Implant placement accuracy in total knee arthroplasty: validation of a CT-based measurement technique
| Autor: | David Maislin, Hosna Akhlaghpour, Valentina Campanelli, Alexander J. Nedopil, Joel Zuhars, Abheetinder S Brar, Rocio Lozano |
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| Rok vydání: | 2020 |
| Předmět: |
Orthodontics
030222 orthopedics business.industry 0206 medical engineering Total knee arthroplasty 02 engineering and technology Gold standard (test) 020601 biomedical engineering 03 medical and health sciences 0302 clinical medicine Medicine Original Article Radiology Nuclear Medicine and imaging Femur Implant Tibia Fiducial marker Cadaveric spasm business Component placement |
| Zdroj: | Quantitative Imaging in Medicine and Surgery. 10:475-484 |
| ISSN: | 2223-4306 2223-4292 |
| DOI: | 10.21037/qims.2020.01.02 |
| Popis: | Background The primary goal of many computer-assisted surgical systems like robotics for total knee arthroplasty (TKA) is to accurately execute a preoperative plan. To assess whether the preoperative plan was executed accurately in 3D, one option is to compare the planned and postoperative implant placement using a preoperative and postoperative CT scan of the patient's limb. This comparison requires a 3D-to-3D surface registration between the preoperative and postoperative 3D bone models and between the planned and postoperative 3D implants. Hence, the present study aimed at validating this measurement technique by determining (I) the anatomical regions that result in the lowest 6-degree of freedom (DoF) errors for 3D-to-3D surface registration of bone models, (II) the 6-DoF errors for 3D-to-3D surface registration of the implant models, and (III) the 6-DoF of the complete measurement technique. Methods Four different regions of the femur were tested to determine which one would result in the most accurate 3D-to-3D registration of the bone models using 12 cadaveric lower limb specimens. Next, total knee arthroplasties were performed on six specimens, and the accuracy of the 3D-to-3D implant registration was evaluated against a gold standard registration performed using fiducial markers. Results The most accurate 3D-to-3D bone registration was obtained when using the largest anatomical regions available after TKA, being the full 3D femur model or the femur model without the distal femur which resulted in root mean square errors within 0.2 mm for translations and 0.2° for rotation. The accuracy of the 3D-to-3D femoral and tibial implant registration was within 0.7 mm for translations and 0.4°-0.6° for rotations, respectively. The accuracy for the overall procedure was within 0.9 mm and 0.6° for both femur and tibia when using femoral regions resulting in accurate 3D-to-3D bone registration. Conclusions In conclusion, this measurement technique can be used in applications where measurement errors up to 0.9 mm in translations and up to 0.6° in rotations in component placement are acceptable. |
| Databáze: | OpenAIRE |
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