A 3D kinematic estimation of knee prosthesis using X-ray projection images: clinical assessment of the improved algorithm for fluoroscopy images

Abstract

In this paper, we propose three ideas to improve a kinematic estimation algorithm for total knee arthroplasty. The first is a two-step estimation algorithm that improves estimation accuracy by excluding certain assumptions needed for the pattern matching algorithm reported by Banks and Hodge. The second is incorporating a 3D geometric articulation model into the algorithm to improve estimation accuracy substantially for the depth translation, and to introduce contact points' trajectories between the articular surfaces. The third is an algorithm to process estimation even when the silhouettes of two components overlap. To assess our algorithm's potential for clinical application, we carried out two experiments. First, we used a robot to position the prosthesis. Estimation accuracy was checked by comparing input data to the robot with the estimates from X-ray photographs. Incorporating our articulation model remarkably reduced the error in the depth translation. Next, we performed a clinical assessment by applying the algorithm and articulation model to fluoroscopy images of a patient who had recently had TKA.

Accuracy of single-plane fluoroscopy in determining relative position and orientation of total knee replacement components

“…2i) views of the components were helpful in determining a reasonable range of medial-lateral translation between the two components. Out-ofplane position estimates can be significantly improved using collision detection, which involves ensuring that the femoral component does not intersect with the polyethylene tibial insert (Hirokawa et al, 2008;Prins et al, 2010). The pose of the insert can be determined based on the tibial tray pose if a fixed bearing implant is used or based on beads embedded in the insert (Fantozzi et al, 2004).…”

Automatic model-based roentgen stereophotogrammetric analysis (RSA) of total knee prostheses

“…However, the RSA application has recently been extended to identify the relative pose (using X-ray) or the moving trajectory of prostheses (using fluoroscopy; Selvik, 1989;Banks and Hodge, 1996;Hoff et al, 1998;Kaptein et al, 2004;Valstar et al, 2005;Bingham and Li, 2006;Hanson et al, 2006;Hirokawa et al, 2008). Historically, the RSA technique can be divided into marker-and model-based techniques.…”

Predicting 3D pose in partially overlapped X-ray images of knee prostheses using model-based Roentgen stereophotogrammetric analysis (RSA)

“…If the projected images of femoral and tibial prostheses are overlapped with each other, it is more difficult for the clinician to evaluate the prosthetic misalignment and wear (Fig. 1b) [4,6,9,12,13,26].…”