
ar
titi
o
n
ed
in
to
g
r
id
s
,
w
it
h
P
L
A
m
ater
ial
an
d
co
n
s
tr
ai
n
t
co
n
d
it
io
n
s
ap
p
lied
.
T
h
e
p
r
o
x
i
m
al
tib
ia
w
as
f
ix
ed
,
an
d
a
2
0
N
lo
a
d
w
a
s
ap
p
lied
to
th
e
tib
ial
ar
ticu
lar
s
u
r
f
ac
e.
T
h
e
a
n
al
y
s
i
s
r
esu
lts
r
ev
ea
led
d
is
p
lace
m
en
t
at
th
e
ar
ticu
lar
s
u
r
f
ac
e
b
o
r
d
er
an
d
s
tr
ess
co
n
ce
n
tr
atio
n
in
th
e
tib
ial
ten
d
o
n
.
I
n
cr
ea
s
in
g
te
n
d
o
n
th
ic
k
n
ess
an
d
d
is
tr
ib
u
tio
n
co
u
ld
i
m
p
r
o
v
e
tib
ial
s
tr
en
g
t
h
an
d
r
ed
u
ce
s
tr
ess
co
n
ce
n
tr
atio
n
.
T
h
e
p
ar
am
eter
co
n
tr
o
l
tab
le
i
n
M
A
T
L
A
B
s
i
m
u
latio
n
o
f
m
ec
h
an
ica
l
w
as
u
s
ed
to
ad
j
u
s
t
th
e
tib
ial
ten
d
o
n
’
s
h
e
ig
h
t
a
n
d
th
ic
k
n
e
s
s
,
in
cr
ea
s
in
g
it
s
th
ic
k
n
es
s
an
d
d
is
tr
ib
u
tio
n
ar
ea
.
T
h
e
u
p
d
ated
m
o
d
el
w
as
t
h
en
co
n
f
ir
m
ed
.
A
f
ter
g
r
id
p
ar
titi
o
n
in
g
,
t
h
e
m
o
d
el's
m
ater
ial
P
L
A
,
co
n
s
tr
ai
n
t
co
n
d
itio
n
s
,
lo
ad
in
g
,
ti
m
e
s
tep
,
a
n
d
s
o
lu
tio
n
m
et
h
o
d
w
er
e
s
et
f
o
r
an
al
y
s
i
s
.
T
h
e
o
p
tim
ized
tib
ial
im
p
lan
t
’
s
s
tr
ess
an
al
y
s
is
d
e
m
o
n
s
tr
ated
a
r
ed
u
ctio
n
in
m
ax
i
m
al
d
i
s
p
lace
m
e
n
t
f
r
o
m
0
.
0
0
3
4
4
m
m
to
0
.
0
0
0
4
3
m
m
a
n
d
a
d
ec
r
ea
s
e
in
m
ax
i
m
al
s
tr
e
s
s
f
r
o
m
7
.
2
3
5
N/m
m
²
to
1
.
1
6
5
N/
m
m
².
T
h
e
o
p
ti
m
ized
m
o
d
el
ex
h
i
b
ited
r
e
d
u
ce
d
d
is
p
lace
m
e
n
t
s
t
r
ain
,
m
o
r
e
u
n
i
f
o
r
m
s
tr
ess
d
is
tr
ib
u
tio
n
,
an
d
i
m
p
r
o
v
ed
tib
ial
s
tr
en
g
t
h
w
it
h
r
ed
u
ce
d
s
tr
ess
co
n
ce
n
tr
atio
n
.
T
h
e
d
esig
n
ed
tib
ial
i
m
p
lan
t
w
as
i
m
p
o
r
ted
in
to
ST
L
f
o
r
m
at,
a
n
d
p
o
s
itio
n
ed
at
a
9
0
°
in
clin
a
tio
n
f
o
r
s
ta
n
d
ar
d
p
lace
m
en
t.
T
h
e
p
ar
t
w
a
s
s
ec
tio
n
ed
in
to
1
4
3
4
lay
er
s
,
ea
ch
0
.
0
3
4
m
m
t
h
ic
k
,
w
ith
a
m
o
ld
in
g
ti
m
e
o
f
5
h
o
u
r
s
.
T
o
p
e
r
f
o
r
m
k
n
ee
-
j
o
in
t
-
r
esec
t
io
n
f
o
r
p
atien
t
-
s
p
ec
i
f
ic
-
i
m
p
l
an
ts
,
a
r
es
u
r
f
ac
e
d
m
o
d
el
f
o
r
p
atien
t
-
s
p
ec
if
ic
k
n
ee
co
m
p
o
n
e
n
ts
is
c
r
ea
ted
b
y
b
o
n
e
ex
cisi
o
n
in
C
A
D,
w
h
ich
is
also
u
ti
lized
to
ev
alu
ate
o
f
f
-
th
e
-
s
h
el
f
co
m
p
o
n
e
n
t
s
[
5
6
]
.
B
ased
o
n
f
em
u
r
g
eo
m
etr
y
,
t
h
er
e
ar
e
th
r
ee
co
n
v
e
n
tio
n
al
s
izes
f
o
r
f
e
m
o
r
al
r
esectio
n
;
th
e
s
ize
Evaluation Warning : The document was created with Spire.PDF for Python.
I
n
t J
R
ec
o
n
f
i
g
u
r
ab
le
&
E
m
b
ed
d
ed
Sy
s
t
I
SS
N:
2089
-
4864
Desig
n
a
n
d
s
tr
u
ctu
r
a
l m
o
d
elli
n
g
o
f p
a
tien
t
-
s
p
ec
ific 3
D
-
p
r
in
t
ed
kn
ee
femu
r
a
n
d
tib
ia
… (
B
o
lu
g
o
d
d
u
S
a
n
d
ee
p
)
579
o
f
th
e
r
esectio
n
is
d
eter
m
i
n
ed
b
y
th
e
an
ter
io
r
-
p
o
s
ter
io
r
(
A
-
P
)
len
g
t
h
[
5
7
]
.
W
ith
an
av
er
ag
e
len
g
t
h
o
f
5
1
.
0
6
1
m
m
,
th
e
A
-
P
co
m
e
s
in
to
th
e
tin
y
g
r
o
u
p
.
T
h
e
k
n
ee
alig
n
s
m
ec
h
a
n
icall
y
w
h
e
n
th
e
v
alg
u
s
an
g
le
is
6
°.
An
i
n
tr
a
m
ed
u
llar
y
r
e
f
er
en
ce
s
y
s
te
m
t
h
at
i
s
o
r
ien
ted
w
it
h
t
h
e
m
ed
u
l
lar
y
ca
n
a
l
an
d
at
a
6
°
an
g
le
b
et
w
ee
n
t
h
e
m
ec
h
a
n
ical
a
n
d
a
n
ato
m
ic
a
x
e
s
is
u
s
ed
to
cu
t
th
e
f
e
m
u
r
.
1
0
m
m
is
th
e
d
ep
th
o
f
t
h
e
d
is
tal
f
e
m
u
r
c
u
t
[
5
8
],
[
5
9
]
.
W
ith
t
y
p
ical
d
is
ta
l
m
ed
ial
a
n
d
later
al
th
ick
n
es
s
es
o
f
5
.
5
m
m
an
d
p
o
s
ter
io
r
m
ed
ial
an
d
la
ter
al
th
ick
n
e
s
s
es
o
f
5
.
3
m
m
a
n
d
5
.
8
m
m
,
r
esp
ec
ti
v
el
y
,
th
e
k
n
ee
-
j
o
in
t
i
m
p
la
n
t
h
as
a
m
o
d
est
b
o
n
e
r
e
s
ec
tio
n
.
T
h
e
tib
ia
is
s
liced
at
a
0
°
an
g
le
w
it
h
t
h
e
m
ec
h
an
ical
an
d
an
ato
m
ical
a
x
es
p
ar
allel.
T
h
e
j
o
in
t
lin
e
r
e
m
a
in
s
u
n
al
ter
ed
w
h
en
1
3
m
m
o
f
tib
ial
b
o
n
e
is
r
e
m
o
v
ed
,
en
ab
li
n
g
t
h
e
u
s
e
o
f
a
1
3
m
m
p
o
l
y
eth
y
len
e
l
in
er
r
ath
er
t
h
an
a
9
m
m
o
n
e
[
6
0
]
,
[
6
1
]
.
Fe
m
o
r
al
A
-
P
len
g
th
cla
s
s
i
f
ica
tio
n
s
h
elp
in
p
er
s
o
n
alizi
n
g
k
n
ee
i
m
p
la
n
t
s
.
T
y
p
icall
y
,
t
h
es
e
s
izes
ar
e
d
iv
id
ed
in
to
g
r
o
u
p
s
b
ased
o
n
th
e
A
-
P
len
g
th
m
ea
s
u
r
e
m
e
n
t
s
.
E
ac
h
g
r
o
u
p
r
ef
lects
s
p
ec
i
f
i
c
d
im
e
n
s
io
n
s
t
h
at
m
atc
h
th
e
n
a
tu
r
al
v
ar
iatio
n
s
i
n
f
e
m
u
r
s
izes
a
m
o
n
g
in
d
i
v
id
u
als.
T
h
is
class
i
f
icatio
n
en
s
u
r
e
s
a
b
etter
f
it
o
f
th
e
p
r
o
s
th
esis
,
o
p
ti
m
izi
n
g
th
e
p
er
f
o
r
m
an
ce
a
n
d
co
m
f
o
r
t
f
o
r
th
e
p
atie
n
t.
A
cc
u
r
ate
g
r
o
u
p
in
g
i
s
cr
u
cia
l
f
o
r
s
u
cc
e
s
s
f
u
l k
n
ee
r
ep
lace
m
e
n
t
s
u
r
g
er
ies,
a
s
it a
llo
w
s
f
o
r
p
r
ec
i
s
e
alig
n
m
e
n
t a
n
d
ar
tic
u
latio
n
w
it
h
i
n
t
h
e
j
o
in
t.
T
h
e
p
r
o
ce
s
s
o
f
m
ea
s
u
r
in
g
a
n
d
ca
t
eg
o
r
izin
g
f
e
m
o
r
al
A
-
P
le
n
g
th
s
t
h
u
s
p
la
y
s
a
v
ita
l
r
o
le
i
n
o
r
th
o
p
ed
ic
s
u
r
g
ical
o
u
tco
m
es.
T
h
e
r
esec
tio
n
o
f
t
h
e
k
n
ee
j
o
in
t
is
ca
teg
o
r
ized
i
n
t
o
th
r
e
e
s
ta
n
d
ar
d
s
izes
ac
co
r
d
in
g
to
th
e
g
eo
m
etr
y
o
f
th
e
f
e
m
u
r
at
t
h
e
r
esectio
n
s
i
te.
T
h
e
class
if
icat
io
n
o
f
f
e
m
o
r
al
A
-
P
len
g
th
s
is
p
r
ese
n
ted
in
T
ab
le
1
.
T
ab
le
1
.
C
lass
if
icatio
n
o
f
k
n
ee
-
b
ased
class
i
f
ica
tio
n
s
o
n
s
izes
S
i
z
e
s
L
e
n
g
t
h
(
mm
)
S
mal
l
5
3
t
o
5
6
M
e
d
i
u
m
6
1
t
o
6
3
L
a
r
g
e
7
4
t
o
7
6
Kn
ee
j
o
in
t
i
m
p
la
n
t
s
an
d
t
h
e
f
e
m
o
r
al
b
o
n
e
r
esect
io
n
p
r
o
f
il
e
ar
e
u
tili
ze
d
to
m
o
d
el
p
atie
n
t
-
s
p
ec
i
f
ic
i
m
p
lan
ts
u
s
in
g
M
A
T
L
A
B
Sim
u
latio
n
.
T
h
e
av
er
ag
e
i
m
p
lan
t
th
ick
n
es
s
v
al
u
es
ar
e
u
s
ed
to
g
en
er
ate
th
e
f
e
m
o
r
al
i
m
p
lan
t
m
o
d
els.
W
ith
a
9
m
m
tib
ial
b
o
n
e
ex
cisi
o
n
,
th
e
tib
ial
im
p
la
n
t
is
u
s
ed
lik
e
t
h
e
tib
ia
p
r
o
f
ile.
T
h
e
lin
er
is
in
s
er
ted
in
to
th
e
tib
ial
tr
a
y
a
f
t
er
a
r
esectio
n
p
r
o
f
ile
is
m
ad
e
o
n
th
e
u
p
p
er
s
u
r
f
ac
e.
T
h
e
lin
e
r
h
as
a
2
m
m
s
h
ell,
an
d
th
e
tib
ial
tr
a
y
i
s
ex
tr
u
d
ed
b
y
4
m
m
a
n
d
9
m
m
,
r
esp
ec
ti
v
el
y
.
T
o
s
im
u
late
an
d
m
o
d
el
k
n
ee
-
j
o
in
t
-
co
m
p
o
n
en
ts
in
3
D
-
p
r
i
n
tin
g
,
MA
T
L
A
B
s
i
m
u
la
tio
n
i
s
u
s
ed
to
i
m
p
o
r
t
k
n
ee
i
m
p
lan
t
f
iles
,
co
n
f
ig
u
r
e
p
r
o
ce
s
s
p
ar
a
m
eter
s
,
a
n
d
ad
d
s
u
p
p
o
r
t
s
tr
u
c
tu
r
es
to
th
e
tib
ia
tr
a
y
a
n
d
f
e
m
o
r
al
i
m
p
lan
t.
Fo
llo
w
i
n
g
v
alid
atio
n
,
G
-
co
d
es
ar
e
p
r
o
d
u
ce
d
b
y
th
e
p
r
o
g
r
a
m
a
n
d
ex
p
o
r
ted
to
th
e
3
D
p
r
in
ter
f
o
r
p
r
in
ti
n
g
.
T
h
e
p
r
o
p
o
s
ed
r
e
s
ea
r
ch
e
x
a
m
in
e
s
t
h
e
ef
f
ec
t
s
o
f
3
D
-
p
r
i
n
ted
P
L
A
co
m
p
o
s
ite
m
ater
ial
o
n
T
KR
.
C
o
m
b
i
n
in
g
P
L
A
w
it
h
r
ec
y
cle
d
P
E
T
(
r
P
E
T
)
h
as
r
esu
lted
i
n
a
s
tab
le,
3
D
-
p
r
in
tab
le
m
a
ter
ial
th
at
allo
w
s
f
o
r
th
e
cr
ea
tio
n
o
f
p
o
r
o
u
s
a
n
d
f
in
el
y
s
tr
u
ct
u
r
ed
s
ca
f
f
o
ld
s
.
T
h
ese
s
ca
f
f
o
ld
s
d
e
m
o
n
s
tr
at
e
o
s
teo
g
en
ic
an
d
an
ti
-
i
n
f
la
m
m
ato
r
y
p
r
o
p
er
ties
.
T
h
is
3
D
-
p
r
in
ted
m
ater
ial
m
ee
ts
m
a
n
y
o
f
th
e
r
eq
u
ir
e
m
e
n
ts
o
u
tlin
ed
i
n
th
e
liter
atu
r
e.
T
h
e
s
tu
d
en
t
v
er
s
io
n
o
f
p
r
o
-
en
g
in
ee
r
,
also
k
n
o
w
n
as
C
r
eo
,
is
u
s
ed
to
s
et
p
r
in
t
p
ar
a
m
eter
s
an
d
s
lice
th
e
ST
L
f
ile
a
f
ter
i
m
p
o
r
tin
g
t
h
e
3
D
m
o
d
el.
T
h
e
o
r
ien
tatio
n
o
f
th
e
k
n
ee
j
o
in
t
is
ad
j
u
s
ted
w
ith
i
n
th
e
p
r
in
t
ar
ea
.
T
h
e
p
r
in
tin
g
v
ar
iab
les ar
e
d
etailed
in
T
ab
le
2
.
T
ab
le
2
.
Ma
ter
ial
p
a
r
am
eter
s
f
o
r
3
D
m
o
d
el
d
esig
n
an
al
y
s
is
M
a
t
e
r
i
a
l
t
y
p
e
L
a
y
e
r
h
e
i
g
h
t
(
mm
)
N
u
mb
e
r
o
f
sh
e
l
l
s
I
n
f
i
l
l
(
%)
I
n
f
i
l
l
t
y
p
e
B
u
i
l
d
t
i
me
f
o
r
f
e
mu
r
a
n
d
l
i
n
e
r
i
m
p
l
a
n
t
B
u
i
l
d
t
i
me
f
o
r
t
i
b
i
a
t
r
a
y
S
u
p
p
o
r
t
s
t
r
u
c
t
u
r
e
P
L
A
0
.
2
2
2
29
H
e
x
a
g
o
a
l
2
h
6
0
mi
n
A
d
d
e
d
Fo
r
th
is
a
n
al
y
s
is
r
ep
o
r
t,
th
e
f
o
llo
w
in
g
s
p
ec
i
f
icatio
n
s
ar
e
u
s
ed
,
af
ter
r
ev
ie
w
in
g
s
e
v
er
al
r
esear
ch
p
ap
er
s
an
d
p
u
b
licatio
n
s
.
P
o
l
y
m
er
m
ater
ials
ar
e
t
y
p
icall
y
cr
ea
ted
u
s
in
g
b
io
lo
g
icall
y
ex
tr
u
d
ed
3
D
p
r
in
tin
g
tech
n
iq
u
es.
B
o
th
n
at
u
r
al
p
o
l
y
m
er
s
a
n
d
p
ar
tiall
y
s
y
n
t
h
etic
p
o
ly
m
er
s
ca
n
b
e
ea
s
il
y
co
n
v
er
ted
in
to
h
y
d
r
o
g
el
b
io
lo
g
ical
in
k
s
,
w
h
ich
m
i
m
ic
th
e
h
y
d
r
o
p
h
il
ic
p
r
o
p
er
ties
an
d
b
io
co
m
p
atib
ilit
y
o
f
b
io
lo
g
ical
t
is
s
u
e
s
.
T
h
eir
m
ec
h
a
n
ical
p
r
o
p
er
ties
ca
n
b
e
ad
j
u
s
ted
to
f
o
r
m
s
tab
le
3D
s
tr
u
ctu
r
e
s
.
Mo
s
t
b
io
lo
g
ical
i
n
k
s
r
ep
o
r
ted
a
r
e
u
s
ed
i
n
g
as
-
p
h
a
s
e
en
v
ir
o
n
m
en
ts
i
n
v
it
r
o
,
alth
o
u
g
h
liq
u
id
-
p
h
a
s
e
s
u
s
p
en
d
ed
3
D
p
r
in
tin
g
i
s
also
b
ein
g
ex
p
lo
r
ed
,
li
m
ited
to
s
p
ec
if
ic
liq
u
id
-
p
h
ase
s
o
lv
e
n
ts
.
T
h
e
ac
tu
al
ap
p
licatio
n
e
n
v
i
r
o
n
m
e
n
t o
f
b
io
m
ater
ials
i
s
co
m
p
lex
,
w
i
th
v
ar
io
u
s
p
r
in
ted
b
io
m
ater
ial
co
m
p
o
n
en
ts
an
d
ce
lls
o
f
f
er
in
g
d
if
f
er
en
t
p
r
o
p
er
ties
an
d
f
u
n
ctio
n
s
.
T
h
is
s
tu
d
y
f
o
cu
s
e
s
o
n
s
elec
ti
n
g
p
o
l
y
m
er
m
ater
ials
,
b
io
lo
g
ical
p
r
in
tin
g
ce
lls
,
an
d
th
eir
u
s
e
in
b
o
n
e
an
d
ca
r
tilag
e
r
ep
air
.
T
h
is
r
ev
ie
w
d
etails
ea
ch
co
m
p
o
n
e
n
t
’
s
c
h
ar
ac
ter
is
tics
,
p
r
o
v
id
in
g
a
b
asis
an
d
p
r
o
g
r
ess
o
f
3
D
p
r
in
ti
n
g
ap
p
licatio
n
s
i
n
b
io
lo
g
ical
b
o
n
e
an
d
ca
r
tilag
e,
as sh
o
w
n
i
n
T
ab
le
s
3
an
d
4
.
Evaluation Warning : The document was created with Spire.PDF for Python.
I
SS
N
:
2
0
8
9
-
4864
I
n
t J
R
ec
o
n
f
i
g
u
r
ab
le
&
E
m
b
ed
d
ed
Sy
s
t
,
Vo
l.
14
,
No
.
2
,
J
u
l
y
20
25
:
575
-
5
8
6
580
T
ab
le
3
.
Ma
ter
ial
p
r
o
p
er
ties
o
f
ca
r
tilag
e
P
r
o
p
e
r
t
i
e
s
V
a
l
u
e
Y
o
u
n
g
’
s mo
d
u
l
u
s
0
.
0
6
-
0
.
0
2
0
M
P
a
P
o
i
ssi
o
n
's
r
a
t
i
o
0
.
4
5
-
0
.
4
9
S
h
e
a
r
mo
d
u
l
u
s
0
.
0
2
0
M
P
a
T
e
mp
e
r
a
t
u
r
e
25
o
C
D
e
n
si
t
y
1
1
0
0
k
g
/
m
3
P
e
r
me
a
b
i
l
i
t
y
10
-
15
t
o
1
0
-
16
m
4
/N
M
a
t
e
r
i
a
l
t
y
p
e
v
i
sco
e
l
a
st
i
c
(
p
o
r
o
u
s)
T
ab
le
4
.
Ma
ter
ial
p
r
o
p
er
ties
o
f
b
o
n
e
P
r
o
p
e
r
t
i
e
s
V
a
l
u
e
Y
o
u
n
g
’
s
mo
d
u
l
u
s
12600
-
19400
M
P
a
P
o
i
ssi
o
n
's
r
a
t
i
o
0
.
3
-
0
.
3
9
S
h
e
a
r
mo
d
u
l
u
s
4
8
5
0
-
5
7
0
0
M
p
a
O
p
e
r
a
t
i
n
g
t
e
m
p
e
r
a
t
u
r
e
25
o
C
D
e
n
si
t
y
1
8
0
0
k
g
/
m
3
M
a
t
e
r
i
a
l
t
y
p
e
S
o
l
i
d
T
e
n
s
i
l
e
s
t
r
e
n
g
t
h
50
-
1
3
5
M
P
a
C
o
mp
r
e
ssi
v
e
st
r
e
n
g
t
h
(
-
50)
to
(
-
2
5
0
)
M
P
a
S
h
e
a
r
st
r
e
n
g
t
h
65
M
P
a
T
h
e
ten
s
ile
p
r
o
p
er
ties
o
f
h
u
m
an
b
o
n
e
a
n
d
3
D
-
p
r
i
n
ted
k
n
ee
b
o
n
e
j
o
in
ts
ar
e
cr
u
cial
f
o
r
as
s
ess
i
n
g
h
o
w
ef
f
ec
tiv
e
l
y
s
y
n
t
h
etic
m
ater
ial
s
ca
n
r
ep
licate
n
at
u
r
al
s
tr
u
c
t
u
r
es
i
n
o
r
th
o
p
ed
ic
ap
p
licatio
n
s
.
C
o
r
tical
b
o
n
e,
a
t
y
p
e
o
f
h
u
m
a
n
b
o
n
e,
d
em
o
n
s
tr
ates
ex
ce
p
tio
n
al
te
n
s
ile
s
tr
en
g
t
h
an
d
to
u
g
h
n
e
s
s
d
u
e
to
its
u
n
iq
u
e
co
m
p
o
s
it
e
s
tr
u
ct
u
r
e,
w
h
ic
h
co
m
b
i
n
es
co
llag
e
n
f
ib
er
s
w
it
h
h
y
d
r
o
x
y
ap
atite
m
i
n
er
al
cr
y
s
tal
s
.
T
h
is
n
atu
r
al
co
m
p
o
s
itio
n
allo
w
s
b
o
n
es to
en
d
u
r
e
s
u
b
s
ta
n
tial s
tr
ess
w
h
ile
r
etai
n
i
n
g
f
le
x
ib
ilit
y
an
d
d
u
r
ab
ilit
y
.
R
ec
en
t
ad
v
a
n
ce
m
e
n
ts
i
n
3
D
p
r
in
tin
g
tech
n
o
lo
g
y
h
a
v
e
en
a
b
led
th
e
f
ab
r
ic
atio
n
o
f
k
n
ee
b
o
n
e
j
o
in
ts
u
s
i
n
g
m
a
ter
ials
s
u
c
h
as
P
L
A
co
m
p
o
s
i
tes.
T
h
ese
m
ater
ials
a
r
e
s
elec
ted
f
o
r
th
eir
b
io
co
m
p
a
tib
ilit
y
,
m
ec
h
an
ica
l
p
r
o
p
er
ties
,
an
d
ea
s
e
o
f
p
r
o
ce
s
s
in
g
.
Ho
w
ev
er
,
r
ep
licati
n
g
t
h
e
in
tr
icate
m
icr
o
s
tr
u
ct
u
r
e
an
d
m
ec
h
a
n
ical
b
e
h
av
io
r
o
f
h
u
m
a
n
b
o
n
e
r
e
m
ai
n
s
a
s
ig
n
if
ica
n
t c
h
a
llen
g
e
.
3.
RE
SU
L
T
S AN
D
D
I
SCU
SS
I
O
N
T
h
e
o
r
th
o
s
is
d
esig
n
w
a
s
ca
r
ef
u
ll
y
co
n
s
id
er
ed
f
o
r
m
ec
h
a
n
ica
l
in
teg
r
it
y
,
u
s
i
n
g
t
w
o
p
o
l
y
m
er
m
a
tr
ices:
P
L
A
a
n
d
r
P
E
T
,
w
i
th
t
w
o
co
m
m
er
cial
b
r
an
d
s
f
o
r
ea
ch
.
T
h
ese
m
ater
ials
w
er
e
ch
o
s
e
n
f
o
r
th
eir
af
f
o
r
d
ab
ilit
y
,
av
ailab
ilit
y
,
an
d
s
u
i
tab
ilit
y
b
ased
o
n
th
e
ir
p
r
o
p
er
ti
es.
T
h
e
DI
C
OM
d
ata
is
i
m
p
o
r
ted
in
to
3
D
Sli
ce
r
w
it
h
th
r
es
h
o
ld
v
alu
e
s
s
et
at
1
5
2
(
lo
w
er
)
an
d
2
,
9
2
3
.
6
0
(
u
p
p
er
)
f
o
r
b
etter
b
o
n
e
v
is
u
aliza
tio
n
.
Sl
ic
in
g
a
n
d
s
m
o
o
t
h
in
g
to
o
ls
ar
e
u
s
ed
to
elim
in
ate
u
n
w
a
n
ted
g
eo
m
etr
ies.
W
h
ile
s
m
o
o
t
h
i
n
g
d
ea
ls
w
it
h
tin
y
,
in
v
is
ib
le
g
eo
m
etr
ies
,
s
licer
s
eli
m
i
n
ate
lar
g
er
ap
p
ar
en
t
g
eo
m
etr
y
.
M
A
T
L
A
B
Si
m
u
latio
n
is
u
s
ed
to
co
r
r
ec
t
o
p
e
n
lo
o
p
s
in
t
h
e
k
n
ee
j
o
in
t th
at
w
er
e
p
r
esen
t d
u
r
i
n
g
th
e
co
n
v
er
s
io
n
f
r
o
m
DI
C
OM
t
o
ST
L
.
Af
ter
i
m
p
o
r
ti
n
g
th
e
k
n
ee
j
o
i
n
t
ST
L
f
ile
i
n
to
M
A
T
L
A
B
Si
m
u
latio
n
,
o
r
ien
tatio
n
s
a
r
e
ch
an
g
ed
to
g
u
ar
a
n
tee
a
s
m
o
o
th
s
u
r
f
ac
e
f
i
n
is
h
,
r
ed
u
ce
s
u
p
p
o
r
t,
an
d
in
cr
ea
s
e
ac
cu
r
ac
y
.
T
h
e
p
r
in
t
p
ar
a
m
eter
s
i
n
cl
u
d
e
t
w
o
s
h
ell
s
,
2
0
%
h
ex
ag
o
n
al
in
f
ill,
an
d
a
0
.
2
0
m
m
la
y
er
h
ei
g
h
t.
T
h
e
p
r
in
t
to
o
k
f
o
u
r
h
o
u
r
s
an
d
t
w
en
t
y
-
s
ix
m
in
u
te
s
w
it
h
s
u
p
p
o
r
ts
u
s
i
n
g
b
io
d
eg
r
a
d
ab
le
P
L
A
.
T
h
e
f
e
m
o
r
al,
tib
ial,
an
d
li
n
er
i
m
p
la
n
ts
o
f
t
h
e
3
D
-
p
r
in
ted
k
n
ee
j
o
in
t
p
r
o
to
ty
p
e
ar
e
s
i
m
i
lar
l
y
m
ad
e
o
f
P
L
A
u
s
in
g
a
3
D
FDM
p
r
in
t
er
w
it
h
0
.
2
0
m
m
la
y
er
h
ei
g
h
t,
2
5
%
in
f
il
l,
an
d
t
w
o
s
h
ell
s
.
T
h
e
f
e
m
u
r
an
d
li
n
er
to
o
k
2
h
o
u
r
s
to
p
r
in
t,
w
h
ile
t
h
e
ti
b
ial
tr
ay
to
o
k
6
0
m
i
n
u
tes.
3
.
1
.
3
-
D
printe
d kneebo
ne
j
o
int
As
s
h
o
w
n
in
T
ab
le
5
,
a
co
m
p
ar
is
o
n
o
f
th
e
te
n
s
ile
p
r
o
p
er
ties
o
f
th
e
m
a
ter
ials
u
s
ed
in
th
i
s
s
tu
d
y
w
i
th
th
o
s
e
o
f
n
at
u
r
al
h
u
m
a
n
b
o
n
e
an
d
3
D
-
p
r
in
ted
k
n
ee
b
o
n
e
j
o
in
ts
r
ev
ea
ls
o
n
l
y
m
in
o
r
d
if
f
er
en
ce
s
in
en
er
g
y
d
is
s
ip
atio
n
.
T
o
en
h
an
ce
t
h
e
p
er
f
o
r
m
a
n
ce
o
f
3
D
-
p
r
in
ted
k
n
ee
b
o
n
e
j
o
in
ts
,
co
m
p
o
s
ite
m
ater
ials
lik
e
P
L
A
b
len
d
ed
w
it
h
r
ec
y
cled
r
P
E
T
h
av
e
b
ee
n
u
til
ized
,
co
m
b
i
n
ed
w
it
h
ad
v
a
n
ce
d
p
r
in
tin
g
tec
h
n
i
q
u
es.
I
n
co
r
p
o
r
atin
g
b
io
ac
tiv
e
ce
r
a
m
ic
s
o
r
n
an
o
m
a
ter
ials
in
to
th
e
p
r
in
tin
g
p
r
o
ce
s
s
ca
n
f
u
r
th
er
i
m
p
r
o
v
e
m
ec
h
a
n
ical
p
r
o
p
er
ties
an
d
b
etter
m
i
m
ic
th
e
h
ier
ar
ch
ical
s
tr
u
ctu
r
e
o
f
n
at
u
r
al
b
o
n
e.
Mo
r
eo
v
er
,
o
p
tim
izi
n
g
p
r
i
n
t
in
g
p
ar
a
m
eter
s
—
s
u
c
h
as
l
a
y
er
th
ic
k
n
ess
a
n
d
o
r
ien
ta
tio
n
—
ca
n
s
ig
n
i
f
ica
n
tl
y
i
n
f
l
u
en
ce
t
h
e
ten
s
ile
p
r
o
p
er
ties
o
f
th
e
f
i
n
al
p
r
in
ted
p
ar
t.
T
h
ese
o
n
g
o
in
g
d
ev
el
o
p
m
e
n
ts
p
r
o
m
i
s
e
to
cr
ea
te
m
o
r
e
ef
f
ec
ti
v
e
an
d
d
u
r
a
b
le
o
r
th
o
p
ed
ic
im
p
la
n
t
s
,
u
lti
m
atel
y
i
m
p
r
o
v
in
g
p
atien
t
o
u
tco
m
es
a
n
d
ad
v
an
ci
n
g
th
e
f
ield
o
f
b
io
m
ed
ical
e
n
g
i
n
ee
r
in
g
.
T
h
e
te
n
s
ile
p
iece
s
af
te
r
3
D
m
o
d
elin
g
w
er
e
an
al
y
ze
d
an
d
p
r
o
ce
s
s
ed
f
o
r
p
o
lis
h
i
n
g
b
y
m
a
k
i
n
g
t
h
e
s
u
r
f
a
ce
r
o
u
g
h
n
es
s
at
4
.
3
m
icr
o
m
ete
r
s
,
to
an
al
y
ze
t
h
e
ten
s
ile
tes
t p
r
o
ce
s
s
.
Evaluation Warning : The document was created with Spire.PDF for Python.
I
n
t J
R
ec
o
n
f
i
g
u
r
ab
le
&
E
m
b
ed
d
ed
Sy
s
t
I
SS
N:
2089
-
4864
Desig
n
a
n
d
s
tr
u
ctu
r
a
l m
o
d
elli
n
g
o
f p
a
tien
t
-
s
p
ec
ific 3
D
-
p
r
in
t
ed
kn
ee
femu
r
a
n
d
tib
ia
… (
B
o
lu
g
o
d
d
u
S
a
n
d
ee
p
)
581
T
ab
le
5
.
C
o
m
p
ar
is
o
n
s
o
f
h
u
m
an
b
o
n
e
an
d
3
-
D
p
r
in
ted
k
n
ee
b
o
n
e
j
o
in
t
H
u
ma
n
b
o
n
e
p
r
o
p
e
r
t
i
e
s
3
D
p
r
i
n
t
e
d
p
r
o
p
e
r
t
i
e
s
T
e
n
si
l
e
C
o
mp
r
e
ssi
v
e
S
h
e
a
r
T
e
n
si
l
e
C
o
mp
r
e
ssi
v
e
S
h
e
a
r
1
5
0
M
p
a
2
5
0
M
p
a
4
5
0
M
p
a
1
4
0
M
p
a
2
5
0
M
p
a
3
0
0
M
p
a
T
h
e
s
tep
s
in
v
o
l
v
ed
in
m
o
d
eli
n
g
3
D
-
p
r
in
ted
k
n
ee
f
e
m
u
r
a
n
d
tib
ia
i
m
p
la
n
ts
u
s
in
g
P
L
A
a
n
d
r
P
E
T
in
th
e
p
r
o
p
o
s
ed
w
o
r
k
ar
e:
a.
Data
ac
q
u
is
it
io
n
−
MRI
s
ca
n
s
:
p
atien
t
-
s
p
ec
i
f
ic
im
ag
in
g
d
ata
in
DI
C
OM
f
o
r
m
at
is
co
llected
.
MRI
s
ca
n
s
ar
e
o
f
ten
p
r
ef
er
r
ed
f
o
r
h
i
g
h
er
r
eso
lu
tio
n
i
n
ca
p
tu
r
i
n
g
b
o
n
e
s
tr
u
ct
u
r
es.
−
Seg
m
en
tatio
n
:
t
h
e
r
eg
io
n
s
o
f
in
ter
est
(
e.
g
.
,
f
e
m
u
r
a
n
d
tib
ia)
ar
e
s
eg
m
e
n
ted
u
s
i
n
g
s
o
f
t
w
ar
e,
u
s
i
n
g
A
N
SIS
an
d
MA
T
L
A
B
to
is
o
late
t
h
e
b
o
n
e
s
tr
u
ct
u
r
es.
b.
3
D
m
o
d
el
cr
ea
tio
n
−
T
h
r
esh
o
ld
in
g
a
n
d
m
a
s
k
in
g
:
t
h
r
es
h
o
ld
in
g
v
al
u
es
ar
e
ad
j
u
s
t
ed
to
f
o
cu
s
o
n
t
h
e
b
o
n
e
ar
ea
s
,
an
d
m
as
k
s
ar
e
cr
ea
ted
to
d
ef
in
e
th
e
b
o
u
n
d
ar
i
es o
f
th
e
3
D
m
o
d
el
s
.
−
R
eg
io
n
g
r
o
w
in
g
an
d
s
u
r
f
ac
e
g
en
er
atio
n
:
to
o
ls
A
NSI
S
an
d
3
D
Vie
w
ar
e
u
s
ed
to
g
en
er
ate
3
D
s
u
r
f
ac
es
o
f
th
e
b
o
n
es
f
r
o
m
s
e
g
m
en
ted
d
at
a.
−
No
is
e
r
e
m
o
v
al
:
to
o
ls
3
D
v
ie
w
an
d
M
A
T
L
A
B
ar
e
u
s
ed
to
s
m
o
o
th
a
n
d
r
ec
tify
g
eo
m
etr
ic
al
er
r
o
r
s
s
u
ch
as
o
p
en
lo
o
p
s
an
d
u
n
w
a
n
ted
ar
tifa
cts.
c.
C
u
s
to
m
iza
tio
n
a
n
d
i
m
p
la
n
t d
esig
n
−
R
ev
er
s
e
e
n
g
i
n
ee
r
i
n
g
:
th
e
n
at
u
r
al
cu
r
v
a
tu
r
e
o
f
t
h
e
b
o
n
es
is
ca
p
tu
r
ed
,
an
d
ad
j
u
s
t
m
e
n
ts
ar
e
m
ad
e
to
en
s
u
r
e
th
e
i
m
p
la
n
t
f
it
s
ac
cu
r
atel
y
.
T
o
o
l A
NSI
S i
s
u
s
ed
f
o
r
d
etailed
d
esig
n
alter
atio
n
s
.
−
Ma
ter
ial
ass
i
g
n
m
e
n
t
:
t
h
e
d
en
s
it
y
o
f
co
r
tical
an
d
ca
n
ce
llo
u
s
b
o
n
e
is
an
al
y
ze
d
to
d
eter
m
in
e
m
ec
h
a
n
ical
p
r
o
p
er
ti
es.
J
o
in
ts
k
n
ee
d
ata
f
r
o
m
M
R
I
s
ca
n
s
i
s
u
s
ed
to
s
i
m
u
late
m
ater
ial
c
h
ar
ac
ter
is
tic
s
.
d.
P
r
ep
ar
atio
n
f
o
r
3
D
p
r
in
tin
g
−
C
o
n
v
er
s
io
n
to
ST
L
: t
h
e
f
i
n
aliz
ed
3
D
m
o
d
els ar
e
co
n
v
er
ted
to
ST
L
f
o
r
m
at
f
o
r
s
licin
g
a
n
d
3
D
p
r
in
tin
g
.
−
Sli
cin
g
a
n
d
p
r
o
ce
s
s
p
ar
a
m
eter
s
: to
o
l 3
D
s
l
icer
is
u
s
ed
to
s
et
p
ar
am
eter
s
: i)
l
a
y
er
h
eig
h
t
:
0
.
2
0
m
m
f
o
r
P
L
A,
ii)
i
n
f
ill
p
atter
n
:
h
ex
a
g
o
n
a
l
i
n
f
ill
i
s
u
s
ed
f
o
r
li
g
h
t
w
ei
g
h
t
s
tr
en
g
t
h
,
ar
o
u
n
d
2
0
–
2
5
%,
an
d
iii)
s
u
p
p
o
r
t
s
tr
u
ct
u
r
es
: a
d
d
ed
to
en
s
u
r
e
s
ta
b
ilit
y
d
u
r
i
n
g
p
r
in
tin
g
.
e.
3
D
P
r
in
tin
g
−
Ma
ter
ial
s
elec
tio
n
:
P
L
A
,
a
b
io
d
eg
r
ad
ab
le
p
o
ly
m
er
,
an
d
r
P
E
T
,
a
r
ec
y
cled
m
ater
ia
l,
ar
e
u
s
ed
f
o
r
en
v
ir
o
n
m
e
n
tal
l
y
f
r
ien
d
l
y
an
d
b
io
co
m
p
atib
le
p
r
in
ti
n
g
.
−
P
r
in
tin
g
p
r
o
ce
s
s
:
t
h
e
m
o
d
els
ar
e
p
r
in
ted
u
s
i
n
g
FDM
p
r
in
ter
s
.
P
ar
am
eter
s
s
u
ch
a
s
p
r
in
tin
g
s
p
ee
d
an
d
te
m
p
er
atu
r
e
ar
e
o
p
t
i
m
ized
f
o
r
m
ater
ial
t
y
p
e.
−
P
o
s
t
-
p
r
o
ce
s
s
in
g
:
s
u
p
p
o
r
t
s
tr
u
ctu
r
es
ar
e
r
em
o
v
ed
,
an
d
th
e
p
r
in
ted
s
u
r
f
ac
e
s
ar
e
clea
n
ed
an
d
p
o
lis
h
ed
to
en
s
u
r
e
a
s
m
o
o
t
h
f
i
n
i
s
h
.
f.
Ver
if
icatio
n
an
d
test
in
g
−
Di
m
e
n
s
io
n
al
ac
cu
r
ac
y
:
th
e
p
r
in
ted
i
m
p
la
n
ts
ar
e
co
m
p
ar
ed
ag
ain
s
t
t
h
e
o
r
ig
in
al
C
A
D
d
es
ig
n
s
to
en
s
u
r
e
ac
cu
r
ac
y
.
−
Me
ch
an
ical
test
i
n
g
:
i
m
p
la
n
t
s
ar
e
test
ed
f
o
r
s
tr
en
g
t
h
an
d
f
l
ex
ib
ilit
y
to
en
s
u
r
e
th
e
y
m
ee
t
b
io
m
ec
h
an
ica
l
r
eq
u
ir
e
m
en
ts
.
−
P
r
o
to
ty
p
in
g
an
d
ass
e
m
b
l
y
:
th
e
f
e
m
u
r
,
tib
ial
tr
ay
,
an
d
lin
er
ar
e
test
ed
in
ass
e
m
b
l
y
to
co
n
f
ir
m
co
m
p
a
tib
ilit
y
an
d
f
u
n
ct
io
n
alit
y
.
g.
C
li
n
ical
co
n
s
id
er
atio
n
s
−
C
u
s
to
m
iza
tio
n
: p
atie
n
t
-
s
p
ec
i
f
i
c
f
ac
to
r
s
,
s
u
c
h
as b
o
n
e
m
o
r
p
h
o
lo
g
y
,
ar
e
ac
co
u
n
ted
f
o
r
d
u
r
i
n
g
d
esig
n
.
−
Su
r
g
ical
ad
ap
tab
ilit
y
: i
m
p
lan
ts
ar
e
d
esig
n
ed
to
ea
s
e
s
u
r
g
ical
p
r
o
ce
d
u
r
es lik
e
T
KA
.
T
h
is
ap
p
r
o
ac
h
en
a
b
les
t
h
e
cr
ea
tio
n
o
f
c
u
s
to
m
ized
,
co
s
t
-
e
f
f
ec
tiv
e,
a
n
d
en
v
ir
o
n
m
e
n
tall
y
s
u
s
tai
n
ab
le
k
n
ee
i
m
p
la
n
ts
.
T
h
e
f
e
m
u
r
a
n
d
tib
ia
ar
e
ea
ch
d
iv
id
ed
i
n
to
f
o
u
r
d
is
ti
n
ct
r
eg
io
n
s
:
F1
to
F4
f
o
r
th
e
f
e
m
u
r
a
n
d
T
1
to
T
4
f
o
r
th
e
tib
ia,
w
i
th
F1
an
d
T
1
r
e
p
r
esen
tin
g
th
e
m
o
s
t
p
r
o
x
i
m
a
l
r
eg
io
n
s
a
n
d
F4
an
d
T
4
th
e
m
o
s
t
d
i
s
tal
.
Data
f
r
o
m
t
h
e
s
ca
n
s
in
cl
u
d
ed
m
ea
s
u
r
e
m
e
n
ts
f
r
o
m
t
h
e
en
tir
e
d
is
tal
f
e
m
u
r
,
th
e
e
n
tire
p
r
o
x
i
m
al
tib
ia,
an
d
th
e
s
u
b
ch
o
n
d
r
al
r
eg
io
n
s
o
f
b
o
th
th
e
f
e
m
u
r
an
d
tib
ia.
T
o
p
er
f
o
r
m
t
h
e
m
o
d
eli
n
g
o
f
th
e
p
r
o
p
o
s
ed
k
n
ee
j
o
in
t
p
r
o
ce
s
s
,
as
s
h
o
w
n
in
F
i
g
u
r
e
s
3
(
a)
-
(
c)
,
th
e
C
T
o
r
NM
R
s
ca
n
s
o
f
a
4
2
-
y
ea
r
-
o
ld
w
o
m
an
w
it
h
lef
t
k
n
ee
o
s
teo
ar
th
r
itis
ca
p
tu
r
e
i
m
a
g
es
o
f
t
h
e
d
is
ea
s
e
s
ite,
w
h
ic
h
ar
e
th
en
i
m
p
o
r
ted
.
T
h
e
co
r
r
ec
t
o
r
i
en
tatio
n
i
s
s
elec
ted
d
u
r
i
n
g
t
h
e
i
m
p
o
r
t
p
r
o
ce
s
s
.
A
s
s
h
o
w
n
i
n
Fig
u
re
3
(
d
)
,
f
o
r
th
e
3
D
m
o
d
el,
th
r
es
h
o
ld
s
e
g
m
en
t
atio
n
is
ap
p
lied
,
an
d
d
is
co
n
n
e
cted
r
eg
io
n
s
ar
e
f
u
r
th
er
d
i
v
id
e
d
in
to
s
u
b
g
r
o
u
p
s
to
cr
ea
te
a
n
e
w
m
as
k
.
T
h
e
s
o
f
t
ti
s
s
u
e
s
ite
is
m
ar
k
ed
as
t
h
e
s
tar
t
in
g
p
o
in
t,
a
n
d
th
e
en
d
p
o
in
t
is
id
en
ti
f
ied
o
n
ce
t
h
e
lin
e
p
en
etr
ate
s
th
e
b
o
n
e,
g
en
e
r
atin
g
a
n
i
n
ten
s
it
y
i
n
ter
f
ac
e
wh
er
e
th
e
p
r
o
m
i
n
en
t
ar
ea
r
ep
r
e
s
en
t
s
th
e
t
h
r
es
h
o
ld
.
Evaluation Warning : The document was created with Spire.PDF for Python.
I
SS
N
:
2
0
8
9
-
4864
I
n
t J
R
ec
o
n
f
i
g
u
r
ab
le
&
E
m
b
ed
d
ed
Sy
s
t
,
Vo
l.
14
,
No
.
2
,
J
u
l
y
20
25
:
575
-
5
8
6
582
T
h
e
s
eg
m
en
ted
DI
C
OM
f
ile
i
s
m
ad
e
i
n
to
in
d
i
v
id
u
a
l
s
ta
n
d
ar
d
tr
ian
g
u
latio
n
lan
g
u
ag
e
(
ST
L
)
f
iles
a
s
s
h
o
w
n
i
n
F
ig
u
r
e
s
3
(
a)
-
(
d
)
.
Af
ter
t
h
r
esh
o
ld
s
e
g
m
en
ta
tio
n
,
th
e
i
m
ag
e
s
w
er
e
p
r
o
ce
s
s
ed
w
i
th
a
m
o
r
p
h
o
lo
g
ica
l
o
p
er
atio
n
to
r
em
o
v
e
s
m
al
l
b
u
r
r
s
an
d
eli
m
i
n
ate
f
lo
atin
g
p
ix
els
t
h
r
o
u
g
h
r
eg
io
n
g
r
o
w
i
n
g
.
T
h
e
m
et
h
o
d
c
alcu
late
3
D
m
o
d
els
is
f
o
r
3
D
r
ec
o
n
s
tr
u
ctio
n
,
a
n
d
th
e
i
m
p
la
n
t
m
o
d
el
w
as
s
m
o
o
th
ed
a
n
d
d
en
o
is
ed
f
o
r
o
p
ti
m
izatio
n
t
h
e
ti
b
ial
i
m
p
la
n
t
m
o
d
e
l
w
a
s
th
e
n
i
m
p
o
r
ted
in
to
th
e
S
T
L
ed
ito
r
f
o
r
g
r
id
r
ep
ai
r
,
d
en
o
is
in
g
,
s
m
o
o
t
h
i
n
g
,
a
n
d
b
o
n
e
cu
tti
n
g
s
i
m
u
latio
n
,
w
it
h
t
h
e
cu
tti
n
g
lin
e.
T
h
e
tib
ial
im
p
la
n
t
b
o
n
e
-
c
u
tt
in
g
m
o
d
el
w
a
s
i
m
p
o
r
ted
in
to
MA
T
L
A
B
s
o
f
t
w
ar
e
f
o
r
f
o
r
w
ar
d
d
esi
g
n
.
T
h
e
i
m
p
la
n
t
m
o
d
el
w
a
s
s
elec
ted
b
ased
o
n
th
e
b
o
n
e
c
u
tti
n
g
s
u
r
f
ac
e,
a
n
d
its
co
m
p
o
n
e
n
t
s
(
s
te
m
,
w
i
n
g
,
p
late,
g
r
o
o
v
e,
an
d
ar
ticu
lar
s
u
r
f
ac
e)
w
er
e
ad
j
u
s
ted
to
f
it th
e
tib
ial
s
u
r
f
ac
e.
(
a)
(
b
)
(
c)
(
d
)
Fig
u
r
e
3
.
3
D
m
o
d
el
v
i
s
u
aliza
ti
o
n
o
f
in
d
i
v
id
u
al
ST
L
f
ile
s
o
f
k
n
ee
f
o
r
p
r
o
p
o
s
ed
m
o
d
el
i
m
p
le
m
en
tatio
n
(
a)
f
e
m
u
r
,
(
b
)
tib
ia,
(
c
)
f
ib
u
la,
an
d
(
d
)
f
e
m
u
r
,
tib
ia,
an
d
f
ib
u
l
a
Kn
ee
j
o
in
t
r
esectio
n
is
s
tan
d
ar
d
ized
in
to
th
r
ee
s
izes
b
ased
o
n
f
e
m
o
r
al
g
eo
m
etr
y
at
th
e
r
es
ec
tio
n
s
ite.
T
h
e
A
-
P
len
g
t
h
o
f
th
e
f
e
m
u
r
,
s
h
o
w
n
i
n
Fi
g
u
r
es
4
(
a)
an
d
(
b
)
,
m
ea
s
u
r
es
5
3
.
3
5
1
m
m
m
ed
ial
l
y
a
n
d
5
6
.
7
9
6
m
m
later
all
y
,
av
er
a
g
in
g
5
5
.
0
7
2
m
m
,
w
h
ic
h
clas
s
if
ies
it
as
s
m
all
.
W
h
en
th
e
tib
io
f
e
m
o
r
al
an
g
le
,
o
r
“
k
n
ee
an
g
le,
”
is
at
6
°
v
a
lg
u
s
,
th
e
k
n
ee
ali
g
n
s
n
eu
tr
all
y
.
Fe
m
u
r
cu
tt
in
g
f
o
llo
ws
t
h
e
i
n
tr
a
m
ed
u
llar
y
r
ef
er
e
n
ce
s
y
s
te
m
,
g
u
id
ed
b
y
th
e
m
ed
u
llar
y
ca
n
al,
ali
g
n
i
n
g
w
it
h
t
h
e
an
ato
m
ical
ax
i
s
.
T
h
is
g
u
id
e
is
an
g
led
at
ap
p
r
o
x
im
atel
y
6
°
b
et
w
ee
n
an
ato
m
ica
l a
n
d
m
ec
h
a
n
ical
a
x
es.
T
h
e
d
is
tal
f
e
m
u
r
cu
t d
ep
th
is
9
m
m
.
Fo
r
its
s
m
all
s
ize,
th
e
a
v
er
ag
e
b
o
n
e
r
esectio
n
th
ic
k
n
e
s
s
i
s
6
.
5
m
m
f
o
r
d
is
tal
m
ed
ial
an
d
later
al
s
ec
tio
n
s
,
an
d
5
.
9
m
m
an
d
5
.
8
m
m
f
o
r
p
o
s
ter
io
r
m
ed
ial
a
n
d
later
al
s
ec
tio
n
s
,
r
e
s
p
ec
tiv
el
y
.
T
h
ese
d
etails
ar
e
illu
s
tr
ated
in
Fi
g
u
r
e
4
(
c)
.
W
ith
p
ar
allel
m
ec
h
a
n
ical
an
d
an
ato
m
ica
l
ax
es,
t
h
e
tib
ia
is
cu
t
at
a
0
°
an
g
le.
Evaluation Warning : The document was created with Spire.PDF for Python.
I
n
t J
R
ec
o
n
f
i
g
u
r
ab
le
&
E
m
b
ed
d
ed
Sy
s
t
I
SS
N:
2089
-
4864
Desig
n
a
n
d
s
tr
u
ctu
r
a
l m
o
d
elli
n
g
o
f p
a
tien
t
-
s
p
ec
ific 3
D
-
p
r
in
t
ed
kn
ee
femu
r
a
n
d
tib
ia
… (
B
o
lu
g
o
d
d
u
S
a
n
d
ee
p
)
583
R
e
m
o
v
i
n
g
1
1
m
m
o
f
tib
ial
b
o
n
e
m
ai
n
tai
n
s
t
h
e
j
o
in
t
lin
e,
all
o
w
i
n
g
f
o
r
an
1
1
m
m
p
o
l
y
et
h
y
l
en
e
lin
er
p
lace
m
e
n
t
in
s
tead
o
f
9
m
m
,
as
s
ee
n
i
n
Fi
g
u
r
e
4
(
d
)
.
T
ab
le
6
s
h
o
w
s
t
h
e
p
er
ce
n
tag
e
v
alu
e
s
o
f
s
tr
ai
n
T
f
o
r
all
T
an
d
F
ac
r
o
s
s
d
if
f
er
en
t
attac
h
m
e
n
t
s
ite
co
m
b
i
n
atio
n
s
.
T
h
e
F2
-
T
1
co
m
b
in
at
io
n
g
e
n
er
all
y
r
es
u
lted
in
th
e
lo
w
est
s
tr
ai
n
T
,
w
it
h
t
w
o
ca
s
es
t
y
in
g
w
ith
F1
-
T
1
.
H
o
w
ev
er
,
in
th
r
ee
ca
s
es,
a
d
if
f
er
en
t
co
m
b
in
a
tio
n
p
r
o
d
u
ce
d
th
e
lo
w
e
s
t
s
tr
ai
n
T
,
w
i
th
n
o
clea
r
p
atter
n
id
en
ti
f
ied
.
A
s
n
o
s
i
n
g
le
co
m
b
in
at
io
n
co
n
s
i
s
te
n
tl
y
m
i
n
i
m
i
ze
d
s
tr
ain
T
,
th
e
f
ir
s
t
h
y
p
o
th
esi
s
w
a
s
f
u
r
t
h
er
an
al
y
ze
d
.
T
h
e
r
an
g
e,
m
ea
n
,
an
d
s
ta
n
d
ar
d
d
ev
iatio
n
o
f
s
t
r
ain
T
f
o
r
ea
ch
co
m
b
in
atio
n
w
er
e
ca
lc
u
lated
to
id
en
ti
f
y
t
h
e
m
o
s
t e
f
f
ec
ti
v
e
s
i
te
,
as d
etailed
in
T
ab
le
6
.
(
a)
(
b
)
(
c)
(
d
)
Fig
u
r
e
4
.
3
D
d
esig
n
o
f
p
atie
n
t
-
s
p
ec
i
f
ic
i
m
p
lan
t o
f
to
tal
k
n
ee
j
o
in
t
,
(
a)
a
n
aly
s
is
o
f
d
is
tal
f
e
m
u
r
s
ca
n
,
(
b
)
a
n
aly
s
i
s
o
f
p
r
o
x
i
m
al
t
ib
ia
s
ca
n
,
(
c)
f
e
m
u
r
,
(
d
)
t
ib
ia
T
ab
le
6
.
Har
d
n
ess
v
alu
e
s
A
t
t
a
c
h
me
n
t
s
i
t
e
c
o
m
b
i
n
a
t
i
o
n
R
a
n
g
e
o
f
st
r
a
i
n
T
M
e
a
n
o
f
st
r
a
i
n
T
S
t
a
n
d
a
r
d
d
e
v
i
a
t
i
o
n
F1
-
T1
2
4
.
6
–
3
1
.
9
1
7
.
4
9
.
5
F1
-
T2
2
5
.
4
–
3
1
.
8
1
7
.
9
9
.
5
F1
-
T3
2
5
.
6
–
4
0
.
0
2
1
.
7
14
F2
-
T1
1
3
.
9
–
2
1
.
8
1
3
.
7
7
F2
-
T2
2
7
.
4
–
3
1
.
0
1
8
.
3
9
.
8
F2
-
T3
2
9
.
7
–
40
22
1
1
.
7
Evaluation Warning : The document was created with Spire.PDF for Python.
I
SS
N
:
2
0
8
9
-
4864
I
n
t J
R
ec
o
n
f
i
g
u
r
ab
le
&
E
m
b
ed
d
ed
Sy
s
t
,
Vo
l.
14
,
No
.
2
,
J
u
l
y
20
25
:
575
-
5
8
6
584
4.
CO
NCLU
SI
O
N
T
h
e
tib
ial
im
p
la
n
t
is
d
esi
g
n
ed
u
s
i
n
g
a
co
m
b
in
atio
n
o
f
r
ev
er
s
e
an
d
f
o
r
w
ar
d
m
et
h
o
d
s
,
w
it
h
p
ar
am
etr
i
c
o
p
tim
izatio
n
to
m
i
n
i
m
ize
s
t
r
ess
co
n
ce
n
tr
at
io
n
an
d
en
s
u
r
e
o
p
tim
al
f
o
r
ce
d
is
tr
ib
u
tio
n
.
T
h
e
o
p
tim
ized
3D
-
m
o
ld
ed
tib
ial
i
m
p
la
n
t
s
h
o
w
s
e
x
ce
lle
n
t
q
u
ali
t
y
,
w
i
th
a
s
m
o
o
th
s
u
r
f
ac
e,
n
o
b
u
c
k
li
n
g
d
ef
o
r
m
at
io
n
,
an
d
m
i
n
i
m
al
ad
h
er
i
n
g
s
lag
.
W
h
ile
th
e
i
m
p
lan
t
m
ee
t
s
s
tr
e
n
g
t
h
r
e
q
u
ir
e
m
e
n
ts
,
it
s
h
ig
h
elas
ticit
y
m
o
d
u
l
u
s
h
as
to
b
e
ad
d
r
ess
ed
th
r
o
u
g
h
h
ea
t
tr
ea
t
m
en
t
i
n
f
u
tu
r
e
s
t
u
d
ies.
F
u
r
th
er
r
esear
ch
i
s
n
ee
d
ed
to
r
e
f
in
e
p
ar
a
m
etr
ic
m
o
d
eli
n
g
,
s
tr
u
ct
u
r
al
ad
d
itiv
e
m
e
th
o
d
s
,
an
d
S
L
M
p
r
o
ce
s
s
p
ar
a
m
e
ter
s
,
p
av
i
n
g
th
e
w
a
y
f
o
r
d
ir
ec
tl
y
m
a
n
u
f
ac
t
u
r
in
g
p
er
s
o
n
alize
d
k
n
ee
i
m
p
la
n
ts
.
RE
F
E
R
E
NC
E
S
[
1
]
A
.
H
e
d
g
e
,
“
H
e
a
l
t
h
c
a
r
e
3
D
P
r
i
n
t
i
n
g
M
a
r
k
e
t
2
0
1
8
P
r
o
mi
n
e
n
t
P
l
a
y
e
r
s
-
A
p
r
e
c
i
a
P
h
a
r
m
a
c
e
u
t
i
c
a
l
s,
A
sp
e
c
t
B
i
o
sy
st
e
ms,
B
i
o
3
D
T
e
c
h
n
o
l
o
g
i
e
s,
B
i
o
b
o
t
s
,
C
y
f
u
se
B
i
o
m
e
d
i
c
a
l
,
D
i
g
i
l
a
b
,
3
D
y
n
a
mi
c
s
S
y
st
e
ms,
E
n
v
i
s
i
o
n
T
e
c
,
L
u
x
e
x
c
e
l
,
M
a
t
e
r
i
a
l
i
s
e
N
V
,
N
a
n
o
3
D
B
i
o
sc
i
e
n
c
e
s,
O
c
e
a
n
z
,
O
r
g
a
n
o
v
o
H
o
,
”
o
p
e
n
PR
,
2
0
1
8
.
[
2
]
C
.
L
.
V
e
n
t
o
l
a
,
“
M
e
d
i
c
a
l
a
p
p
l
i
c
a
t
i
o
n
s
f
o
r
3
D
p
r
i
n
t
i
n
g
:
c
u
r
r
e
n
t
a
n
d
p
r
o
j
e
c
t
e
d
u
se
s,
”
P
h
a
rm
a
c
y
a
n
d
T
h
e
r
a
p
e
u
t
i
c
s
,
v
o
l
.
3
9
,
n
o
.
1
0
,
p
p
.
7
0
4
–
7
1
1
,
2
0
1
4
.
[
3
]
D
.
B
.
Jo
n
e
s,
R
.
S
u
n
g
,
C
.
W
e
i
n
b
e
r
g
,
T
.
K
o
r
e
l
i
t
z
,
a
n
d
R
.
A
n
d
r
e
w
s,
“
T
h
r
e
e
-
d
i
me
n
s
i
o
n
a
l
mo
d
e
l
i
n
g
may
i
mp
r
o
v
e
su
r
g
i
c
a
l
e
d
u
c
a
t
i
o
n
a
n
d
c
l
i
n
i
c
a
l
p
r
a
c
t
i
c
e
,
”
S
u
rg
i
c
a
l
I
n
n
o
v
a
t
i
o
n
,
v
o
l
.
2
3
,
n
o
.
2
,
p
p
.
1
8
9
–
1
9
5
,
2
0
1
6
,
d
o
i
:
1
0
.
1
1
7
7
/
1
5
5
3
3
5
0
6
1
5
6
0
7
6
4
1
.
[
4
]
M
.
I
.
M
o
h
a
mm
e
d
,
A
.
P
.
F
i
t
z
p
a
t
r
i
c
k
,
S
.
K
.
M
a
l
y
a
l
a
,
a
n
d
I
.
G
i
b
so
n
,
“
C
u
st
o
mi
se
d
d
e
si
g
n
a
n
d
d
e
v
e
l
o
p
me
n
t
o
f
p
a
t
i
e
n
t
sp
e
c
i
f
i
c
3
D
p
r
i
n
t
e
d
w
h
o
l
e
man
d
i
b
l
e
i
mp
l
a
n
t
,
”
i
n
Pr
o
c
e
e
d
i
n
g
s
o
f
t
h
e
2
7
t
h
A
n
n
u
a
l
I
n
t
e
r
n
a
t
i
o
n
a
l
S
o
l
i
d
Fr
e
e
f
o
rm
F
a
b
r
i
c
a
t
i
o
n
S
y
m
p
o
si
u
m
,
A
u
st
i
n
,
T
X
,
U
S
A
,
A
u
g
u
st
2
0
1
6
.
[
5
]
D
.
C
.
A
c
k
l
a
n
d
,
D
.
R
o
b
i
n
so
n
,
M
.
R
e
d
h
e
a
d
,
P
.
V
.
S
.
L
e
e
,
A
.
M
o
sk
a
l
j
u
k
,
a
n
d
G
.
D
i
mi
t
o
u
l
i
s
,
“
A
p
e
r
so
n
a
l
i
z
e
d
3
D
-
p
r
i
n
t
e
d
p
r
o
st
h
e
t
i
c
j
o
i
n
t
r
e
p
l
a
c
e
me
n
t
f
o
r
t
h
e
h
u
m
a
n
t
e
mp
o
r
o
man
d
i
b
u
l
a
r
j
o
i
n
t
:
F
r
o
m
i
mp
l
a
n
t
d
e
si
g
n
t
o
i
mp
l
a
n
t
a
t
i
o
n
,
”
J
o
u
rn
a
l
o
f
t
h
e
Me
c
h
a
n
i
c
a
l
Be
h
a
v
i
o
r
o
f
Bi
o
m
e
d
i
c
a
l
Ma
t
e
r
i
a
l
s
,
v
o
l
.
6
9
,
p
p
.
4
0
4
–
4
1
1
,
2
0
1
7
,
d
o
i
:
1
0
.
1
0
1
6
/
j
.
j
m
b
b
m
.
2
0
1
7
.
0
1
.
0
4
8
.
[
6
]
K
.
P
h
a
n
,
A
.
S
g
r
o
,
M
.
M
.
M
a
h
a
r
a
j
,
P
.
D
’
U
r
so
,
a
n
d
R
.
J.
M
o
b
b
s
,
“
A
p
p
l
i
c
a
t
i
o
n
o
f
a
3
D
c
u
s
t
o
m
p
r
i
n
t
e
d
p
a
t
i
e
n
t
sp
e
c
i
f
i
c
sp
i
n
a
l
i
mp
l
a
n
t
f
o
r
C
1
/
2
a
r
t
h
r
o
d
e
si
s
,
”
J
o
u
r
n
a
l
o
f
S
p
i
n
e
S
u
r
g
e
ry
,
v
o
l
.
2
,
n
o
.
4
,
p
p
.
3
1
4
–
3
1
8
,
2
0
1
6
.
[
7
]
L
.
E.
D
i
me
n
t
,
M
.
S
.
T
h
o
m
p
so
n
,
a
n
d
J.
H
.
M
.
B
e
r
g
man
n
,
“
C
l
i
n
i
c
a
l
e
f
f
i
c
a
c
y
a
n
d
e
f
f
e
c
t
i
v
e
n
e
ss o
f
3
D
p
r
i
n
t
i
n
g
:
a
sy
st
e
mat
i
c
r
e
v
i
e
w
,
”
B
M
J
O
p
e
n
,
v
o
l
.
7
,
n
o
.
1
2
,
a
r
t
i
c
l
e
e
0
1
6
8
9
1
,
2
0
1
7
,
d
o
i
:
1
0
.
1
1
3
6
/
b
m
j
o
p
e
n
-
2
0
1
7
-
0
1
6
8
9
1
.
[
8
]
J.
G
a
r
c
i
a
,
Z
.
Y
a
n
g
,
R
.
M
o
n
g
r
a
i
n
,
R
.
L
.
L
e
a
sk
,
a
n
d
K
.
L
a
c
h
a
p
e
l
l
e
,
“
3
D
p
r
i
n
t
i
n
g
ma
t
e
r
i
a
l
s
a
n
d
t
h
e
i
r
u
se
i
n
me
d
i
c
a
l
e
d
u
c
a
t
i
o
n
:
a
r
e
v
i
e
w
o
f
c
u
r
r
e
n
t
t
e
c
h
n
o
l
o
g
y
a
n
d
t
r
e
n
d
s
f
o
r
t
h
e
f
u
t
u
r
e
,
”
B
MJ
S
i
m
u
l
a
t
i
o
n
a
n
d
T
e
c
h
n
o
l
o
g
y
E
n
h
a
n
c
e
d
L
e
a
rn
i
n
g
,
v
o
l
.
4
,
n
o
.
1
,
p
p
.
27
–
4
0
,
2
0
1
7
,
d
o
i
:
1
0
.
1
1
3
6
/
b
mj
s
t
e
l
-
2
0
1
7
-
0
0
0
2
3
4
.
[
9
]
R
.
J.
M
o
n
d
s
c
h
e
i
n
,
A
.
K
a
n
i
t
k
a
r
,
C
.
B
.
W
i
l
l
i
a
ms,
S
.
S
.
V
e
r
b
r
i
d
g
e
,
a
n
d
T
.
E.
L
o
n
g
,
“
P
o
l
y
m
e
r
st
r
u
c
t
u
r
e
-
p
r
o
p
e
r
t
y
r
e
q
u
i
r
e
me
n
t
s
f
o
r
st
e
r
e
o
l
i
t
h
o
g
r
a
p
h
i
c
3
D
p
r
i
n
t
i
n
g
o
f
so
f
t
t
i
ssu
e
e
n
g
i
n
e
e
r
i
n
g
s
c
a
f
f
o
l
d
s,”
Bi
o
m
a
t
e
ri
a
l
s
,
v
o
l
.
1
4
0
,
p
p
.
1
7
0
–
1
8
8
,
2
0
1
7
,
d
o
i
:
1
0
.
1
0
1
6
/
j
.
b
i
o
mat
e
r
i
a
l
s.2
0
1
7
.
0
6
.
0
0
5
.
[
1
0
]
W
.
Z
h
u
,
X
.
M
a
,
M
.
G
o
u
,
D
.
M
e
i
,
K
.
Z
h
a
n
g
,
a
n
d
S
.
C
h
e
n
,
“
3
D
p
r
i
n
t
i
n
g
o
f
f
u
n
c
t
i
o
n
a
l
b
i
o
ma
t
e
r
i
a
l
s
f
o
r
t
i
ss
u
e
e
n
g
i
n
e
e
r
i
n
g
,
”
C
u
rr
e
n
t
O
p
i
n
i
o
n
i
n
Bi
o
t
e
c
h
n
o
l
o
g
y
,
v
o
l
.
4
0
,
p
p
.
1
0
3
–
1
1
2
,
2
0
1
6
,
d
o
i
:
1
0
.
1
0
1
6
/
j
.
c
o
p
b
i
o
.
2
0
1
6
.
0
3
.
0
1
4
.
[
1
1
]
A
S
T
M
,
S
t
a
n
d
a
rd
T
e
c
h
n
o
l
o
g
y
f
o
r
A
d
d
i
t
i
v
e
M
a
n
u
f
a
c
t
u
ri
n
g
-
G
e
n
e
r
a
l
Pr
i
n
c
i
p
l
e
s/
T
e
rm
i
n
o
l
o
g
y
,
AS
T
M
I
S
O
/
A
S
T
M
5
2
9
0
0
:
2
0
1
5
(
E)
,
W
e
st
C
o
n
s
h
o
h
o
c
k
e
n
,
P
A
,
U
S
A
,
2
0
1
5
.
[
1
2
]
H
.
J.
C
h
e
n
a
n
d
M
.
G
a
r
i
e
l
,
A
r
o
a
d
m
a
p
f
r
o
m
I
d
e
a
t
o
I
m
p
l
e
m
e
n
t
a
t
i
o
n
–
3
D
Pri
n
t
i
n
g
f
o
r
Pre
-
S
u
rg
i
c
a
l
A
p
p
l
i
c
a
t
i
o
n
s
,
C
r
e
a
t
e
S
p
a
c
e
I
n
d
e
p
e
n
d
e
n
t
P
u
b
l
i
s
h
i
n
g
P
l
a
t
f
o
r
m,
S
c
o
t
t
s
V
a
l
l
e
y
,
C
A
,
U
S
A
,
1
st
e
d
i
t
i
o
n
,
2
0
1
2
.
[
1
3
]
A
.
C
o
h
e
n
,
A
.
L
a
v
i
v
,
P
.
B
e
r
man
,
R
.
N
a
sh
e
f
,
a
n
d
J.
A
b
u
-
T
a
i
r
,
“
M
a
n
d
i
b
u
l
a
r
r
e
c
o
n
st
r
u
c
t
i
o
n
u
si
n
g
st
e
r
e
o
l
i
t
h
o
g
r
a
p
h
i
c
3
-
d
i
me
n
si
o
n
a
l
p
r
i
n
t
i
n
g
mo
d
e
l
i
n
g
t
e
c
h
n
o
l
o
g
y
,
”
O
ra
l
S
u
r
g
e
ry,
O
ra
l
Me
d
i
c
i
n
e
,
O
ra
l
P
a
t
h
o
l
o
g
y
,
O
ra
l
Ra
d
i
o
l
o
g
y
,
a
n
d
E
n
d
o
d
o
n
t
o
l
o
g
y
,
v
o
l
.
1
0
8
,
n
o
.
5
,
p
p
.
6
6
1
–
6
6
6
,
2
0
0
9
,
d
o
i
:
1
0
.
1
0
1
6
/
j
.
t
r
i
p
l
e
o
.
2
0
0
9
.
0
5
.
0
2
3
.
[
1
4
]
D
.
W
h
i
t
l
e
y
,
R
.
S
.
Ei
d
so
n
,
I
.
R
u
d
e
k
,
a
n
d
S
.
B
e
n
c
h
a
r
i
t
,
“
I
n
-
o
f
f
i
c
e
f
a
b
r
i
c
a
t
i
o
n
o
f
d
e
n
t
a
l
i
m
p
l
a
n
t
s
u
r
g
i
c
a
l
g
u
i
d
e
s
u
si
n
g
d
e
sk
t
o
p
st
e
r
e
o
l
i
t
h
o
g
r
a
p
h
i
c
p
r
i
n
t
i
n
g
a
n
d
i
mp
l
a
n
t
t
r
e
a
t
me
n
t
p
l
a
n
n
i
n
g
so
f
t
w
a
r
e
:
a
c
l
i
n
i
c
a
l
r
e
p
o
r
t
,
”
J
o
u
rn
a
l
o
f
Pr
o
s
t
h
e
t
i
c
D
e
n
t
i
st
r
y
,
v
o
l
.
1
1
8
,
n
o
.
3
,
p
p
.
2
5
6
–
2
6
3
,
2
0
1
7
,
d
o
i
:
1
0
.
1
0
1
6
/
j
.
p
r
o
sd
e
n
t
.
2
0
1
6
.
1
0
.
0
1
7
.
[
1
5
]
H
.
D
o
d
z
i
u
k
,
“
A
p
p
l
i
c
a
t
i
o
n
o
f
3
D
p
r
i
n
t
i
n
g
i
n
h
e
a
l
t
h
c
a
r
e
,
”
K
a
r
d
i
o
c
h
i
ru
rg
i
a
i
T
o
ra
k
o
c
h
i
r
u
rg
i
a
P
o
l
sk
a
,
v
o
l
.
1
3
,
n
o
.
3
,
p
p
.
2
8
3
–
2
9
3
,
2
0
1
7
,
d
o
i
:
1
0
.
5
1
1
4
/
k
i
t
p
.
2
0
1
6
.
6
2
6
2
5
.
[
1
6
]
D
.
I
b
r
a
h
i
m
e
t
a
l
.
,
“
D
i
me
n
s
i
o
n
a
l
e
r
r
o
r
o
f
se
l
e
c
t
i
v
e
l
a
se
r
si
n
t
e
r
i
n
g
,
t
h
r
e
e
-
d
i
me
n
s
i
o
n
a
l
p
r
i
n
t
i
n
g
a
n
d
P
o
l
y
J
e
t
™
mo
d
e
l
s
i
n
t
h
e
r
e
p
r
o
d
u
c
t
i
o
n
o
f
m
a
n
d
i
b
u
l
a
r
a
n
a
t
o
m
y
,
”
J
o
u
rn
a
l
o
f
C
ra
n
i
o
-
M
a
x
i
l
l
o
f
a
c
i
a
l
S
u
r
g
e
r
y
,
v
o
l
.
3
7
,
n
o
.
3
,
p
p
.
1
6
7
–
1
7
3
,
2
0
0
9
,
d
o
i
:
1
0
.
1
0
1
6
/
j
.
j
c
ms.
2
0
0
8
.
1
0
.
0
0
8
.
[
1
7
]
"
O
u
r
3
D
P
r
i
n
t
e
r
s"
.
S
t
ra
t
a
S
y
s
.
O
n
l
i
n
e
.
[
A
v
a
i
l
a
b
l
e
]
:
h
t
t
p
s:
/
/
w
w
w
.
s
y
s
-
u
k
.
c
o
m/
n
e
w
s/
3
d
-
p
r
i
n
t
e
d
-
su
r
g
i
c
a
l
-
g
u
i
d
e
s
-
a
n
d
d
e
n
t
a
l
-
i
m
p
l
a
n
t
s/
.
[
1
8
]
J.
S
.
M
a
t
su
mo
t
o
e
t
a
l
.
,
“
T
h
r
e
e
d
i
me
n
si
o
n
a
l
p
h
y
si
c
a
l
mo
d
e
l
l
i
n
g
:
a
p
p
l
i
c
a
t
i
o
n
s
a
n
d
e
x
p
e
r
i
e
n
c
e
a
t
may
o
c
l
i
n
i
c
,
”
Ra
d
i
o
G
ra
p
h
i
c
s
,
v
o
l
.
3
5
,
n
o
.
7
,
p
p
.
1
9
8
9
–
2
0
0
6
,
2
0
1
5
,
d
o
i
:
1
0
.
1
1
4
8
/
r
g
.
2
0
1
5
1
4
0
2
6
0
.
[
1
9
]
M
e
d
t
r
o
n
i
c
c
a
se
s
t
u
d
y
,
C
u
st
o
m s
u
r
g
i
c
a
l
i
n
st
r
u
me
n
t
s
b
e
c
o
mi
n
g
w
o
r
k
i
n
g
p
r
o
t
o
t
y
p
e
s u
si
n
g
F
D
M
3
D
p
r
i
n
t
i
n
g
t
e
c
h
n
o
l
o
g
y
.
[
2
0
]
K
.
S
.
T
a
n
a
k
a
a
n
d
N
.
L
i
g
h
t
d
a
l
e
-
M
i
r
i
c
,
“
A
d
v
a
n
c
e
s
i
n
3
d
-
p
r
i
n
t
e
d
p
e
d
i
a
t
r
i
c
p
r
o
st
h
e
se
s
f
o
r
u
p
p
e
r
e
x
t
r
e
mi
t
y
d
i
f
f
e
r
e
n
c
e
s,”
J
o
u
r
n
a
l
o
f
Bo
n
e
a
n
d
J
o
i
n
t
S
u
r
g
e
r
y
,
v
o
l
.
9
8
,
n
o
.
1
5
,
p
p
.
1
3
2
0
–
1
3
2
6
,
2
0
1
6
,
d
o
i
:
1
0
.
2
1
0
6
/
j
b
j
s.
1
5
.
0
1
2
1
2
.
[
2
1
]
S
.
L
.
S
i
n
g
,
J.
A
n
,
W
.
Y
.
Y
e
o
n
g
,
a
n
d
F
.
E.
W
i
r
i
a
,
“
L
a
se
r
a
n
d
e
l
e
c
t
r
o
n
b
e
a
m
p
o
w
d
e
r
-
b
e
d
a
d
d
i
t
i
v
e
ma
n
u
f
a
c
t
u
r
i
n
g
o
f
me
t
a
l
l
i
c
i
mp
l
a
n
t
s:
a
r
e
v
i
e
w
o
n
p
r
o
c
e
s
se
s
,
m
a
t
e
r
i
a
l
s
a
n
d
d
e
s
i
g
n
s
,
”
J
o
u
r
n
a
l
o
f
O
r
t
h
o
p
a
e
d
i
c
R
e
s
e
a
r
c
h
,
v
o
l
.
3
4
,
n
o
.
3
,
p
p
.
3
6
9
–
3
8
5
,
d
o
i
:
1
0
.
1
0
0
2
/
j
o
r
.
2
3
0
7
5
.
[
2
2
]
F
.
A
u
r
i
c
c
h
i
o
a
n
d
S
.
M
a
r
c
o
n
i
,
“
3
D
p
r
i
n
t
i
n
g
:
c
l
i
n
i
c
a
l
a
p
p
l
i
c
a
t
i
o
n
s
i
n
o
r
t
h
o
p
a
e
d
i
c
s
a
n
d
t
r
a
u
mat
o
l
o
g
y
,
”
EFO
RT
O
p
e
n
Re
v
i
e
w
s
,
v
o
l
.
1
,
n
o
.
5
,
p
p
.
1
2
1
–
1
2
7
,
2
0
1
6
,
1
0
.
1
3
0
2
/
2
0
5
8
-
5
2
4
1
.
1
.
0
0
0
0
1
2
.
[
2
3
]
C
.
G
.
H
e
l
g
u
e
r
o
e
t
a
l
.
,
“
B
i
o
me
c
h
a
n
i
c
a
l
p
r
o
p
e
r
t
i
e
s
o
f
3
D
-
p
r
i
n
t
e
d
b
o
n
e
sc
a
f
f
o
l
d
s
a
r
e
i
mp
r
o
v
e
d
b
y
t
r
e
a
t
me
n
t
b
y
C
R
F
P
,
”
J
o
u
r
n
a
l
o
f
O
rt
h
o
p
a
e
d
i
c
S
u
rg
e
ry
a
n
d
R
e
a
s
e
a
r
c
h
,
v
o
l
.
1
2
,
n
o
.
1
,
p
.
1
9
5
,
2
0
1
7
,
d
o
i
:
1
0
.
1
1
8
6
/
s
1
3
0
1
8
-
0
1
7
-
0
7
0
0
-
2
.
[
2
4
]
M
.
A
sad
i
-
Ed
y
v
a
n
d
,
M
.
S
o
l
a
t
i
-
H
a
s
j
i
n
,
A
.
F
a
r
z
a
d
,
a
n
d
N
.
A
.
A
.
O
sman
,
“
Ef
f
e
c
t
o
f
t
e
c
h
n
i
c
a
l
p
a
r
a
me
t
e
r
s
o
n
p
o
r
o
u
s
st
r
u
c
t
u
r
e
a
n
d
st
r
e
n
g
t
h
o
f
3
D
p
r
i
n
t
e
d
c
a
l
c
i
u
m
s
u
l
f
a
t
e
p
r
o
t
o
t
y
p
e
s,”
Ro
b
o
t
i
c
s
a
n
d
C
o
m
p
u
t
e
r
-
I
n
t
e
g
r
a
t
e
d
M
a
n
u
f
a
c
t
u
ri
n
g
,
v
o
l
.
3
7
,
p
p
.
5
7
–
6
7
,
2
0
1
5
,
d
o
i
:
10
.
1
0
1
6
/
j
.
r
c
i
m.
2
0
1
5
.
0
6
.
0
0
5
.
[
2
5
]
M
.
S
.
M
a
n
n
o
o
r
e
t
a
l
.
,
“
3
D
p
r
i
n
t
e
d
b
i
o
n
i
c
e
a
r
s,”
N
a
n
o
L
e
t
t
e
rs
,
v
o
l
.
1
3
,
n
o
.
6
,
p
p
.
2
6
3
4
–
2
6
3
9
,
2
0
1
3
,
d
o
i
:
1
0
.
1
0
2
1
/
n
l
4
0
0
7
7
4
4
.
[
2
6
]
M
.
V
u
k
i
e
v
i
c
,
B
.
M
o
sad
e
g
h
,
J
.
K
.
M
i
n
,
a
n
d
S
.
H
.
L
i
t
t
l
e
,
“
C
a
r
d
i
a
c
3
D
p
r
i
n
t
i
n
g
a
n
d
i
t
s
f
u
t
u
r
e
d
i
r
e
c
t
i
o
n
s,”
J
AC
C
:
C
a
rd
i
o
v
a
sc
u
l
a
r
I
m
a
g
i
n
g
,
v
o
l
.
1
0
,
n
o
.
2
,
p
p
.
1
7
1
–
1
8
4
,
2
0
1
7
,
d
o
i
:
1
0
.
1
0
1
6
/
j
.
j
c
mg
.
2
0
1
6
.
1
2
.
0
0
1
.
[
2
7
]
D
.
S
.
C
.
S
o
o
n
,
M
.
P
.
C
h
a
e
,
C
.
H
.
C
.
P
i
l
g
r
i
m,
W
.
M
.
R
o
z
e
n
,
R
.
T
.
S
p
y
c
h
a
l
,
a
n
d
D
.
J.
H
u
n
t
e
r
-
S
mi
t
h
,
“
3
D
h
a
p
t
i
c
mo
d
e
l
l
i
n
g
f
o
r
Evaluation Warning : The document was created with Spire.PDF for Python.