Repeatability, reproducibility, and agreement of three computational methods to approximate the functional flexion-extension axis of the tibiofemoral joint using 3D bone models of the femur

Lozano, Rocio; Howell, Stephen M.; Hull, Maury L.

doi:10.1080/10255842.2019.1644503

Cited by 4 publications

(3 citation statements)

References 22 publications

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“…In parallel to the clinical studies, modern techniques such as 3D reconstruction, simulation, high‐speed cameras, gait analyzes, etc. are increasingly used to analyze the separate biomechanical concepts and thereby to explain the differences in the results [4, 6, 15–17, 20, 22, 27]. These studies can make basic statements about the biomechanical characteristics of the unique alignment concepts.…”

Section: Discussionmentioning

confidence: 99%

A patient-specific 3D model of the knee to compare the femoral rollback before and after total knee arthroplasty (TKA)

et al. 2021

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Purpose Total knee arthroplasty (TKA) is nowadays performed as a standard procedure on a large number of patients suffering from arthrosis. Replacing the knee joint causes changes in the geometry and kinematics of the knee, which are unique to each individual. This research focuses on the method to detect these changes after TKA and on the impact on the knee movement. This approach could reduce complications in patients with post-operative pain and reduce the number of revisions. Methods A 3D model of a patient’s knee was made by measuring the movement with a medically certified infrared stereo camera. This measurement was combined with the 3D model of the patient’s bones, previously segmented from the CT scan. This model is printed in 3D, one part being the mechanism that follows the movement of the patient, and the other part being the 3D copy of the femur and tibia bones. The knee replacement operation is performed directly on the model and the resulting rollback is being measured before and after TKA. Results We observe a difference in the rollback before and after TKA on the 3D printed model. The variation in size and shape of the femoral implant compared to the natural femur condyles is one of the reasons for the changes in the rollback effect. The rollback is half as large after the prosthesis insertion, which confirms the fact that the femoral prosthesis geometry influences the knee kinematics. Conclusions In this study, a first 3D model combining the patient-specific kinematic and the geometry of his bones has been constructed. This model allows the surgeon to validate the plan of the operation, but also to understand the problems and consequences generated by the prosthesis insertion. The rollback is one of the most important motion of the knee joint and this behavior could be quantified, providing comparative analysis of the knee joint before and after the operation. As a future study, the model could be used to analyse more parameters of the TKA such as the impact of different implantation methods.

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Section: Discussionmentioning

confidence: 99%

A patient-specific 3D model of the knee to compare the femoral rollback before and after total knee arthroplasty (TKA)

et al. 2021

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“…In addressing this limitation, the method developed here requires minimal user input to generate the longitudinal axis and has shown excellent intra-and inter-observer agreement (ICCs = 0.999) thereby eliminating the potential variability introduced by the observer. Additionally, the methodology for establishing the mediolateral axis requires no user input and displays similar accuracy (within 1°) to other studies assessing the use of geometric primitives under similar circumstances (Eckhoff et al 2005;Lozano et al 2019), although the reporting of the angular error is commonly based on a case-specific reference axis limiting any direct comparisons. While the accuracy of the axes definitions is of high importance, the computational demand and training requirements for the operator must also be considered.…”

Section: Discussionmentioning

confidence: 99%

“…Previous research has identified fitting geometric primitives to the femoral condyles as a means of estimating the flexion-extension (FE) axis of the knee, providing a mechanism of bypassing the need for manual anatomical landmark identification (Eckhoff et al 2005 ; Lozano et al 2019 ; Miranda et al 2010 ; Moro-oka et al 2007 ; Roos et al 2005 ). This methodology, coupled with a similar fit to the tibia, may provide the basis for the development of a tibial coordinate system to be applied in cases where skeletal anatomy is disrupted due to fracture.…”

Section: Introductionmentioning

confidence: 99%

Development and evaluation of a method to define a tibial coordinate system through the fitting of geometric primitives

Millar

Arnold

Solomon

et al. 2021

International Biomechanics

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Coordinate system definition is a critical element of biomechanical modeling of the knee, and cases of skeletal trauma present major technical challenges. This paper presents a method to define a tibial coordinate system by fitting geometric primitives to surface anatomy requiring minimal user input. The method presented here utilizes a conical fit to both the tibial shaft and femoral condyles to generate independent axes forming the basis of a tibial coordinate system. Definition of the tibial axis showed high accuracy when shape fitting to ≥50 mm of shaft with <3° of angular variation from the axis obtained using the full tibia. Repeatability and reproducibility of the axis was compared using intraclass correlation coefficients which showed excellent intra- and inter-observer agreement across cases. Additionally, shape fitting to the distal femoral condyles showed high accuracy compared to the reference axis established automatically through identifying the medial and lateral epicondyles (<4°). Utilizing geometric primitives to estimate functional axes for the tibia and femur removes reliance on anatomical landmarks that can be displaced by fracture or inaccurately identified by observers. Furthermore, fitting of such primitives provides a more complete understanding of the true bony anatomy, which cannot be done through simple landmark identification.

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Errors in using fixed flexion facet centers to determine tibiofemoral kinematics increase fourfold for multi-radius femoral component designs with early versus late decreases in the radius of curvature

Hull

2022

The Knee

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Repeatability, reproducibility, and agreement of three computational methods to approximate the functional flexion-extension axis of the tibiofemoral joint using 3D bone models of the femur

Cited by 4 publications

References 22 publications

A patient-specific 3D model of the knee to compare the femoral rollback before and after total knee arthroplasty (TKA)

A patient-specific 3D model of the knee to compare the femoral rollback before and after total knee arthroplasty (TKA)

Development and evaluation of a method to define a tibial coordinate system through the fitting of geometric primitives

Errors in using fixed flexion facet centers to determine tibiofemoral kinematics increase fourfold for multi-radius femoral component designs with early versus late decreases in the radius of curvature

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