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Development and validation of a robust patellar reference coordinate system for biomechanical and clinical studies
Bernardo Innocenti1, Edoardo Bori1, Stephane Piccolo1
1Bio Electro and Mechanical Systems (BEAMS) Department, Université Libre de Bruxelles, Bruxelles, Belgium.
Background:
This study aimed to develop and validate a reference coordinate system for the human patella, based on the registration of bony landmarks on a computed tomography (CT) scan.
Methods:
Thirty-three native cadaveric specimens were scanned, and an observer marked a set of seven anatomical landmarks on each of them. Such markers were used to define the reference coordinate system. In order to validate its robustness, statistical distribution of the point registration was then studied. Afterwards, three different observers marked the anatomical landmarks on a sub-sample of six specimens and the intra-observer and inter-observer variability of the point registration was performed.
Results:
Results of this study showed the highest values to be 1.46 mm (intra) and 4.08 mm (inter), both observed for the patellar ridge top. The intra-class correlation coefficient (ICC) for inter-observer variability ranked higher than 0.8 for all the landmarks used for the identification of the reference frame, and ranged from 0.4-0.9 for other landmarks.
Conclusions:
This study demonstrates low intra-observer and inter-observer variability in the CT registration of landmarks that define and validate a robust coordinate system of the patella that could be used to perform accurate biomechanical and clinical studies.
