Apparatus for In Vivo Knee Laxity Assessment Using High-Speed Stereo Radiography

Computational modeling is of growing importance in orthopedics and biomechanics as a tool to understand differences in pathology and predict outcomes from surgical interventions. However, the computational models of the knee have historically relied on in vitro data to create and calibrate model material properties due to the unavailability of accurate in vivo data. This work demonstrates the design and use of a custom device to quantify anterior-posterior (AP) and internal-external (IE) in vivo knee laxity, with an accuracy similar to existing in vitro methods. The device uses high-speed stereo radiography (HSSR) tracking techniques to accurately measure the resulting displacements of the femur, tibia, and patella bones during knee laxity assessment at multiple loads and knee flexion angles. The accuracy of the knee laxity apparatus was determined by comparing laxity data from two cadaveric specimens between the knee laxity apparatus and an existing in vitro robotic knee joint simulator. The accuracy of the knee laxity apparatus was within 1 mm (0.04 in.) for AP and 2.5 deg for IE. Additionally, two living subjects completed knee laxity testing to confirm the laboratory use of the novel apparatus. This work demonstrates the ability to use custom devices in HSSR to collect accurate data, in vivo, for calibration of computational models.