Evaluation of knee functional calibration with and without the effect of soft tissue artefact |
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| Affiliation: | 1. The Royal Children׳s Hospital, Melbourne, Australia;2. The Murdoch Childrens Research Institute, Australia;3. The University of Melbourne, School of Engineering, Australia;4. Laboratoire de recherche en Imagerie et Orthopédie (LIO), ETS, Montreal, Canada;5. Ecole Polytechnique Fédérale de Lausanne, Lausanne, Switzerland;1. Roessingh Research and Development P.O. Box 310, 7500 AH Enschede, The Netherlands;2. University of Twente MIRA research institute for Biomedical Technology and Technical Medicine Department of Biomechanical Engineering P. O. Box 217, 7500 AE Enschede, The Netherlands;3. Roessingh, Center for Rehabilitation P.O. Box 310 7500 AE Enschede, The Netherlands;4. Military Rehabilitation Centre ‘Aardenburg’ Department Research and Development P.O. Box 185, 3940 AD Doorn, The Netherlands;1. Gazi University, School of Medicine, Department of Internal Medicine, Section of Rheumatology, Ankara, Turkey;2. Rush Medical College, Department of Internal Medicine, Section of Rheumatology, Department of Biochemistry, Chicago, IL, USA;1. Department of Biomechanical Engineering, Faculty of Mechanical, Maritime, and Materials Engineering, Delft University of Technology (TU Delft), Mekelweg 2, 2628CD Delft, The Netherlands;2. Department of Orthopedics, UMC Utrecht, Heidelberglaan100, 3584CX Utrecht, The Netherlands;3. Department of Rheumatology, UMC Utrecht, Heidelberglaan100, 3584CX Utrecht, The Netherlands;1. Division of Human Mechanical Systems and Design, Faculty of Engineering, Hokkaido University, N13 W8, Kita-ku, Sapporo, Hokkaido 060-8628, Japan;2. Division of Human Mechanical Systems and Design, Graduate School of Engineering, Hokkaido University, N13 W8, Kita-ku, Sapporo, Hokkaido 060-8628, Japan;1. DOD/VA Extremity Trauma and Amputation Center of Excellence, USA;2. Research & Development Section, Department of Rehabilitation, Walter Reed National Military Medical Center, Bethesda, MD 20889, USA;3. Department of Physical Medicine and Rehabilitation, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA |
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| Abstract: | Functional calibration methods were devised to improve repeatability and accuracy of the knee flexion–extension axis, which is used to define the medio-lateral axis of the femur coordinate system in gait analysis. Repeatability of functional calibration methods has been studied extensively in healthy individuals, but not accuracy in the absence of a benchmark knee axis. We captured bi-plane fluoroscopy data of the knee joint in 17 subjects with unilateral total knee arthroplasty during treadmill walking. The prosthesis provided a benchmark knee axis to evaluate the functional calibration methods. Stereo-photogrammetry data of thigh and shank marker clusters were captured simultaneously to investigate the effect of soft tissue artefact (STA). Three methods were tested, the Axis Transformation Technique (ATT) finds the best single fixed axis of rotation, 2DofKnee finds the axis that minimises knee varus–valgus and trajAJC finds the axis perpendicular to the trajectory, in the transverse plane of the femur, of a point located on the longitudinal axis of the tibia. Using fluoroscopy data, functional axes formed an angle of less than 2° in the transverse plane with the benchmark axis. True internal–external range of movement was correlated with decreased accuracy for ATT, while varus–valgus range of movement was correlated with decreased accuracy for 2DofKnee and trajAJC. STA had negative impact on accuracy and variability. Using stereo-photogrammetry data, the accuracy of 2DofKnee was 1.7°(SD: 5.1°), smaller than ATT 2.9°(SD: 5.1°) but not to trajAJC 1.7°(SD: 5.2°). Our results confirm that of previous studies, which utilised the femur condylar axis as reference. |
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| Keywords: | Soft tissue artefact Functional calibration Knee Total knee arthroplasty |
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