A computational tool for automatic selection of total knee replacement implant size using X-ray images.

Autor:	Burge TA; Dyson School of Design Engineering, Imperial College, London, United Kingdom., Jones GG; MSk Lab, Imperial College, London, United Kingdom., Jordan CM; Imperial College Healthcare, London, United Kingdom., Jeffers JRT; Department of Mechanical Engineering, Imperial College, London, United Kingdom., Myant CW; Dyson School of Design Engineering, Imperial College, London, United Kingdom.
Jazyk:	angličtina
Zdroj:	Frontiers in bioengineering and biotechnology [Front Bioeng Biotechnol] 2022 Sep 29; Vol. 10, pp. 971096. Date of Electronic Publication: 2022 Sep 29 (Print Publication: 2022).
DOI:	10.3389/fbioe.2022.971096
Abstrakt:	Purpose: The aim of this study was to outline a fully automatic tool capable of reliably predicting the most suitable total knee replacement implant sizes for patients, using bi-planar X-ray images. By eliminating the need for manual templating or guiding software tools via the adoption of convolutional neural networks, time and resource requirements for pre-operative assessment and surgery could be reduced, the risk of human error minimized, and patients could see improved outcomes. Methods: The tool utilizes a machine learning-based 2D-3D pipeline to generate accurate predictions of subjects' distal femur and proximal tibia bones from X-ray images. It then virtually fits different implant models and sizes to the 3D predictions, calculates the implant to bone root-mean-squared error and maximum over/under hang for each, and advises the best option for the patient. The tool was tested on 78, predominantly White subjects (45 female/33 male), using generic femur component and tibia plate designs scaled to sizes obtained for five commercially available products. The predictions were then compared to the ground truth best options, determined using subjects' MRI data. Results: The tool achieved average femur component size prediction accuracies across the five implant models of 77.95% in terms of global fit (root-mean-squared error), and 71.79% for minimizing over/underhang. These increased to 99.74% and 99.49% with ±1 size permitted. For tibia plates, the average prediction accuracies were 80.51% and 72.82% respectively. These increased to 99.74% and 98.98% for ±1 size. Better prediction accuracies were obtained for implant models with fewer size options, however such models more frequently resulted in a poor fit. Conclusion: A fully automatic tool was developed and found to enable higher prediction accuracies than generally reported for manual templating techniques, as well as similar computational methods. Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. (Copyright © 2022 Burge, Jones, Jordan, Jeffers and Myant.)
Databáze:	MEDLINE
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