Medical imaging of knee kinematics after joint replacement

关节置换后膝关节运动学的医学成像

• 批准号: 350822-2008
• 负责人: Anglin, Carolyn
• 金额: $ 2.93万
• 依托单位: University of Calgary
• 依托单位国家: 加拿大
• 项目类别: Collaborative Health Research Projects
• 财政年份: 2010
• 资助国家: 加拿大
• 起止时间: 2010-01-01 至 2011-12-31
• 项目状态: 已结题
• 来源: https://www.nserc-crsng.gc.ca/ase-oro/Details-Detailles_eng.asp?id=459233
• 关键词: Medical; imaging; knee; kinematics; after

The primary reason for someone to get a knee replacement is to reduce his or her pain due to arthritis. Unfortunately, some people still have considerable pain after the surgery, often in the region of the kneecap (called anterior knee pain). Frequently this pain is attributed to incorrect tracking of the kneecap (patella) on the thigh bone (femur) due to improper component design, incorrect placement of the components, excessively tight soft tissues or poor surgical technique. Currently, the only method most surgeons use to 'look inside' the knee is X-rays, which are two-dimensional images at a single angle of knee flexion. These provide inadequate information to study the movements of the bones. We are proposing to develop a new method to measure the three-dimensional positions of both the bones and components after knee replacement surgery at different flexion angles, using computed tomography (CT). CT produces a 3D image of the patient's knees. The metal components create streaks on the image, making it difficult to identify the bones and components accurately, however we are proposing several ways to address this. We will validate the protocol using reference arrays inserted into cadaveric knee specimens. We will then apply the protocol to patients in order to judge whether or not a recent implant design improves kneecap motion; subsequently, we will compare patients with and without pain. In addition, and in contrast, to CT, we will develop a protocol for two-dimensional fluoroscopic imaging, which is dynamic (i.e. captures a video of movement), inexpensive, widely available and could be applied in

进行膝关节置换术的主要原因是为了减轻关节炎引起的疼痛。 不幸的是，有些人在手术后仍然有相当大的疼痛，通常是在膝盖骨区域（称为膝前痛）。通常，这种疼痛是由于组件设计不当、组件放置不正确、软组织过紧或手术技术不佳导致膝盖骨（髌骨）在大腿骨（股骨）上的跟踪不正确。目前，大多数外科医生用来“查看”膝盖内部的唯一方法是 X 射线，它是膝盖弯曲单个角度的二维图像。这些为研究骨骼运动提供了不充分的信息。 我们建议开发一种新方法，使用计算机断层扫描 (CT) 来测量膝关节置换手术后不同屈曲角度下骨骼和组件的三维位置。 CT 生成患者膝盖的 3D 图像。金属组件会在图像上产生条纹，导致很难准确识别骨骼和组件，但我们提出了几种方法来解决这个问题。我们将使用插入尸体膝盖标本的参考阵列来验证协议。然后，我们将该方案应用于患者，以判断最近的植入物设计是否改善了膝盖骨的运动；随后，我们将比较有疼痛和没有疼痛的患者。此外，与 CT 相反，我们将开发一种二维荧光成像协议，该协议是动态的（即捕捉运动视频）、廉价、广泛可用并且可应用于