Computed tomography analysis of radiostereometric data to determine flexion axes after total joint replacement: Application to the elbow joint

• Published in: Journal of biomechanics 2010-07, Vol.43 (10), p.1947-1952
• Main Authors: Ericson, A, Olivecrona, H, Stark, A, Noz, M.E, Maguire, G.Q, Zeleznik, M.P, Arndt, A
• Format: Article
• Language: English
• Subjects: 3D computed tomography; Accuracy; Adult; Arthroplasty, Replacement - methods; Biological and medical sciences; Biomechanics; Elbow flexion axes; Elbow Joint - diagnostic imaging; Elbow Joint - surgery; Elbow prosthesis; Female; Humans; Information technology; Informationsteknik; Joint visualization; Kinematics; Medical sciences; Middle Aged; Orthopedic surgery; Patients; Physical Medicine and Rehabilitation; Prostheses; Prosthesis Implantation; Radiostereometric analysis; Range of Motion, Articular; Rheumatoid arthritis; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; TECHNOLOGY; TEKNIKVETENSKAP; Tomography; Tomography, X-Ray Computed - methods; Transplants & implants
• ISSN: 0021-9290; 1873-2380; 1873-2380
• DOI: 10.1016/j.jbiomech.2010.03.016

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.