Novel methods for 3D postoperative analysis of total knee arthroplasty using 2D-3D image registration
Novel methods for 3D postoperative analysis of total knee arthroplasty using 2D-3D image registration
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DOI：
10.1016/j.clinbiomech.2010.11.013
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发表时间：
2011-05-01
影响因子：
1.8
通讯作者：
Lee, Kunwoo
中科院分区：
文献类型：
--
作者：
Kim, Youngjun;Kim, Kang-Il;Lee, Kunwoo
背景资料：全膝关节置换术后患者的影像学评价是评估植入物正确位置和肢体对线轴的重要工具，因为这将决定植入物的长期耐久性。近年来，2D-3D医学图像配准方法被开发用于全膝关节置换术后的3D分析。然而，大多数这些技术只集中在膝关节implants.Methods：一个2D-3D医学图像配准实现计算的三维位置，不仅植入物，而且下肢骨。本文介绍了全膝关节置换术后的以下3D分析方法：（1）自动计算植入物和骨骼的相对角度，（2）评估插入植入物的外旋角度，（3）测量和比较两种屈伸间隙平衡。最后，这些方法已被应用于5例接受全膝关节replaces.Findings：一个实用的方法，可以评估病人的膝关节条件已成功开发。2D-3D配准的可重复性和准确性约为0.2 mm，如从使用模型骨骼的测试中获得的。基于三维信息，提出了新的术后分析方法，并成功应用于患者。说明：可以计算膝关节植入物和下肢骨的三维位置，以便进行全膝关节置换术的全面术后分析。拟议的术后评价分析有助于对植入物状态、下肢对线和间隙平衡进行各种3D评价，这在以前是不可行的。(C)2010爱思唯尔有限公司保留所有权利。
Background: Radiographic evaluation of patients after total knee arthroplasty is an important tool for assessing the correct position of the implants and the axis of limb alignment because this will determine long-term durability of the implants. Recently, 2D-3D medical image registration methods are developed for 3D postoperative analysis of total knee arthroplasty. However, most of these techniques have focused only on knee implants.Methods: A 2D-3D medical image registration is implemented to compute the 3D positions of not only implants but also lower limb bones. The following 3D postoperative analysis methods for total knee arthroplasty are presented in this paper: (1) automatic calculation of relative angles of implants and bones, (2) assessment of external rotation angles of inserted implants, and (3) measurement and comparison of both flexion-extension gap balances. Finally these methods have been applied in five patients who underwent total knee replacements.Findings: A practical method that can evaluate the patient's knee conditions has been successfully developed. The repeatability and accuracy of 2D-3D registration were around 0.2 mm as obtained from the tests using model bones. Based on the 3D information, the novel methods of postoperative analysis were proposed and successfully applied to the patients.Interpretation: The 3D positions for both knee implants and lower limb bones can be calculated in order to perform comprehensive postoperative analyses of total knee arthroplasty. The proposed analyses of the postoperative evaluations facilitated various 3D evaluations of the status of implants, alignment of lower limb and gap balances which were not previously feasible. (C) 2010 Elsevier Ltd. All rights reserved.