Errors in calculating A-P tibial contact locations in total knee arthroplasty using 3D model-to-2D image registration in radiographs: An in vitro study of two methods

[+] Author and Article Information
Derrick Ross

Biomedical Engineering Graduate Group, University of California, Davis

Stephen Howell

Department of Biomedical Engineering, University of California, Davis

Maury Hull

Department of Mechanical and Aerospace Engineering, Department of Biomedical Engineering, and Department of Orthopaedic Surgery, University of California, Davis, 1 Shields Ave, Davis, CA, 95616

1Corresponding author.

ASME doi:10.1115/1.4037632 History: Received January 10, 2017; Revised August 10, 2017


Knowledge of A-P tibial contact locations provides an objective assessment of the relative motion of the tibia on the femur following total knee arthroplasty, which can be used to compare the effects of different components, surgical techniques, and alignment goals on knee function in vivo. Both the closest point method and the penetration method have been used to calculate A-P tibial contact locations using 3D model-to-2D image registration. Because the errors in calculating the A-P tibial contact locations using these two methods are unknown, the primary purpose of this study was to determine these errors. The A-P tibial contact locations were calculated with the two methods and simultaneously measured with a tibial force sensor in ten fresh frozen cadaveric knee specimens with a total knee arthroplasty. Single-plane radiographs of the knee specimens were taken at 0°, 30°, 60°, and 90° of flexion in neutrally, internally, and externally rotated orientations. While the radiographs were exposed, reference A-P tibial contact locations were simultaneously collected using the tibial force sensor to be compared to the calculated A-P tibial contact locations. The overall root mean squared errors (RMSEs) in the A-P tibial contact location calculated with the closest point method, the penetration method with penetration, and penetration method without penetration were 5.5 mm, 3.6 mm, and 8.9 mm, respectively. The overall RMSE was lowest for the penetration method with

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