Feasibility of using orthogonal fluoroscopic images to measure in vivo joint kinematics

Accurately determining in vivo knee kinematics is still a challenge in biomedical engineering. This paper presents an imaging technique using two orthogonal images to measure 6 degree-of-freedom (DOF) knee kinematics during weight-bearing flexion. Using this technique, orthogonal images of the knee were captured using a 3-D fluoroscope at different flexion angles during weight-bearing flexion. The two orthogonal images uniquely characterized the knee position at the specific flexion angle. A virtual fluoroscope was then created in solid modeling software and was used to reproduce the relative positions of the orthogonal images and X-ray sources of the 3-D fluoroscope during the actual imaging procedure. Two virtual cameras in the software were used to represent the X-ray sources. The 3-D computer model of the knee was then introduced into the virtual fluoroscope and was projected onto the orthogonal images by the two virtual cameras. By matching the projections of the knee model to the orthogonal images of the knee obtained during weight-bearing flexion, the knee kinematics in 6 DOF were determined. Using regularly shaped objects with known positions and orientations, this technique was shown to have an accuracy of 0.1 mm and 0.1 deg in determining the positions and orientations of the objects, respectively.