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3D kinematics of mobile-bearing total knee arthroplasty using X-ray fluoroscopy

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International Journal of Computer Assisted Radiology and Surgery Aims and scope Submit manuscript

Abstract

Purpose

  Total knee arthroplasty (TKA) 3D kinematic analysis requires 2D/3D image registration of X-ray fluoroscopic images and a computer-aided design (CAD) model of the knee implant. However, these techniques cannot provide information on the radiolucent polyethylene insert, since the insert silhouette does not appear clearly in X-ray images. Therefore, it is difficult to obtain the 3D kinematics of the polyethylene insert, particularly the mobile-bearing insert. A technique for 3D kinematic analysis of a mobile-bearing insert used in TKA was developed using X-ray fluoroscopy. The method was tested and a clinical application was evaluated.

Methods

Tantalum beads and a CAD model of the mobile-bearing TKA insert are used for 3D pose estimation of the mobile-bearing insert used in TKA using X-ray fluoroscopy. The insert model was created using four identical tantalum beads precisely located at known positions in a polyethylene insert using a specially designed insertion device. Finally, the 3D pose of the insert model was estimated using a feature-based 2D/3D registration technique, using the silhouette of beads in fluoroscopic images and the corresponding CAD insert model. In vitro testing for the repeatability of the positioning of the tantalum beads and computer simulations for 3D pose estimation of the mobile-bearing insert were performed.

Experimental results

The pose estimation accuracy achieved was sufficient for analyzing mobile-bearing TKA kinematics (RMS error: within 1.0 mm and 1.0\(^{\circ }\), except for medial–lateral translation). In a clinical application, nine patients with mobile-bearing TKA were investigated and analyzed with respect to a deep knee bending motion.

Conclusions

A 3D kinematic analysis technique was developed that enables accurate quantitative evaluation of mobile-bearing TKA kinematics. This method may be useful for improving implant design and optimizing TKA surgical techniques.

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Acknowledgments

A part of this study was supported by the Global COE Program “in silico medicine” at Osaka University, and by Grants-in-Aid for Hybrid Organ Project and Scientific Research for Young Scientists (B) (23700206) from The Ministry of Education, Culture, Sports, Science and Technology, Japan.

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Authors and Affiliations

  1. The Center for Advanced Medical Engineering and Informatics, Osaka University, 2-2 Yamadaoka, Suita, Osaka , 565-0871, Japan

    Takaharu Yamazaki & Shinichi Tamura

  2. Department of Orthopaedics, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka , 565-0871, Japan

    Kazuma Futai & Hideki Yoshikawa

  3. Division of Orthopaedic Biomaterial Science, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka , 565-0871, Japan

    Tetsuya Tomita & Kazuomi Sugamoto

  4. Department of Radiology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka , 565-0871, Japan

    Yoshinobu Sato

Authors
  1. Takaharu Yamazaki
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  2. Kazuma Futai
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  3. Tetsuya Tomita
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  4. Yoshinobu Sato
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  5. Hideki Yoshikawa
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  6. Shinichi Tamura
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  7. Kazuomi Sugamoto
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Corresponding author

Correspondence to Takaharu Yamazaki.

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Yamazaki, T., Futai, K., Tomita, T. et al. 3D kinematics of mobile-bearing total knee arthroplasty using X-ray fluoroscopy. Int J CARS 10, 487–495 (2015). https://doi.org/10.1007/s11548-014-1093-x

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  • DOI: https://doi.org/10.1007/s11548-014-1093-x

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