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Su Y, Sun Y, Hosny M, Gao W, Fu Y. Facial landmark-guided surface matching for image-to-patient registration with an RGB-D camera. Int J Med Robot 2022; 18:e2373. [PMID: 35133715 DOI: 10.1002/rcs.2373] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Revised: 01/17/2022] [Accepted: 01/29/2022] [Indexed: 01/01/2023]
Abstract
BACKGROUND Fiducial marker-based image-to-patient registration is the most common way in image-guided neurosurgery, which is labour-intensive, time consuming, invasive and error prone. METHODS We proposed a method of facial landmark-guided surface matching for image-to-patient registration using an RGB-D camera. Five facial landmarks are localised from preoperative magnetic resonance (MR) images using deep learning and RGB image using Adaboost with multi-scale block local binary patterns, respectively. The registration of two facial surface point clouds derived from MR images and RGB-D data is initialised by aligning these five landmarks and further refined by weighted iterative closest point algorithm. RESULTS Phantom experiment results show the target registration error is less than 3 mm when the distance from the camera to the phantom is less than 1000 mm. The registration takes less than 10 s. CONCLUSIONS The proposed method is comparable to the state-of-the-arts in terms of the accuracy yet more time-saving and non-invasive.
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Affiliation(s)
- Yixian Su
- State Key Laboratory of Robotics and System, School of Life Science and Technology, Harbin Institute of Technology, Harbin, China
| | - Yu Sun
- State Key Laboratory of Robotics and System, School of Life Science and Technology, Harbin Institute of Technology, Harbin, China
| | - Mohamed Hosny
- State Key Laboratory of Robotics and System, School of Life Science and Technology, Harbin Institute of Technology, Harbin, China.,Department of Electrical Engineering, Benha Faculty of Engineering, Benha University, Benha, Egypt
| | - Wenpeng Gao
- State Key Laboratory of Robotics and System, School of Life Science and Technology, Harbin Institute of Technology, Harbin, China
| | - Yili Fu
- State Key Laboratory of Robotics and System, School of Life Science and Technology, Harbin Institute of Technology, Harbin, China
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Regodić M, Freyschlag CF, Kerschbaumer J, Galijašević M, Hörmann R, Freysinger W. Novel microscope-based visual display and nasopharyngeal registration for auditory brainstem implantation: a feasibility study in an ex vivo model. Int J Comput Assist Radiol Surg 2021; 17:261-270. [PMID: 34792744 PMCID: PMC8784369 DOI: 10.1007/s11548-021-02514-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Accepted: 09/29/2021] [Indexed: 12/03/2022]
Abstract
Purpose An auditory brainstem implant (ABI) represents an alternative for patients with profound hearing loss who are constrained from receiving a cochlear implant. The positioning of the ABI electrode influences the patient’s auditory capacity and, therefore, quality of life and is challenging even with available intraoperative electrophysiological monitoring. This work aims to provide and assess the feasibility of visual-spatial assistance for ABI positioning. Methods The pose of the forceps instrument that grasps the electrode was electromagnetically navigated and interactively projected in the eyepieces of a surgical microscope with respect to a target point. Intraoperative navigation was established with an experimental technique for automated nasopharyngeal patient registration. Two ABI procedures were completed in a human specimen head. Results An intraoperative usability study demonstrated lower localization error when using the proposed visual display versus standard cross-sectional views. The postoperative evaluations of the preclinical study showed that the center of the electrode was misplaced to the planned position by 1.58 mm and 3.16 mm for the left and the right ear procedure, respectively. Conclusion The results indicate the potential to enhance intraoperative feedback during ABI positioning with the presented system. Further improvements consider estimating the pose of the electrode itself to allow for better orientation during placement. Supplementary Information The online version contains supplementary material available at 10.1007/s11548-021-02514-x.
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Affiliation(s)
- Milovan Regodić
- Department of Otorhinolaryngology, Medical University of Innsbruck, Innsbruck, Austria. .,Department of Radiation Oncology, Medical University of Vienna, Vienna, Austria.
| | | | | | - Malik Galijašević
- Department of Neuroradiology, Medical University of Innsbruck, Innsbruck, Austria.,Neuroimaging Research Core Facility, Medical University of Innsbruck, Innsbruck, Austria
| | - Romed Hörmann
- Department of Anatomy, Histology and Embryology, Medical University of Vienna, Vienna, Austria
| | - Wolfgang Freysinger
- Department of Otorhinolaryngology, Medical University of Innsbruck, Innsbruck, Austria
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Tian F, Li N, Zheng Z, Huang Q, Zhu T, Li Q, Wang W, Tsai TY, Wang S. The effects of marathon running on three-dimensional knee kinematics during walking and running in recreational runners. Gait Posture 2020; 75:72-77. [PMID: 31606722 DOI: 10.1016/j.gaitpost.2019.08.009] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Revised: 06/22/2019] [Accepted: 08/09/2019] [Indexed: 02/02/2023]
Abstract
BACKGROUND Running-related musculoskeletal injuries are common. Knee injuries are most frequent, and often occur during or shortly after marathons. RESEARCH QUESTION The effects of a marathon on runners' knee kinematics remain unclear. No studies have shown comprehensive three-dimensional (3D) knee kinematic changes following a marathon. This study aimed to observe the effects of running a marathon on 3D knee kinematics and identify the phases of walking and running gait in which significant changes occur. METHODS Based on an electronic survey, 10 healthy, recreational runners (20 knees) with similar running experience were included. Their 3D knee kinematics (during treadmill walking and running) were collected using a portable, optical motion capture system within 24 h before and within 6 h after running a marathon. RESULTS All measurements after the marathon were compared with pre-marathon measurements. (1) For walking post-marathon: varus rotation increased by 1.8° [95% confidence interval (CI) 0.1-3.4, P = 0.036] at peak knee extension during stance; anterior translation increased by 2.2 mm (95% CI 0.3-4.1, P = 0.025) at initial contact; range of motion (ROM) in internal-external rotation increased less than 1°, P = 0.023; ROM in anteroposterior translation increased by 3.8 mm, P = 0.048. (2) For running post-marathon: flexion rotation increased by 1.6° (95% CI 0.2-2.9, P = 0.025) at initial contact; varus rotation increased by 2.0° (95% CI 0.2-3.8, P = 0.031) at peak knee extension during stance. SIGNIFICANCE Significant differences in varus rotation and anterior translation were identified following a marathon, which could potentially contribute to injury. These results provide important information for runners and coaches about knee kinematic alterations following a marathon.
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Affiliation(s)
- Fei Tian
- Key Laboratory of Exercise and Health Sciences of Ministry of Education, School of kinesiology, Shanghai University of Sport, Shanghai, China; Department of Rehabilitation Medicine, Heping Hospital Affiliated to Changzhi Medical College, Shanxi, China
| | - Ningwei Li
- Key Laboratory of Exercise and Health Sciences of Ministry of Education, School of kinesiology, Shanghai University of Sport, Shanghai, China
| | - Zhi Zheng
- Key Laboratory of Exercise and Health Sciences of Ministry of Education, School of kinesiology, Shanghai University of Sport, Shanghai, China
| | - Qiuyue Huang
- Key Laboratory of Exercise and Health Sciences of Ministry of Education, School of kinesiology, Shanghai University of Sport, Shanghai, China
| | - Ting Zhu
- Key Laboratory of Exercise and Health Sciences of Ministry of Education, School of kinesiology, Shanghai University of Sport, Shanghai, China
| | - Qiang Li
- Department of Orthopedics, The First Affiliated Hospital of Fujian Medical University, Fujian, China
| | - Wenjin Wang
- Key Laboratory of Exercise and Health Sciences of Ministry of Education, School of kinesiology, Shanghai University of Sport, Shanghai, China
| | - Tsung-Yuan Tsai
- School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, China
| | - Shaobai Wang
- Key Laboratory of Exercise and Health Sciences of Ministry of Education, School of kinesiology, Shanghai University of Sport, Shanghai, China.
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Does mobile-bearing have better flexion and axial rotation than fixed-bearing in total knee arthroplasty? A randomised controlled study based on gait. J Orthop Translat 2019; 20:86-93. [PMID: 31908938 PMCID: PMC6939107 DOI: 10.1016/j.jot.2019.07.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2018] [Revised: 05/28/2019] [Accepted: 07/30/2019] [Indexed: 12/31/2022] Open
Abstract
Objective To analyse the 6 degrees of freedom of the knee and gait data of patients with medial knee osteoarthritis before and after fixed-bearing (FB) and mobile-bearing (MB) total knee arthroplasty (TKA) and examine the influence of TKA on gait characteristics and the difference between FB and MB prosthesis. We also sought to explore the prosthesis options available for TKA in these patients. Methods Thirty patients who underwent TKA at the Department of Orthopedics at our hospital from June to October 2017 were included. All patients had a lower limb mechanical axis (hip-knee-ankle angle) of less than 180° which were regarded as genu varum knees and had medial knee osteoarthritis. Patients were randomised divided into the FB group and the MB group according to the knee prosthesis implanted. An infrared navigation three-dimensional portable knee motion analysis system (Opti-Knee®, Shanghai Innomotion, Inc.) was used to acquire data on the 6 degrees of freedom of both knees when walking on flat ground before and after surgery (angle of tibia relative to femur parameters: flexion-extension, internal rotation–external rotation, abduction–adduction; displacement parameters: anterior–posterior, proximal–distal, medial–lateral). Postoperative follow-up efficacy was assessed using the Oxford Knee Score system. Results There were significant differences in the maximum values of the internal/external rotation and flexion/extension angle between patients post-TKA and the healthy population, p values were 0.007 and <0.001,respectively. The postoperative maximum values of genu varum and internal rotation in both FB [(−9.49 ± 5.99°), (−5.77 ± 3.42°), respectively] and MB [(−9.64 ± 4.83°), (−7.54 ± 4.51°), respectively] groups were lower than the preoperative ones [FB (−15.13 ± 6.78°), (−8.28 ± 4.83°); MB (−13.28 ± 3.98°), (−9.46 ± 4.99°), respectively] (p ≤ 0.001), while the postoperative maximum values of flexion angle and anterior displacement in both FB [(46.11 ± 4.14°), (0.71 ± 0.35 cm), respectively] and MB [(49.33 ± 3.98°), (0.75 ± 0.89 cm), respectively] groups were larger than the preoperative ones [FB (43.15 ± 3.77°), (0.26 ± 0.74 cm); MB (44.62 ± 5.92°), (0.33 ± 0.79°), respectively] (p ≤ 0.001). The postoperative range of flexion/extension angle in both FB (40.13 ± 4.14°) and MB (45.82 ± 3.76°) groups was significantly larger than the preoperative one [FB (36.17 ± 6.07°), MB (37.09 ± 3.93°), respectively] (p ≤ 0.001). There were also significant increases in range of anterior–posterior displacement in the FB group (0.85 ± 0.32 cm) postoperatively compared with the preoperative one (0.71 ± 0.92 cm) (p = 0.016) and significant increases in range of medial-lateral displacement (0.64 ± 0.73 cm) in the MB group postoperatively compared with the preoperative one (0.52 ± 0.91 cm) (p = 0.025). The mean flexion/extension angle of the MB group was significantly greater than the FB group after surgery in both the stance phase and the swing phase (p < 0.001). There were significant differences in postoperative knee axial rotation during the gait cycle between the MB and FB groups (p = 0.028) and that postoperative internal rotation of the tibia relative to the femur increased in the MB group. The Oxford Knee Score at the last follow-up visit about 7.5 months after surgery was 15.6 ± 1.3 and 15.1 ± 1.1 points for FB and MB groups, respectively. This difference was not significant (p = 0.428). Conclusions TKA can make the parameters of knee gait characteristics closer to the normal population. Medial knee osteoarthritis patients who received a MB prosthesis in TKA had better joint flexion function and axial rotation than the FB one. However, there is insufficient evidence to suggest that the MB prosthesis is a better option for patients with medial knee osteoarthritis. The translational potential of this article To date, no consensus for prosthesis selection in TKA has been established. This study found significant differences in joint flexion/extension angle and internal/external rotation during gait post-TKA surgery in medial knee osteoarthritis patients who received different prostheses. This will provide some references for prosthesis selection for a large number of genu varum patients in clinical practice.
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Neri T, Testa R, Laurendon L, Dehon M, Putnis S, Grasso S, Parker DA, Farizon F, Philippot R. Determining the change in length of the anterolateral ligament during knee motion: A three-dimensional optoelectronic analysis. Clin Biomech (Bristol, Avon) 2019; 62:86-92. [PMID: 30710797 DOI: 10.1016/j.clinbiomech.2019.01.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2018] [Revised: 09/11/2018] [Accepted: 01/23/2019] [Indexed: 02/07/2023]
Abstract
BACKGROUND The variation of the anterolateral ligament (ALL) length during knee motion is still unclear, and the knee position in which a reconstruction graft should be tensioned remains controversial. The objective of this study was to determine the variation of the ALL length during knee motion using a three-dimensional optoelectronic system. METHODS Kinematic analyses of 20 cadaveric knees were performed using a Motion Analysis® system. The variability of the measurements made during the five acquisition cycles was studied. Reliability was evaluated by two separate measurement sessions, with complete system reinstallation, using different cadavers and a new operator. The ALL length was analysed from extension to full flexion in three rotational conditions. FINDINGS When analysing the reliability of the five cycles, 82% of the measurements we found to have an Intra Class Correlation (ICC) >0.85. The reproducibility of inter-sessional measures by different operators and different cadavers was either good (ICC >0.75) or excellent (ICC >0.85). The ALL length was maximum in full internal rotation with the knee at 25° of flexion. INTERPRETATION This three-dimensional optoelectronic protocol allowed us to analyse the variation of the ALL length during intact knee motion with good reliability and the required accuracy to analyse this variable. The maximal length and highest tension of the ALL was reported at 25° of knee flexion in internal rotation, suggesting this as the optimal position for the knee joint when tensioning an ALL reconstruction.
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Affiliation(s)
- Thomas Neri
- Univ Lyon - UJM-Saint-Etienne, Inter-university Laboratory of Human Movement Science, EA 7424, F-42023 Saint-Etienne, France; Department of Orthopedic Surgery, University Hospital of Saint Etienne, France; Sydney Orthopaedic Research Institute, Sydney, Australia.
| | - Rodolphe Testa
- Univ Lyon - UJM-Saint-Etienne, Inter-university Laboratory of Human Movement Science, EA 7424, F-42023 Saint-Etienne, France
| | - Loic Laurendon
- Department of Orthopedic Surgery, University Hospital of Saint Etienne, France
| | - Margaux Dehon
- Department of Orthopedic Surgery, University Hospital of Saint Etienne, France
| | - Sven Putnis
- Sydney Orthopaedic Research Institute, Sydney, Australia
| | - Samuel Grasso
- Sydney Orthopaedic Research Institute, Sydney, Australia
| | - David A Parker
- Sydney Orthopaedic Research Institute, Sydney, Australia
| | - Frederic Farizon
- Univ Lyon - UJM-Saint-Etienne, Inter-university Laboratory of Human Movement Science, EA 7424, F-42023 Saint-Etienne, France; Department of Orthopedic Surgery, University Hospital of Saint Etienne, France
| | - Remi Philippot
- Univ Lyon - UJM-Saint-Etienne, Inter-university Laboratory of Human Movement Science, EA 7424, F-42023 Saint-Etienne, France; Department of Orthopedic Surgery, University Hospital of Saint Etienne, France
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Diakov G, Freysinger W. Vector field analysis for surface registration in computer-assisted ENT surgery. Int J Med Robot 2018; 15:e1977. [PMID: 30548164 PMCID: PMC6590403 DOI: 10.1002/rcs.1977] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2018] [Revised: 11/25/2018] [Accepted: 11/28/2018] [Indexed: 12/14/2022]
Abstract
Background Manual paired‐point registration for navigated ENT‐surgery is prone to human errors; automatic surface registration is often caught in local minima. Methods Anatomical features of the human occiput are integrated into an algorithm for surface registration. A vector force field is defined between the patient and operating room datasets; registration is facilitated through gradient‐based vector field analysis optimization of an energy function. The method is validated exemplarily on patient surface data provided by a mechanically positioned A‐mode ultrasound sensor. Results Successful registrations were achieved within the entire parameter space, as well as from positions of local minima that were found by the Gaussian fields algorithm for surface registration. Sub‐millimetric registration error was measured in clinically relevant anatomical areas on the anterior skull and within the generally accepted margin of 1.5 mm for the entire head. Conclusion The satisfactory behavior of this approach potentially suggests a wider clinical integration.
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Affiliation(s)
- Georgi Diakov
- Department of Oto-, Rhino-, Laryngology, 4D-Visualization Laboratory, Innsbruck Medical University, Innsbruck, Austria
| | - Wolfgang Freysinger
- Department of Oto-, Rhino-, Laryngology, 4D-Visualization Laboratory, Innsbruck Medical University, Innsbruck, Austria
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Probe versus microscope: a comparison of different methods for image-to-patient registration. Int J Comput Assist Radiol Surg 2018; 13:1539-1548. [PMID: 29869745 PMCID: PMC6153656 DOI: 10.1007/s11548-018-1800-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2017] [Accepted: 05/22/2018] [Indexed: 11/03/2022]
Abstract
PURPOSE Computer-aided navigation is widely used in ENT surgery. The position of a surgical instrument is shown in the CT/MR images of the patient and can thus be a good support for the surgeon. The accuracy is highly dependent on the registration done prior to surgery. A microscope and a probe can both be used for registration and navigation, depending on the surgical intervention. A navigation system typically only reports the fiducial registration error after paired-point registration. However, the target registration error (TRE)-a measurement for the accuracy in the surgical area-is much more relevant. The aim of this work was to compare the performance of a microscope relative to a conventional probe-based approach with different registration methods. METHODS In this study, optical tracking was used to register a plastic skull to its preoperative CT images with paired-point registration. Anatomical landmarks and skin-affixed markers were used as fiducials and targets. With both microscope and probe, four different registration methods were evaluated based on their TREs at 10 targets. For half of the experiments, a surface registration and/or external fiducials were used additionally to paired-point registration to study their influence to accuracy. RESULTS Overall, probe registration leads to a smaller TRE ([Formula: see text]) than registration with a microscope ([Formula: see text]). Additional surface registration does not result in better accuracy of navigation for microscope and probe. The lowest mean TRE for both pointers can be achieved with paired-point registration only and radiolucent markers. CONCLUSION Our experiments showed that a probe used for registration and navigation achieves lower TREs compared using a microscope. Neither additional surface registration nor additional fiducials on an external reference element are necessary for improved accuracy of navigated ENT surgery on a plastic skull.
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Perwög M, Bardosi Z, Freysinger W. Experimental validation of predicted application accuracies for computer-assisted (CAS) intraoperative navigation with paired-point registration. Int J Comput Assist Radiol Surg 2017; 13:425-441. [PMID: 28801767 DOI: 10.1007/s11548-017-1653-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2017] [Accepted: 07/24/2017] [Indexed: 11/28/2022]
Abstract
PURPOSE The target registration error (TRE) is a crucial parameter to estimate the potential usefulness of computer-assisted navigation intraoperatively. Both image-to-patient registration on base of rigid-body registration and TRE prediction methods are available for spatially isotropic and anisotropic data. This study presents a thorough validation of data obtained in an experimental operating room setting with CT images. METHODS Optical tracking was used to register a plastic skull, an anatomic specimen, and a volunteer to their respective CT images. Plastic skull and anatomic specimen had implanted bone fiducials for registration; the volunteer was registered with anatomic landmarks. Fiducial localization error, fiducial registration error, and total target error (TTE) were measured; the TTE was compared to isotropic and anisotropic error prediction models. Numerical simulations of the experiment were done additionally. RESULTS The user localization error and the TTE were measured and calculated using predictions, both leading to results as expected for anatomic landmarks and screws used as fiducials. TRE/TTE is submillimetric for the plastic skull and the anatomic specimen. In the experimental data a medium correlation was found between TRE and target localization error (TLE). Most of the predictions of the application accuracy (TRE) fall in the 68% confidence interval of the measured TTE. For the numerically simulated data, a prediction of TTE was not possible; TRE and TTE show a negligible correlation. CONCLUSION Experimental application accuracy of computer-assisted navigation could be predicted satisfactorily with adequate models in an experimental setup with paired-point registration of CT images to a patient. The experimental findings suggest that it is possible to run navigation and prediction of navigation application accuracy basically defined by the spatial resolution/precision of the 3D tracker used.
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Affiliation(s)
- Martina Perwög
- Medical University Innsbruck, Anichstr. 35, Innsbruck, Austria.
| | - Zoltan Bardosi
- Medical University Innsbruck, Anichstr. 35, Innsbruck, Austria
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Yao ZL, Wang SB, Zhang Y, Huang WH, Shen HY, Ma LM, Huang HY, Xia H. Clinical Significance of a Novel Knee Joint Stability Assessment System for Evaluating Anterior Cruciate Ligament Deficient Knees. Orthop Surg 2017; 8:75-80. [PMID: 27028384 DOI: 10.1111/os.12225] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2015] [Accepted: 12/08/2015] [Indexed: 01/24/2023] Open
Abstract
OBJECTIVE To investigate the six degrees of freedom (6DOF) kinematics of anterior cruciate ligament (ACL) deficient knees during gait and to explore the clinical significance of a novel knee joint stability assessment system (Opti_Knee, Innomotion, Shanghai, China) in comparison with imaging and arthroscopic examination. METHODS Three subjects diagnosed with ACL deficient knees on the basis of preoperative MRI and CT findings were subjected to treadmill gait analysis. Motion of both knees in 6DOF was measured and analyzed with an optical joint kinematics measurement system. Arthroscopic examination, the gold standard, was performed to confirm the final diagnosis and the clinical diagnosis of ACL deficiency by imaging and motion marker techniques compared with this gold standard. RESULTS Only two of the three subjects diagnosed with ACL deficiency by imaging techniques were later confirmed to have this condition by arthroscopic examination; the third was found to have an intact ACL. When the kinematics of their injured and contralateral knees were compared, abnormalities were found in the two subjects confirmed by arthroscopy to be ACL deficient However, no kinematic difference between the two knees was found in the ACL intact subject. CONCLUSIONS Opti_Knee (Innomotion) can detect abnormal kinematics in ACL deficient knees and thus provides an effective way of assisting the diagnosis of this condition and has potential for clinical application.
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Affiliation(s)
- Zi-long Yao
- Southern Medical University, Guangzhou, Guangdong, China.,Department of Orthopaedic Surgery, Guangzhou General Hospital of Guangzhou Military Command, Guangzhou, Guangdong, China.,Department of Orthopedics, Guangdong Key Lab of Orthopaedic Technology and Implant, Guangzhou General Hospital of Guangzhou Military Command, Guangzhou, Guangdong, China
| | - Shao-bai Wang
- Key Laboratory of Exercise and Health Science, Ministry of Education, Shanghai University of Sport, Shanghai, China
| | - Yu Zhang
- Department of Orthopaedic Surgery, Guangzhou General Hospital of Guangzhou Military Command, Guangzhou, Guangdong, China.,Department of Orthopedics, Guangdong Key Lab of Orthopaedic Technology and Implant, Guangzhou General Hospital of Guangzhou Military Command, Guangzhou, Guangdong, China
| | - Wen-han Huang
- Department of Orthopaedic Surgery, Guangzhou General Hospital of Guangzhou Military Command, Guangzhou, Guangdong, China.,Department of Orthopedics, Guangdong Key Lab of Orthopaedic Technology and Implant, Guangzhou General Hospital of Guangzhou Military Command, Guangzhou, Guangdong, China
| | - Hong-yuan Shen
- Department of Orthopaedic Surgery, Guangzhou General Hospital of Guangzhou Military Command, Guangzhou, Guangdong, China.,Department of Orthopedics, Guangdong Key Lab of Orthopaedic Technology and Implant, Guangzhou General Hospital of Guangzhou Military Command, Guangzhou, Guangdong, China
| | - Li-min Ma
- Department of Orthopaedic Surgery, Guangzhou General Hospital of Guangzhou Military Command, Guangzhou, Guangdong, China.,Department of Orthopedics, Guangdong Key Lab of Orthopaedic Technology and Implant, Guangzhou General Hospital of Guangzhou Military Command, Guangzhou, Guangdong, China
| | - Hua-yang Huang
- Department of Orthopaedic Surgery, Guangzhou General Hospital of Guangzhou Military Command, Guangzhou, Guangdong, China.,Department of Orthopedics, Guangdong Key Lab of Orthopaedic Technology and Implant, Guangzhou General Hospital of Guangzhou Military Command, Guangzhou, Guangdong, China
| | - Hong Xia
- Department of Orthopaedic Surgery, Guangzhou General Hospital of Guangzhou Military Command, Guangzhou, Guangdong, China.,Department of Orthopedics, Guangdong Key Lab of Orthopaedic Technology and Implant, Guangzhou General Hospital of Guangzhou Military Command, Guangzhou, Guangdong, China
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Zhang Y, Huang W, Yao Z, Ma L, Lin Z, Wang S, Huang H. Anterior Cruciate Ligament Injuries Alter the Kinematics of Knees With or Without Meniscal Deficiency. Am J Sports Med 2016; 44:3132-3139. [PMID: 27511793 DOI: 10.1177/0363546516658026] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Numerous studies have investigated kinematic alterations in patients with an isolated anterior cruciate ligament (ACL) injury. However, a substantial proportion of patients with injured ACLs also have concomitant meniscal tears. PURPOSE To evaluate the in vivo alteration of knee kinematics after an ACL tear, with or without a combined medial or lateral meniscal tear, during level walking activity. STUDY DESIGN Controlled laboratory study. METHODS Fifty-six patients with unilateral ACL-deficient (ACLD) knees were studied. Among these patients, 15 had isolated ACL injuries (group 1), 15 had combined ACL and medial meniscal injuries (group 2), 15 had combined ACL and lateral meniscal injuries (group 3), and 11 had combined ACL and medial/lateral meniscal injuries (group 4). The kinematics of each knee was determined using an optical tracking system during treadmill gait. Range of motion (ROM) and kinematic alterations were compared between the contralateral ACL-intact (ACLI) and ACLD knees. RESULTS All ACLD knees, with or without meniscal deficiency, had significantly less flexion than the ACLI knees (~3°-8°; P < .05). In groups 1, 3, and 4, the injured knees exhibited more femoral external rotation by approximately 1° to 2° (P < .05). Group 4 showed posterior femoral translation (anterior tibial translation) in the swing phase (~13 mm), while groups 2 and 3 showed increased anterior femoral translation (~2-3 mm). During medial-lateral translation, patients in group 2 had a more medial femoral shift (~4 mm) relative to the tibia initially, while those in group 4 exhibited a lateral femoral shift. CONCLUSION The results indicate that meniscal injuries alter the kinematics of the ACLD knee when compared with knees with an isolated ACL injury. The location of the meniscal tear also affects knee kinematics. CLINICAL RELEVANCE Considering the varying effects of meniscal injuries on knee joint kinematics, these data provide insight into the pathological function of the ACL-injured knee joint during walking.
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Affiliation(s)
- Yu Zhang
- Department of Orthopedics, Guangdong Key Laboratory of Orthopaedic Technology and Implant Materials, Guangzhou General Hospital of Guangzhou Military Command, Guangzhou, China .,Graduate School, Southern Medical University, Guangzhou, China
| | - Wenhan Huang
- Department of Orthopedics, Guangdong Key Laboratory of Orthopaedic Technology and Implant Materials, Guangzhou General Hospital of Guangzhou Military Command, Guangzhou, China.,Graduate School, Southern Medical University, Guangzhou, China
| | - Zilong Yao
- Department of Orthopedics, Guangdong Key Laboratory of Orthopaedic Technology and Implant Materials, Guangzhou General Hospital of Guangzhou Military Command, Guangzhou, China.,Graduate School, Southern Medical University, Guangzhou, China
| | - Limin Ma
- Department of Orthopedics, Guangdong Key Laboratory of Orthopaedic Technology and Implant Materials, Guangzhou General Hospital of Guangzhou Military Command, Guangzhou, China
| | - Zefeng Lin
- Department of Orthopedics, Guangdong Key Laboratory of Orthopaedic Technology and Implant Materials, Guangzhou General Hospital of Guangzhou Military Command, Guangzhou, China
| | - Shaobai Wang
- Key Laboratory of Exercise and Health Science of Ministry of Education, Shanghai University of Sport, Shanghai, China
| | - Huayang Huang
- Department of Orthopedics, Guangdong Key Laboratory of Orthopaedic Technology and Implant Materials, Guangzhou General Hospital of Guangzhou Military Command, Guangzhou, China
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iPhone-Assisted Augmented Reality Localization of Basal Ganglia Hypertensive Hematoma. World Neurosurg 2016; 94:480-492. [DOI: 10.1016/j.wneu.2016.07.047] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2016] [Revised: 06/30/2016] [Accepted: 07/01/2016] [Indexed: 11/20/2022]
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Estimating FLEimage distributions of manual fiducial localization in CT images. Int J Comput Assist Radiol Surg 2016; 11:1043-9. [PMID: 27025605 PMCID: PMC4893364 DOI: 10.1007/s11548-016-1389-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2016] [Accepted: 03/15/2016] [Indexed: 12/02/2022]
Abstract
Purpose The fiducial localization error distribution (FLE) and fiducial configuration govern the application accuracy of point-based registration and drive target registration error (TRE) prediction models. The error of physically localizing patient fiducials (\documentclass[12pt]{minimal}
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\begin{document}$${\hbox {FLE}}_\mathrm{patient}$$\end{document}FLEpatient) is negligible when a registration probe matches the implanted screws with mechanical precision. Reliable trackers provide an unbiased estimate of the positional error (\documentclass[12pt]{minimal}
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\begin{document}$${\hbox {FLE}}_\mathrm{tracker}$$\end{document}FLEtracker) with cheap repetitions. FLE further contains the localization error in the imaging data (\documentclass[12pt]{minimal}
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\begin{document}$${\hbox {FLE}}_\mathrm{image}$$\end{document}FLEimage), sampling of which in general is expensive and possibly biased. Finding the best techniques for estimating \documentclass[12pt]{minimal}
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\begin{document}$${\hbox {FLE}}_\mathrm{image}$$\end{document}FLEimage is crucial for the applicability of the TRE prediction methods. Methods We built a ground-truth (gt)-based unbiased estimator (\documentclass[12pt]{minimal}
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\begin{document}$$\widehat{{\hbox {FLE}}_\mathrm{gt}}$$\end{document}FLEgt^) of \documentclass[12pt]{minimal}
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\begin{document}$${\hbox {FLE}}_\mathrm{image}$$\end{document}FLEimage from the samples collected in a virtual CT dataset in which the true locations of image fiducials are known by definition. Replacing true locations in \documentclass[12pt]{minimal}
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\begin{document}$${\hbox {FLE}}_\mathrm{gt}$$\end{document}FLEgt by the sample mean creates a practical difference-to-mean (dtm)-based estimator (\documentclass[12pt]{minimal}
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\begin{document}$$\widehat{{\hbox {FLE}}_\mathrm{dtm}}$$\end{document}FLEdtm^) that is applicable on any dataset. To check the practical validity of the dtm estimator, ten persons manually localized nine fiducials ten times in the virtual CT and the resulting \documentclass[12pt]{minimal}
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\begin{document}$${\hbox {FLE}}_\mathrm{dtm}$$\end{document}FLEdtm and \documentclass[12pt]{minimal}
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\begin{document}$${\hbox {FLE}}_\mathrm{gt}$$\end{document}FLEgt distributions were tested for statistical equality with a kernel-based two-sample test using the maximum mean discrepancy (MMD) (Gretton in J Mach Learn Res 13:723–773, 2012) statistics at \documentclass[12pt]{minimal}
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\begin{document}$$\alpha =0.05$$\end{document}α=0.05. Results \documentclass[12pt]{minimal}
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\begin{document}$${\hbox {FLE}}_\mathrm{dtm}$$\end{document}FLEdtm and \documentclass[12pt]{minimal}
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\begin{document}$${\hbox {FLE}}_\mathrm{gt}$$\end{document}FLEgt were found (for most of the cases) not to be statistically significantly different; conditioning them on persons and/or screws however yielded statistically significant differences much more often. Conclusions We conclude that \documentclass[12pt]{minimal}
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\begin{document}$$\widehat{{\hbox {FLE}}_\mathrm{dtm}}$$\end{document}FLEdtm^ is the best candidate (within our model) for estimating \documentclass[12pt]{minimal}
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\begin{document}$${\hbox {FLE}}_\mathrm{image}$$\end{document}FLEimage in homogeneous TRE prediction models. The presented approach also allows ground-truth-based numerical validation of \documentclass[12pt]{minimal}
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\begin{document}$${\hbox {FLE}}_\mathrm{image}$$\end{document}FLEimage estimators and (manual/automatic) image fiducial localization methods in phantoms with parameters similar to clinical datasets.
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Zhang Y, Yao Z, Wang S, Huang W, Ma L, Huang H, Xia H. Motion analysis of Chinese normal knees during gait based on a novel portable system. Gait Posture 2015; 41:763-8. [PMID: 25743776 DOI: 10.1016/j.gaitpost.2015.01.020] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2014] [Revised: 12/26/2014] [Accepted: 01/19/2015] [Indexed: 02/02/2023]
Abstract
Normative tibiofemoral data of Chinese or Asian subjects during gait is rarely reported. This study is aimed at investigating the six-degree-of-freedom (6DOF) knee kinematics of adult Chinese during gait, based on a novel portable system. Twenty-eight healthy Chinese subjects (56 knees) were studied during their treadmill gaits. A set of optical marker clusters were attached to the thighs and shanks of each subject, who was tracked by an optical joint kinematics measurement system. Knee landmarks were initially digitized with respect to the marker cluster sets to determine the local coordinate systems for calculation of 6DOF knee joint kinematics. The range of motion (ROM) in 6DOF and 5 kinematic parameters were calculated and compared between bilateral knees and genders. We discovered that knee rotations, as well as motion in proximodistal and mediolateral translations, showed similar patterns in flexion and extension. However, the anteroposterior translations did not show a clear pattern. The results of ROM in 6DOF obtained in this study are comparable with those reported in existing literature. No statistical difference was found between left and right knees either in the ROMs or in the 5 kinematic parameters. However, the ROM in the mediolateral direction during gait was found to be higher in men than women (P=0.014). In addition, the femurs of female subjects rotated more internally than the femurs of male during the stance phase (P=0.011). We concluded that normal Chinese knees exhibited distinct gait patterns, except for anteroposterior motion. Women and men exhibit different axial rotations and mediolateral translation patterns during their treadmill gait.
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Affiliation(s)
- Yu Zhang
- Department of Orthopaedic Surgery, Guangzhou General Hospital of Guangzhou Military Command, Guangzhou, Guangdong 510010, China.
| | - Zilong Yao
- Department of Orthopaedic Surgery, Guangzhou General Hospital of Guangzhou Military Command, Guangzhou, Guangdong 510010, China; Graduate School, Southern Medical University, Guangzhou, Guangdong, China
| | | | - Wenhan Huang
- Department of Orthopaedic Surgery, Guangzhou General Hospital of Guangzhou Military Command, Guangzhou, Guangdong 510010, China; Graduate School, Southern Medical University, Guangzhou, Guangdong, China
| | - Limin Ma
- Department of Orthopaedic Surgery, Guangzhou General Hospital of Guangzhou Military Command, Guangzhou, Guangdong 510010, China
| | - Huayang Huang
- Department of Orthopaedic Surgery, Guangzhou General Hospital of Guangzhou Military Command, Guangzhou, Guangdong 510010, China
| | - Hong Xia
- Department of Orthopaedic Surgery, Guangzhou General Hospital of Guangzhou Military Command, Guangzhou, Guangdong 510010, China
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Kral F, DiFranco M, Puschban J, Hoermann R, Riechelmann H, Freysinger W. A new nasopharyngeal dynamic reference frame improves accuracy in navigated skull base targets. Surg Innov 2013; 21:283-9. [PMID: 24108364 DOI: 10.1177/1553350613503738] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE We questioned whether the position of the dynamic reference frame (DRF) influences the application accuracy in electromagnetically navigated cranial procedures. A carrier for an electromagnetic DRF was developed, which could be fixed at the posterior edge of the vomer near the center of the head. This nasopharyngeal DRF was compared with a standard DRF fixed to the surface of the forehead. METHODS Image coordinates and real-world coordinates were co-registered and the total target error (TTE) was measured in the frontal and the lateral skull base of formalin fixed human head. At each anatomical site, 10 targets served for TTE determinations and 5 different fiducial combinations were used for registration. RESULTS With the nasopharyngeal DRF, lower TTE values (2.8 ± 1.4 mm; mean ± SD) were observed when compared with the forehead DRF (3.7 ± 2.8 mm; P = .004). TTEs of both anatomical sites investigated were significantly lower when using the nasopharyngeal DRF (frontal skull base 3.4 vs 2.1 mm, P = .005 and lateral skull base 3.9 vs 3.5 mm, P = .013) than with the standard forehead mounted one. CONCLUSION Positioning the DRF in the center of the head significantly improved the application accuracy of targets in the skull base with electromagnetic navigation by 25%.
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Affiliation(s)
- Florian Kral
- Medical University Innsbruck, Innsbruck, Austria
| | | | | | - Romed Hoermann
- Division Clinical and Functional Anantomy, Medical University Innsbruck
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