A Workflow-Efficient Approach to Pre- and Post-Operative Assessment of Weight-Bearing Three-Dimensional Knee...

Area of Science:

• Orthopedics
• Medical Imaging
• Biomechanics

Background:

• Knee kinematics correlate with disease severity and outcomes after total knee arthroplasty (TKA).
• Accurate 3D knee kinematics measurement is crucial for preoperative planning and postoperative assessment.
• Existing methods for measuring 3D knee kinematics are not clinically practical for routine use.

Purpose of the Study:

• To develop a clinically practical, accurate, and time-efficient method for measuring 3D dynamic knee kinematics.
• To enable routine clinical assessment of knee function in patients undergoing or having undergone TKA.

Main Methods:

• Utilized upgraded C-arm fluoroscopy with machine-learning-enhanced software for 3D knee kinematics measurement.
• Performed 8-second horizontal sweeping pulsed fluoroscopic scans during weight-bearing activities.
• Employed limited-arc cone-beam reconstruction and model-image registration to quantify kinematics.

Main Results:

• The protocol is efficient, completable by a single technician in ten minutes.
• No specialized equipment beyond a step and stool is required.
• Image analysis can be performed rapidly on-board or via the cloud, integrating with existing EMR systems.

Conclusions:

• Developed an efficient and accurate method for assessing 3D knee kinematics using upgraded C-arm fluoroscopy.
• This approach makes 3D knee kinematics measurement feasible for routine clinical workup.
• Enables better preoperative planning and postoperative assessment for TKA patients.