Error Analysis of Methods for Determining Tibiofemoral Kinematics in the Native Knee and After Total Knee Replacement: An in vivo Study Using Single-Plane Fluoroscopy During Weight-Bearing Deep Knee Bend

eScholarship, University of California 2022-01-01

Background: One of the primary goals of total knee replacement is to restore native knee function. Tibiofemoral kinematics provides an objective measure of knee function and have been used to characterize and compare knee function among native (i.e., healthy), replaced, osteoarthritic, and anterior cruciate ligament (ACL) deficient knees. Tibiofemoral kinematics specifically refers to the relative rigid body motions of the tibia with respect to the femur in all six degrees of freedom. Quantification of clinically meaningful tibiofemoral kinematics requires a joint coordinate system where motions are free from kinematic crosstalk errors. One common method to determine tibiofemoral kinematics is to capture single-plane fluoroscopic images of a patient activity and determine the relative position and orientation of the tibia with respect to the femur. This method involves the use of 3D model-to-2D image registration in which projections of 3D models of the native knee (or replaced knee) are fitted to the silhouette of their respective components in the image. The most common software used to perform this registration is JointTrack, of which there are two different versions (JointTrack Manual and JointTrack Auto). Because the precisions of the two different JointTrack programs are unknown, the first objective was to determine the overall precision of both programs in determining the AP positions of the femoral condyles for an example set of TKR components. The rationale behind using the AP Positions as the primary dependent variable is that it is one of the most common variables used to determine tibiofemoral kinematics in the literature and uses a method (lowest point) that has been validated by many research groups. Furthermore, the TKR knee was analyzed because JointTrack was specifically designed to perform image registration with the replaced knee. While the AP positions of the femoral condyles provide information about tibiofemoral kinematics in primarily one degr

Biomechanics; Biomedical engineering; anterior-posterior position; femoral condyle; joint coordinate system; relative rigid body motions; six degrees of freedom; total knee arthroplasty; publication

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