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A novel technology for 3D knee prosthesis planning and treatment evaluation using 2D X-ray radiographs: a clinical evaluation

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

Abstract

Purpose

 To present a clinical validation of a novel technology called “3X” which allows for 3D prosthesis planning and treatment evaluation in total knee arthroplasty (TKA) using only 2D X-ray radiographs.

Materials and methods

 After local institution review board approvals, 3X was evaluated on 43 cases (23 for preoperative planning and 20 for postoperative treatment evaluation). All the patients underwent CT scans according to a standard protocol. The results measured on the CT data were regarded as the ground truth. Additionally, two X-ray images were acquired for each affected leg and were used by 3X technology to derive patient-specific measurements of the leg. In total, we compared seven parameters for planning TKA and five parameters for postoperative prosthesis alignment.

Results

 Our experimental results demonstrated that the mean distances between the surface models reconstructed from 2D X-rays and the associated surface models obtained from 3D CT data were smaller than 1.5 mm. The average differences for all angular parameters were smaller than \(1.5^{\circ }\). In over 78% cases 3X technology derived the same femoral component size as the CT-based ground truth and this value went down to 70% when 3X technology was used to predict the size of tibial component.

Conclusion

 3X is a technology that allows for true 3D preoperative planning and postoperative treatment evaluation based on 2D X-ray radiographs.

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Acknowledgements

The project was partially supported by the Swiss Commission for Technology and Innovation (CTI) via Project CTI 18193.1 PFLS-LS.

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Authors and Affiliations

  1. Institute for Surgical Technology and Biomechanics, University of Bern, Bern, Switzerland

    Guoyan Zheng, Alper Akcoltekin & Benedikt Thelen

  2. Clinic for Orthopedic, Sports Medicine and Rehabilitation, Krankenhaus Mrkisch Oderland GmbH, Wriezen, Germany

    Hagen Hommel

  3. Medivation AG, Brugg, Switzerland

    Jan Stifter

  4. Institute for Orthopaedic Research and Training, KU Leuven, Campus Pellenberg, Louvain, Belgium

    Geert Peersman

Authors
  1. Guoyan Zheng
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  2. Hagen Hommel
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  3. Alper Akcoltekin
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Correspondence to Guoyan Zheng.

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The authors declare that they have no conflict of interest.

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Informed consent was obtained from all individuals included in the study.

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Zheng, G., Hommel, H., Akcoltekin, A. et al. A novel technology for 3D knee prosthesis planning and treatment evaluation using 2D X-ray radiographs: a clinical evaluation. Int J CARS 13, 1151–1158 (2018). https://doi.org/10.1007/s11548-018-1789-4

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  • DOI: https://doi.org/10.1007/s11548-018-1789-4

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