TY - GEN
T1 - Intra-op measurement of the mechanical axis deviation
T2 - 15th International Conference on Medical Image Computing and Computer-Assisted Intervention, MICCAI 2012
AU - Wang, Lejing
AU - Fallavollita, Pascal
AU - Brand, Alexander
AU - Erat, Okan
AU - Weidert, Simon
AU - Thaller, Peter Helmut
AU - Euler, Ekkehard
AU - Navab, Nassir
N1 - Publisher Copyright:
© Springer-Verlag Berlin Heidelberg 2012.
PY - 2012
Y1 - 2012
N2 - The alignment of the lower limb in high tibial osteotomy (HTO) or total knee arthroplasty (TKA) must be determined intraoperatively. One way to do so is to deform the mechanical axis deviation (MAD), for which a tolerance measurement of 10mm is widely accepted. Many techniques are proposed in clinical practice such as visual inspection, cable method, grid with lead impregnated reference lines, or more recently, navigation systems. Each has their disadvantages including reliability of the MAD measurement, excess radiation, prolonged operation time, complicated setup and high cost. To alleviate such shortcomings, we propose a novel clinical protocol that allows quick and accurate intraoperative calculation of MAD. This is achieved by an X-ray stitching method requiring only three X-ray images placed into a panoramic image frame during the entire procedure. The method has been systematically analyzed in a simulation framework in order to investigate its accuracy and robustness. Furthermore, we validated our protocol via a preclinical study comprising 19 human cadaver legs. Four surgeons determined MAD measurements using our X-ray panorama and compared these values to a gold-standard CT-based technique. The maximum average MAD error was 3.5mm which shows great potential for the technique.
AB - The alignment of the lower limb in high tibial osteotomy (HTO) or total knee arthroplasty (TKA) must be determined intraoperatively. One way to do so is to deform the mechanical axis deviation (MAD), for which a tolerance measurement of 10mm is widely accepted. Many techniques are proposed in clinical practice such as visual inspection, cable method, grid with lead impregnated reference lines, or more recently, navigation systems. Each has their disadvantages including reliability of the MAD measurement, excess radiation, prolonged operation time, complicated setup and high cost. To alleviate such shortcomings, we propose a novel clinical protocol that allows quick and accurate intraoperative calculation of MAD. This is achieved by an X-ray stitching method requiring only three X-ray images placed into a panoramic image frame during the entire procedure. The method has been systematically analyzed in a simulation framework in order to investigate its accuracy and robustness. Furthermore, we validated our protocol via a preclinical study comprising 19 human cadaver legs. Four surgeons determined MAD measurements using our X-ray panorama and compared these values to a gold-standard CT-based technique. The maximum average MAD error was 3.5mm which shows great potential for the technique.
UR - https://www.scopus.com/pages/publications/84872910868
U2 - 10.1007/978-3-642-33418-4_75
DO - 10.1007/978-3-642-33418-4_75
M3 - Conference contribution
C2 - 23286099
AN - SCOPUS:84872910868
SN - 9783642334177
T3 - Lecture Notes in Computer Science (including subseries Lecture Notes in Artificial Intelligence and Lecture Notes in Bioinformatics)
SP - 609
EP - 616
BT - Medical Image Computing and Computer-Assisted Intervention - MICCAI2012 - 15th International Conference, Proceedings
A2 - Montillo, Albert
A2 - Tu, Zhuowen
A2 - Langs, Georg
A2 - Menze, Bjoern H.
A2 - Langs, Georg
A2 - Ayache, Nicholas
A2 - Delingette, Hervé
A2 - Lu, Le
A2 - Menze, Bjoern H.
A2 - Criminisi, Antonio
A2 - Golland, Polina
A2 - Mori, Kensaku
PB - Springer Verlag
Y2 - 5 October 2012 through 5 October 2012
ER -