A robust and semi-automatic quantitative measurement of patellofemoral instability based on four dimensional computed tomography

Chen, Hao; Kluijtmans, Leo A. J.; Bakker, Max; Dunning, Hans; Kang, Yan; Groes, Sebastiaan van de; Sprengers, André

doi:10.1016/j.medengphy.2020.01.012

Cited by 15 publications

(5 citation statements)

References 31 publications

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“…The sensitivity of the coordinate system was determined in a previous publication, which concluded that with common anatomy, the kinematics of the knee can be described with acceptable certainty [16]. A detailed description of the calculation of the femoral and tibial coordinate systems can be found in Chen et al [17]. Furthermore a detailed description of the calculation of the patellar coordinate system can be found in a previous publication [16].…”

Section: Methodsmentioning

confidence: 99%

Fully automatic extraction of knee kinematics from dynamic CT imaging; normative tibiofemoral and patellofemoral kinematics of 100 healthy volunteers

Dunning¹,

Groes²,

Buckens³

et al. 2023

The Knee

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Section: Methodsmentioning

confidence: 99%

Fully automatic extraction of knee kinematics from dynamic CT imaging; normative tibiofemoral and patellofemoral kinematics of 100 healthy volunteers

Dunning¹,

Groes²,

Buckens³

et al. 2023

The Knee

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“…The method for solving the average model is described in part B. The procedure for calculating the mark point on the model to be measured using the registration algorithm and the method for optimizing the mark point on the tibia model to be measured as described in part C. The method of measuring TT-TG on the femur model and the tibial using the mark points obtained in part C was described in part D. The specific measurements (part C, part D) were implemented and tested in the 3D Slicer software.3D Slicer was an open-source software platform [15] for medic imagery informatics, image processing, and 3D visualization widely used in medicine and research [16][17][18]. 3D Slicer offered a programming interface for customization and had the advantage of being highly scalable and easy to develop twice.…”

Section: Methodsmentioning

confidence: 99%

An Automatic Method to Measure the TT-TG Distance Using 3D Slicer Software

2022

Proceedings of WCSE 2022 Spring Event: 2022 9th International Conference on Industrial Engineering and Applications

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The tibial tubercle-trochlear groove distance (TT-TG) is an essential indicator of the lateral forces on the patellofemoral joint, which is valuable for evaluating tibial tuberosity lateralization and diagnosing patellar instability. The orthopaedic surgeons mainly used the image overlay technique to measure the TT-TG distance manually, but this method was prone to inaccuracy due to the nonstandard position and subjectivity of surgeons. In this study, we proposed an automated method for measuring TT-TG on 3D models of the femur and tibia. Firstly, the average model is automatically calculated from a set of the femur and tibial models to be measured, And the orthopaedic surgeon labels the markers on the average model. Next, the Bayesian coherent point drift (BCPD) algorithm is used to register the average model with the model to be measured and calculate the corresponding makers on the model to be measured and make some optimization of the markers. Specifically, we used the markers on the undertested femur to calculate the lowest point of the trochlear groove. We used the lowest point of the trochlear groove and the mark point on the tibia to be measured to calculate TT-TG. We have measured TT-TG distance for a total 56 subjects and compared them with the values measured manually by the physician; the mean error is 0.645 mm for 33 male subjects and 0.690mm for 23 female subjects. This method can aid physicians in measuring TT-TG.

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“…1 The Scho ¨ttle point is commonly regarded as the radiographic femoral origin of the MPFL. 28 To determine the Scho ¨ttle point, we established the anatomic femoral coordinate system of each static femoral surface model, as previously described by Chen et al 5 Subsequently, the femoral surface models were rotated to the mediolateral view that superimposed the femoral condyles. Afterward, the models were converted to a 2-dimensional representation.…”

Section: Patellofemoral Attachmentsmentioning

confidence: 99%

Length Changes of the Medial Patellofemoral Ligament During In Vivo Knee Motion: An Evaluation Using Dynamic Computed Tomography

Boot,

van de Groes,

Dunning

et al. 2023

Am J Sports Med

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Background: Medial patellofemoral ligament (MPFL) reconstruction is associated with high complication rates because of graft overloading from incorrect graft positioning. To improve clinical outcomes, it is crucial to gain a better understanding of MPFL elongation patterns. Purpose: To assess MPFL length changes in healthy knees from 0° to 90° of dynamic flexion and their relationship with anatomic parameters of the patellofemoral joint. Study Design: Descriptive laboratory study. Methods: Dynamic computed tomography scans of an active flexion-extension-flexion movement in 115 knees from 63 healthy participants were evaluated to construct knee joint models. Using these models, the MPFL length was measured as the shortest wrapping path from the Schöttle point on the femur to 3 insertion points on the superomedial border of the patella (proximal, central, and distal). MPFL length changes (%) relative to the length in full extension were calculated, and their correlations with the tibial tuberosity–trochlear groove distance, Caton-Deschamps index, and lateral trochlear inclination were analyzed. Results: The proximal fiber was the longest in full extension and progressively decreased to a median length of −6.0% at 90° of flexion. The central fiber exhibited the most isometric pattern during knee flexion, showing a median maximal decrease of 2.8% relative to the full extension length and no evident elongation. The distal fiber first slightly decreased in length but increased at deeper flexion angles. The median overall length changes were 4.6, 4.7, and 5.7 mm for the proximal, central, and distal patellar insertion, respectively. These values were either not or very weakly correlated with the tibial tuberosity–trochlear groove distance, Caton-Deschamps index, and lateral trochlear inclination when the anatomic parameters were within the healthy range. Conclusion: The median MPFL length changed by approximately 5 mm between 0° and 90° of flexion. Proximally, the length continuously decreased, indicating slackening behavior. Distally, the length increased at deeper flexion angles, indicating tightening behavior. Clinical Relevance: In MPFL reconstruction techniques utilizing the Schöttle point to establish the femoral insertion, one should avoid distal patellar insertion, as it causes elongation of the ligament, which may increase the risk for complications due to overloading.

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A robust and semi-automatic quantitative measurement of patellofemoral instability based on four dimensional computed tomography

Cited by 15 publications

References 31 publications

Fully automatic extraction of knee kinematics from dynamic CT imaging; normative tibiofemoral and patellofemoral kinematics of 100 healthy volunteers

Fully automatic extraction of knee kinematics from dynamic CT imaging; normative tibiofemoral and patellofemoral kinematics of 100 healthy volunteers

An Automatic Method to Measure the TT-TG Distance Using 3D Slicer Software

Length Changes of the Medial Patellofemoral Ligament During In Vivo Knee Motion: An Evaluation Using Dynamic Computed Tomography

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