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

Acker, Stacey M.; Li, Rebecca; Murray, Heather; John, Paul; Banks, Scott A.; Mu, Shang; Wyss, Urs P.; Deluzio, Kevin J.

doi:10.1016/j.jbiomech.2010.10.033

Cited by 49 publications

(42 citation statements)

References 12 publications

(19 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The mean differences and limits of agreement reported herein for the 1 and 8 ms pulse widths for all flexion velocities were within previously reported values that were upwards to 2.1° and 1.9mm (Acker et al 2011). Additionally, these errors are much less than those experienced using traditional skin-markers (Miranda et al 2013), demonstrating the utility of fluoroscopic based kinematic assessment.…”

Section: Discussionsupporting

confidence: 90%

“…Similar to Acker et al, landmarks on the implant were used to create the digital and the anatomical coordinate system (i.e. identifiable landmarks on the implant both digitally (Blender) and physically (Optotrak) were used to create the coordinate systems) (Acker et al 2011). An open source model-based tracking program was used to manipulate the position and orientation of 3D CAD models of the femoral and tibial components, such that model edges were coincident with edges of the projected silhouettes on each radiograph frame, Figure 1 (JointTrack, www.sourceforge.net/projects/jointtrack).…”

Section: Methodsmentioning

confidence: 99%

“…The 3D position and orientation of the tibia relative to the femur were determined for all frames of each trial and the “limits of agreement” were defined using a Bland-Altman technique (Acker et al 2011; Bland and Altman 1999). This method compares the differences between the two collection techniques relative to their mean, and allows the 95% limits of agreement to be quantified.…”

Section: Methodsmentioning

confidence: 99%

“…Prior studies aimed to assess the accuracy of this shape-matching technique have reported absolute accuracies on the order of a millimeter and sub-degrees (Banks and Hodge 1996; Mahfouz et al 2003; Yamazaki et al 2004). Relative joint kinematics has reported errors of less than 2.1 degrees and 1.9 mm using a single plane fluoroscopy system (Acker et al 2011; Lebel et al 2011). It is important to note that many of these studies determine accuracy based on a foam model of the bones without soft tissue – an idealistic case without added noise from surrounding musculature and skin.…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Characterizing fluoroscopy based kinematic accuracy as a function of pulse width and velocity

Ellingson

Mozingo²,

Magnuson

et al. 2016

Journal of Biomechanics

View full text Add to dashboard Cite

Fluoroscopic imaging has become increasingly popular to investigate total knee arthroplasty kinematics non-invasively - 3D implant models are aligned with 2D image projections, and optimized via an edge-contour alignment technique. Previous studies have quantified the accuracy of this approach, however they do not adequately address the impact of image collection parameters. A particularly sensitive parameter is the pulse width, or exposure time per frame At longer pulse widths, a more motion is captured in a single frame; this can lead to image blur and subsequent degradation to image edge quality. Therefore, the comparative accuracy of relative joint kinematics as a function of pulse width and joint velocity needs to be defined. A limits of agreement approach was taken to define the mean differences between optoelectric kinematic measures (gold standard) and fluoroscopic methods at various pulse widths (1, 8, 16ms) and knee velocities (50, 100, 225°/s). The mean absolute differences between the optoelectric and fluoroscopic methods for 1ms pulse width was less than 1.5° and 0.9mm. Comparable rotational differences (1.3°) were observed for the 8ms pulse width but had larger translational differences (1.4mm). The 16ms pulse width yielded the greatest mean differences (2.0° and 1.6mm), which increased with knee flexion velocity. The importance of pulse width and velocity should not be overlooked for future studies - this parameter has proven to be a sensitive metric in the quantification of joint motion via fluoroscopy and must be identified and reported in future studies.

show abstract

Section: Discussionsupporting

confidence: 90%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Characterizing fluoroscopy based kinematic accuracy as a function of pulse width and velocity

Ellingson

Mozingo²,

Magnuson

et al. 2016

Journal of Biomechanics

View full text Add to dashboard Cite

show abstract

“…A static CT is projected to reconstruct knee kinematics. A similar protocol is used in [13]; the authors describe a method to align CAD projections of knee implants to fluoroscopic images. They perform dynamic acquisitions at 8Hz moving a Sawbone model with an implant between 0 • and 90 • .…”

Section: Fig8 : "Exted" -> "Extend"mentioning

confidence: 99%

Fluoroscopy-based tracking of femoral kinematics with statistical shape models

Valenti

Momi

et al. 2015

Int J CARS

View full text Add to dashboard Cite

Abstract:Purpose Precise knee kinematics assessment helps to diagnose knee pathologies and to improve the design of customized prosthetic components. The first step in identifying knee kinematics is to assess the femoral motion in the anatomical frame. However, no work has been done on pathological femurs, whose shape can be highly different from healthy ones. Method We propose a new femoral tracking technique based on Statistical Shape Models (SSMs) and two calibrated fluoroscopic images, taken at different flexion-extension angles. The cost function optimization is based on genetic algorithms, to avoid local minima. The proposed approach was evaluated on 3 sets of digitally reconstructed radiographic images of osteoarthritic patients. Results It is found that using the estimated shape, rather than that calculated from CT, significantly reduces the pose accuracy, but still has reasonably good results (angle errors around 2 degrees, translation around 1.5mm). Cover Letter. Powered by Editorial Manager® and ProduXion Manager® from Aries Systems CorporationThe authors thank the reviewers and the editor for their interest in this topic and for giving them the possibility to improve the paper with their comments. Hereunder we answer the questions arisen, with indications on the changes made to the manuscript According to the reviewer comment, we modified the text in the "State of the Art" section as follows:"Knee kinematics assessment has great importance both to understand the problems associated with a large number of knee pathologies and to improve the design of prosthetic components. In case of severe osteoarthritis, that are eligible for joint implant surgery, in vivo pre-operatory knee kinematics is fundamental to understand the relative motion between the three joint bones. The relative movement can give an insight of how the ligaments are stretched and their stability, and how could be the feeling for the patient. In this way, pre operatory knee kinematics could help the surgeon to decide which prosthesis should be used and how to correct the misalignment of the bones [3]. Currently, the reconstruction of the pose of the knee can be done using 3D scans such as real-time Magnetic Resonance Imaging (MRI) or through a 2D/3D registration method that superimposes the shape extracted from MRI or Computed Tomography (CT) onto an image, usually X-ray or fluoroscopy. Real-time MRI is suitable to study joint kinematics, as it evidences the muscle structure during movements. However, it can only be used with relatively slow movements, and the accuracy obtained increases from 1mm to more than 3mm depending on the velocity of the movement. In addition, MRI scans are highly expensive [4]. Traditional CT and MRI provide an accurate evaluation of the morphology of the knee, but are limited to static positioning of the patient.[…]The use of dynamic fluoroscopy to detect knee kinematics is described in [12]. The authors use a fluoroscopic system flashing at 30Hz, obtaining continuous images of the knee flexion from 0° to 120°...

show abstract

Validation of a machine learning technique for segmentation and pose estimation in single plane fluoroscopy

Broberg

Chen

Jensen

et al. 2023

Journal Orthopaedic Research

View full text Add to dashboard Cite

Kinematics of total knee replacements (TKR) play an important role in assessing the success of a procedure and would be a valuable addition to clinical practice; however, measuring TKR kinematics is time consuming and labour intensive. Recently, an automatic single-plane fluoroscopic method utilizing machine learning has been developed to facilitate a quick and simple process for measuring TKR kinematics. This study aimed to validate the new automatic single-plane technique using biplanar radiostereometric analysis (RSA) as the gold standard. Twenty-four knees were imaged at various angles of flexion in a dedicated RSA lab and 113 image pairs were obtained. Only the lateral RSA images were used for the automatic single-plane technique to simulate single-plane fluoroscopy. Two networks helped automate the kinematics measurement process, one segmented implant components and the other generated an initial pose estimate for the optimization algorithm. Kinematics obtained via the automatic single plane and manual biplane techniques were compared using root-mean-square error and Bland-Altman plots. Two observers measured the kinematics using the automated technique and results were compared with assess reproducibility. Root-mean-square errors were 0.8 mm for anterior-posterior translation, 0.5 mm for superior-inferior translation, 2.6 mm for medial-lateral translation, 1.0°for flexion-extension, 1.2°for abduction-adduction, and 1.7°for internal-external rotation. Reproducibility, reported as root-mean-square errors between operator measurements, was submillimeter for in-plane translations and below 2°for all rotations. Clinical Significance: The advantages of the automated single plane technique should aid in the kinematic measurement process and help researchers and clinicians perform TKR kinematic analyses.

show abstract

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

Cited by 49 publications

References 12 publications

Characterizing fluoroscopy based kinematic accuracy as a function of pulse width and velocity

Characterizing fluoroscopy based kinematic accuracy as a function of pulse width and velocity

Fluoroscopy-based tracking of femoral kinematics with statistical shape models

Validation of a machine learning technique for segmentation and pose estimation in single plane fluoroscopy

Contact Info

Product

Resources

About