Functional Correctability of the Knee Joint using 3D-to-2D Registration of X-Ray Imaging in Stressed Positions

4 pages•Published: September 25, 2020

Jialong Li, David Liu, Stephen McMahon, Jonathan Baré, Andrew Shimmin, Brad Miles, Qing Li and Joshua Twiggs

Abstract

Correcting the knee joint to accommodate the pre-existing soft tissue structures is a major aim in total knee arthroplasty. 3D-to-2D registration of segmented boney geometry obtained from computer tomography (CT) scans to functionally stressed positions in X-Ray (XR) imaging can be a more accurate method of obtaining the laxity envelop. From which, a more patient specific limit for the correctability of the knee joint can be found. Supine CT scans were segmented, and 3D bone models and anatomical landmarks were registered to 2D functional stressed XR imaging. The functional position of the patient femoral and tibial bone is then used to calculate the varus and valgus extent of the patient’s knee joint laxity. 103 preoperative knees undergoing primary total knee arthroplasty identified from six different surgeons. The range of patients who are correctable back to within 3 degrees when a force is applied is 52%. 65% of patients who were within 3 degrees varus/valgus for tibia varus were correctable, while 41% of patients who were within 3 degrees varus/valgus for femoral valgus were correctable. 26% of patients were correctable when the LDFA is outside the threshold and MPTA is not, while 56% of patients were correctable when the MPTA is outside the threshold and LDFA is not. This study demonstrates the complexity of soft tissue structures of the knee joint. The main finding of this study is that correctability is more sensitive to the proximal tibial than the distal and posterior femoral articulating geometry. A lack of dependency between correctability of the knee joint and anatomical measures specific to flexion of the knee is seen. Careful consideration should be made intraoperatively when balancing the knee joint flexion gaps surrounding the soft tissue structures.

Keyphrases: arthroplasty, biomechanics, image processing, ligament laxity, multicenter trials, surgery planning assistance

In: Ferdinando Rodriguez Y Baena and Fabio Tatti (editors). CAOS 2020. The 20th Annual Meeting of the International Society for Computer Assisted Orthopaedic Surgery, vol 4, pages 179-182.

Links:	https://easychair.org/publications/paper/mPPl
	https://doi.org/10.29007/g7l8

BibTeX entry

@inproceedings{CAOS2020:Functional_Correctability_Knee_Joint,
  author    = {Jialong Li and David Liu and Stephen McMahon and Jonathan Baré and Andrew Shimmin and Brad Miles and Qing Li and Joshua Twiggs},
  title     = {Functional Correctability of the Knee Joint using 3D-to-2D Registration of X-Ray Imaging in Stressed Positions},
  booktitle = {CAOS 2020. The 20th Annual Meeting of the International Society for Computer Assisted Orthopaedic Surgery},
  editor    = {Ferdinando Rodriguez Y Baena and Fabio Tatti},
  series    = {EPiC Series in Health Sciences},
  volume    = {4},
  publisher = {EasyChair},
  bibsource = {EasyChair, https://easychair.org},
  issn      = {2398-5305},
  url       = {/publications/paper/mPPl},
  doi       = {10.29007/g7l8},
  pages     = {179-182},
  year      = {2020}}

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