Estimation of three-dimensional knee joint movement using bi-plane x-ray fluoroscopy and 3D-CT

Abstract

Acquisition of exact information of three-dimensional knee joint movement is desired in plastic surgery. Conventional X-ray fluoroscopy provides dynamic but just two-dimensional projected image. On the other hand, three-dimensional CT provides three-dimensional but just static image. In this paper, a method for acquiring three-dimensional knee joint movement using both bi-plane, dynamic X-ray fluoroscopy and static three-dimensional CT is proposed. Basic idea is use of 2D/3D registration using digitally reconstructed radiograph (DRR) or virtual projection of CT data. Original ideal is not new but the application of bi-plane fluoroscopy to natural bones of knee is reported for the first time. The technique was applied to two volunteers and successful results were obtained. Accuracy evaluation through computer simulation and phantom experiment with a knee joint of a pig were also conducted.

Three-dimensional motion study of femur, tibia, and patella at the knee joint from bi-plane fluoroscopy and CT images

“…Because an image intensifier was used as a detector, distortion took place in the images. Thus, a distortion correction technique was applied to those images [12]. The fluoroscopic image size was 512 9 512 pixels, and each pixel had 8 bits.…”

“…A 2D/3D registration method that uses both fluoroscopy images and CT or MR images has been studied for acquiring knee joint motion [2][3][4][5][6][7][8][9][10][11][12][13][14][15]. This method was applied successfully for obtaining the 3D motion of a knee joint with an implant that had been attached by total knee arthroplasty [2][3][4][5][6].…”

“…The dynamic 3D motion of the human femur and tibia has been acquired by the 2D/3D registration method by use of fluoroscopy and CT or MR images [12,13]. On the other hand, analysis of the static 3D position of the human patella was performed only at several angles [14,15].…”