Perthes disease is a childhood disorder often resulting in femoral head deformity. Categorical/dichotomous outcomes of deformity are typical clinically, however quantitative, continuous measures, such as Sphericity Deviation Score (SDS), are critical for studying interventions. SDS uses radiographs in two planes to quantify femoral head deformity. Limitations of SDS may include non-orthogonal planes and lost details due to projections. We applied this method in 3D, with specific objectives to: 1. Develop SDS-like sphericity measures from 3D data 2. Obtain 2D and 3D sphericity for normal and Perthes hips 3. Compare slice-based (3D) and projection-based (2D) sphericity CT images of 16 normal (8 subjects) and 5 Perthes hips (4 subjects) were segmented to create 3D hip models. Ethics board approval was obtained for this study. SDS consists of roundness error (RE) in two planes and ellipsoid deformation (ED) between planes. We implemented a modified SDS which was applied to (a) orthogonal projections simulating radiographs (sagittal/coronal; 2D-mSDS), and (b) largest radii slices (sagittal/coronal; 3D-mSDS). Mean 2D-mSDS was higher for Perthes (27.2 (SD 11.4)) than normal (11.9 (SD 4.1)). Mean 3D-mSDS showed similar trends, but was higher than 2D (Perthes 33.6 (SD 5.3), normals 17.0 (SD 3.1)). Unlike 2D-mSDS, 3D-mSDS showed no overlap between groups. For Perthes hips, 2D-mSDS was consistent with SDS. For normal hips, 2D-mSDS was higher than expected (similar to Stulberg II). Projection-based (2D) measures may produce lower mSDS due to spatial averaging. Slice-based (3D) measures may better distinguish between normal and Perthes shapes, which may better differentiate effectiveness of treatments.
This paper presents a methodology for measuring the femoro-pelvic joint angle based on We scanned a healthy subject in a lying position in a 3T MRI scanner to obtain high resolution (HR) images including two transverse T1-weighted TSE sequence scans at the pelvis and knee and a sagittal T1-weighted dual sense scan at the hip joint. We then scanned the same subject in a weight-bearing configuration in a 0.5T open MRI scanner to obtain related low resolution (LR) images of the femur and acetabulum. Four scan cycles were obtained with the subject being removed and reinserted between cycles in the Open MRI scanner. In each cycle, a block was inserted (up position) and removed (down position) under the subject's foot. The femur and acetabulum bone models were manually segmented and the models from the LR (sitting) images were registered to the HR (supine) images. The femoroacetabular angles relative to the LR scanning plane for four cycles were calculated. The femoral angle relative to the scanner were quite repeatable (SD < 0.9°), the pelvic angles less so (SD ∼2.6–4.3°). The hip flexion angle ranged from 23°–34° in the down and up positions, respectively, so the block induced a mean angle change in the flexion direction of approximately 11° (SD = 1.7°). We found that the femoral position could be accurately re-acquired upon repositioning, while the pelvic position was notably more variable. Limb position changes induced by inserting a block under the subject's foot were consistent (standard deviations in the relative attitude angles under 2°). Overall, our measurement method produces plausible measures of both the femoroacetabular angles and the changes induced by the block, and the reproducibility of relative joint changes is good. ACKNOWLEDGMENTS: Dr. Kang was supported by the National Science and Engineering Research Council of Canada (NSERC) through a Postdoctoral Fellowship and conducted her research at the Centre for Hip Health and Mobility at Vancouver General Hospital, Canada.
Measurements of patellar kinematics are essential to investigate the link between anterior knee pain following knee arthroplasty and patellar maltracking. A major challenge in studying the patellofemoral (PF) joint postoperatively is that the patellar component is only partially visible in the sagittal and close-to-sagittal radiographs. The narrow angular distance between these radiographs makes the application of conventional bi-planar fluoroscopy impossible. In this study a methodology has been introduced and validated for accurate estimation of the 3D kinematics of the PF joint post-arthroplasty using a novel multi-planar fluoroscopy approach. An optoelectronic camera (Optotrak Certus) was used to track the motion of an ISO-C fluoroscopy C-arm (Siemens Siremobil) using two sets of markers attached to the X-ray source and detector housings. The C-arm was used in the Digital Radiography (DR) mode, which resembles an ordinary X-ray fluoroscopy image. A previously-developed technique (Cho et al., 2005; Daly et al., 2008) was adapted to find the geometric parameters of the imaging system. Thirty-eight DRs of the calibration phantom were obtained for the 190 of rotation of the C-arm at 5 rotational increments while data from motion markers were recorded continuously at a frequency of 100 Hz. A total knee replacement prosthesis was implanted on an artificial bone model of the knee, and the implant components and bones were rigidly fixed in place using a urethane rigid foam. For the purpose of validation, positions of the implant components were determined using a coordinate measuring machine (CMM). Sagittal and obliquely sagittal radiographs of the model were taken where the patellar component was most visible. For each DR the geometric parameters of the system were interpolated based on the location of the motion markers. The exact location of the projection was then determined in 3D space. JointTrack Bi-plane software (Dr. Scott Banks, University of Florida, Gainesville) was used to conduct 2D-3D registration between the radiographs and the reverse-engineered models of the implant components. Results of the registration were directly compared to the ground-truth obtained from the CMM to calculate the accuracies.Purpose
Method
