Tracking of the anterior pelvic plane is of interest for medical interventions such as total hip arthroplasty, for which it is used as a reference for the positioning of the acetabular cup. We introduce and evaluate a new portable ultrasound device for the measure of the pelvic tilt in different positions of daily living. This device consists of two ultrasound probes articulated with respect to each other in order to visualise simultaneously the bony landmarks of interest that are one of the anterior superior iliac spine and the pubic symphysis. A series of sensors and the calibration of the ultrasound probes allow the measurement of the relative position of the landmarks with respect to a vertical line. The accuracy of the device has been investigated through a simulation study and showed errors (mean ± standard deviation [minimum; maximum]) as 0.18° ± 0.96° [−3.85°; 4.33°], with 99% of measurements within a ± 2.5° with respect to the actual pelvic tilt. This level of accuracy is similar to what can be found in the literature for the same purposes. Our device gathers advantages such as being portable and user friendly in order to be used during the pre-operative consultation. It is also non invasive and non irradiant. Further investigations will be run to assess this accuracy in vitro and in vivo.
The anterior cruciate ligament (ACL) is one of the most common ligament injuries. Several ACL reconstructions exist and are consequently performed. An accurate and comprehensive description of knee motion is essential for an adequate assessment of these surgeries, in terms of restoring knee motion. We propose to compare these reconstructions thanks to an index of articular coherence. This index measures the instantaneous state surface configurations during a motion. More specifically, this refers to the position between two articular surfaces facing each other. First of all, the index has to refer to a position known to be physiological. This initial position of the bones, named reference, directly results from the segmentation of CT scans. First we compute all distances between the two surfaces and then we compute the Cumulative Distribution Function (CDF). We process this way for each iteration of the motion. Then we obtain a batch of CDF curves which provide us qualitative information relative to the motion such as potential collisions or dislocations. The graph of all CDF curves is called Figure of Articular Coherence (FoAC). A good articular coherence is characterised by CDF which are close to the reference. This qualitative method is coupled to a quantitative one named Index of Articular Coherence (IoAC) which computes the Haussdorff distance between the temporal distributions and the reference. This distance has to be as low as possible. The tools were tested on cadaveric experiments of ACL reconstruction provided by Hagemeister et al, (1999). They recorded the knee flexion/extension motion in following situations: the intact knee, after ACL resection, after three methods of ACL reconstruction on the same knee (‘over-the-top’ method (OTT), two different two tunnel reconstructions (2 tunnel). Our method was used, for the time being, for one specimen. We compare different post-surgery kinematics thanks to the FoAC and IoAC.Introduction
Methods
