Assessment of knee kinematics with dynamic radiostereometry: Validation of an automated model-based method of analysis using bone models

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Radiostereometic analysis (RSA) is a precise method for the functional assessment of joint kinematics. Traditionally, the method is based on tracking of surgically implanted bone markers and analysis is user intensive. We propose an automated method of analysis based on models generated from computed tomography (CT) scans and digitally reconstructed radiographs. The study investigates method agreement between marker-based RSA and the CT bone model-based RSA method for assessment of knee joint kinematics in an experimental setup. Eight cadaveric specimens were prepared with bone markers and bone volume models were generated from CT-scans. Using a mobile fixture setup, dynamic RSA recordings were obtained during a knee flexion exercise in two unique radiographic setups, uniplanar and biplanar. The method agreement between marker-based and CT bone model-based RSA methods was compared using bias and LoA. Results obtained from uniplanar and biplanar recordings were compared and the influence of radiographic setup was considered for clinical relevance. The automated method had a bias of −0.19 mm and 0.11° and LoA within ±0.42 mm and ±0.33° for knee joint translations and rotations, respectively. The model pose estimation of the tibial bone was more precise than the femoral bone. The radiographic setup had no clinically relevant effect on results. In conclusion, the automated CT bone model-based RSA method had a clinical precision comparable to that of marker-based RSA. The automated method is non-invasive, fast, and clinically applicable for functional assessment of knee kinematics and pathomechanics in patients.

TidsskriftJournal of Orthopaedic Research
Sider (fra-til)597-608
Antal sider12
StatusUdgivet - mar. 2021

Bibliografisk note

Funding Information:
This study was supported by The Orthopaedic Research Found at Aarhus University Hospital and the A. P. M?ller Foundation.

Funding Information:
This study was supported by The Orthopaedic Research Found at Aarhus University Hospital and the A. P. Møller Foundation.

Publisher Copyright:
© 2020 Orthopaedic Research Society. Published by Wiley Periodicals LLC

Copyright 2021 Elsevier B.V., All rights reserved.

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