Visualization of patient’s knee movement and joint contact area during knee flexion for orthopaedic surgery planing validation

ABSTRACT

The high number of revision surgery by total knee replacement to reduce joint pain shows the complexity of the procedure and the current difficulties to make the right diagnosis. This work presents a joint contact area visualization during a recorded flexion and extension of the knee to improve the understanding of the knee kinematics before and after the operation. The position of the patient’s bones is registered using two trackers, one placed on the upper leg and one on the lower leg. The movement of the knee joint is recorded with an infrared stereo camera. Thanks to a visualization software, the doctor can spontaneously observe the pressure zones at the joint and the movement of the bones recorded from live measurements. The visualization of contact areas together with the patient’s bone’s geometry helps for patient diagnosis. The kinematics of the knee flexion brings more information on the validity of the flexion movement before and after surgery, enabling the two to be compared as well as separately analysed. The contact areas can also be compared pre- and post-operatively, or between right and left knees. The accuracy of the visualization software has been tested using a 3D phantom model of a knee joint.

KEYWORDS:

• Computer aided diagnosis
• surgical planning and simulation
• visualization in biomedical imaging

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Notes on contributors

Alexandra Mercader

Alexandra Mercader received her double Master's degree in Electrical Engineering from the Technical University of Munich (TUM) in 2017 and from Telecom Bretagne (France). She is a research assistant at the Institute of Micro Technology and Medical Device Technology (MiMed). Her research interests include mechanism design, surgical robotics and planning as well as automated design for 3D printing. (linkedin:  https://www.linkedin.com/in/alexandra-mercader-a155a98a/)

Heinz Roettinger

Heinz Röttinger was a consultant orthopedic surgeon in Munich from 1990 to 2008. He was also a manager and medical director of the German Orthopedic Hospital in Bahrain. Since 2016, he is at the head of the department for orthopedics and arthroplasty at Surgical Hospital Munich South. His area of specialization is primary and revision arthroplasty in hip and knee and minimally invasive solutions(MIS) in hip and knee arthroplasty. He is the developer of “Röttinger MIS anterolateralhip approach” and co-developer of an unicompartimental knee implant with “minimally invasive”demands. His research focus is the comparison of kinetic and kinematic processes at individualised knee joints before and after artificial replacement.

Amir Bigdeli

Amir Bigdeli finished his medical studies at the Ludwig-Maximilians-University in Munich in 2007. He further trained as a specialist in radiology at the Institute for Diagnostic and Interventional Radiology, University Hospital Cologne and at the Institute for Clinical Radiology, Lukaskrankenhaus Neuss. He was also a functional senior physician at HELIOS Amper-Klinikum Dachau and since 2016 he works as a senior physician at the Surgical Hospital Munich South. His research focus is 3D imaging and 3D printing in musculoskeletal imaging.

Tim C. Lueth

Tim C. Lueth received the M.Sc. degree in electrical engineering from the Technical University of Darmstadt, Germany, in 1989, and the Ph.D. degree in robotics from the Technical University of Karlsruhe, Germany, in 1993. Since 2007, he has been a Professor (status only) with the Departement of Medical Imaging (Chair Dr. Walter Kucharczyk), University of Toronto, Toronto, Canada. He is currently a Professor, the Chair, and the Director of the Institute of Micro Technology and Medical Device Technology, Technical University of Munich, Munich, Germany. His current research interests include mechatronic devices, bionics, and automated design for 3D printing. He is also a Founder Board Member of the German Society for Robotics. He received fellowships of the Alexander von Humboldt Foundation and the Japanese Science and Technology Agency. (linkedin: https://www.linkedin.com/in/tim-lueth-0a569282/)