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Computed tomography analysis of radiostereometric data to determine flexion axes after total joint replacement: Application to the elbow joint |
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| Authors: | A Ericson H Olivecrona A Stark ME Noz GQ Maguire MP Zeleznik A Arndt |
| Institution: | 1. Department of Molecular Medicine and Surgery, Section of Orthopaedics and Sports Medicine, Karolinska Institute at Karolinska University Hospital Solna, 171 76 Stockholm, Sweden;2. Department of Radiology, New York University School of Medicine, New York, NY 10016, USA;3. School of Information and Communication Technology, Royal Institute of Technology, 164 40 Kista, Sweden;4. Saya Systems Inc., Salt Lake City, UT 84109, USA;5. Department of Clinical Science, Intervention and Technology, Section of Orthopaedics, Karolinska Institute, 141 86 Stockholm, Sweden;2. Department of Orthopaedics, Clinical Sciences, Lund University, Malmö, Sweden;3. Department of Orthopaedics, Clinical Sciences, Lund University, Lund, Sweden;4. Clinical Epidemiology Research & Training Unit, Boston University School of Medicine, Boston, MA, USA;6. Research Unit for Musculoskeletal Function and Physiotherapy, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark;1. Biomechanics Laboratory, Division of Orthopedic Research, Mayo Clinic, Rochester, MN, USA;2. Department of Orthopaedic Surgery and Traumatology, Ghent University Hospital, Ghent, Belgium;3. Mayo Medical School, Mayo Graduate School, and Medical Scientist Training Program, College of Medicine, Mayo Clinic, Rochester, MN, USA;4. Division of Orthopaedics, Department of Development and Regeneration, KU Leuven, University Hospitals Leuven, Pellenberg, Belgium;5. Department of Orthopaedic Surgery and Traumatology, AZ Monica, Antwerp, Belgium;6. Department of Orthopaedic Surgery and Traumatology, University Hospital Antwerp, Edegem, Belgium |
| Abstract: | Kinematic analysis for in vivo assessment of elbow endoprostheses requires knowledge of the exact positions of motion axes relative to bony landmarks or the prosthesis. A prosthesis-based reference system is required for comparison between individuals and studies. The primary aim of this study was to further develop an earlier described algorithm for fusion of radiostereometric analysis (RSA) data and data obtained in 3D computed tomography (CT) for application to the elbow after total joint replacement. The secondary aim was to propose a method for marking of prostheses in 3D CT, enabling definition of a prosthesis-based reference system. Six patients with elbow endoprostheses were investigated.The fusion of data made it possible to visualize the motion axes in relation to the prostheses in the 3D CT volume. The differences between two repeated positioning repetitions of the longitudinal prosthesis axis were less than 0.6° in the frontal and sagittal planes. Corresponding values for the transverse axis were less than 0.6° in the frontal and less than 1.4° (in four out of six less than 0.6°) in the horizontal plane.This study shows that by fusion of CT and RSA data it is possible to determine the accurate position of the flexion axes of the elbow joint after total joint replacement in vivo. The proposed method for implant marking and registration of reference axes enables comparison of prosthesis function between patients and studies. |
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