Comput. Aided Surg. - Non-invasive computer-assisted measurement of knee alignment.


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The quantification of knee alignment is a routine part of orthopaedic practice and is important for monitoring disease progression, planning interventional strategies, and follow-up of patients. Currently available technologies such as radiographic measurements have a number of drawbacks. The aim of this study was to validate a potentially improved technique for measuring knee alignment under different conditions. An image-free navigation system was adapted for non-invasive use through the development of external infrared tracker mountings. Stability was assessed by comparing the variance (F-test) of repeated mechanical femoro-tibial (MFT) angle measurements for a volunteer and a leg model. MFT angles were then measured supine, standing and with varus-valgus stress in asymptomatic volunteers who each underwent two separate registrations and repeated measurements for each condition. The mean difference and 95% limits of agreement were used to assess intra-registration and inter-registration repeatability. For multiple registrations the range of measurements for the external mountings was 1? larger than for the rigid model with statistically similar variance (p=0.34). Thirty volunteers were assessed (19 males, 11 females) with a mean age of 41 years (range: 20-65) and a mean BMI of 26 (range: 19-34). For intra-registration repeatability, consecutive coronal alignment readings agreed to almost ?1?, with up to ?0.5? loss of repeatability for coronal alignment measured before and after stress maneuvers, and a ?0.2? loss following stance trials. Sagittal alignment measurements were less repeatable overall by an approximate factor of two. Inter-registration agreement limits for coronal and sagittal supine MFT angles were ?1.6? and ?2.3?, respectively. Varus and valgus stress measurements agreed to within ?1.3? and ?1.1?, respectively. Agreement limits for standing MFT angles were ?2.9? (coronal) and ?5.0? (sagittal), which may have reflected a variation in stance between measurements. The system provided repeatable, real-time measurements of coronal and sagittal knee alignment under a number of dynamic, real-time conditions, offering a potential alternative to radiographs.

Resumo Limpo

quantif knee align routin part orthopaed practic import monitor diseas progress plan intervent strategi followup patient current avail technolog radiograph measur number drawback aim studi valid potenti improv techniqu measur knee align differ condit imagefre navig system adapt noninvas use develop extern infrar tracker mount stabil assess compar varianc ftest repeat mechan femorotibi mft angl measur volunt leg model mft angl measur supin stand varusvalgus stress asymptomat volunt underw two separ registr repeat measur condit mean differ limit agreement use assess intraregistr interregistr repeat multipl registr rang measur extern mount larger rigid model statist similar varianc p thirti volunt assess male femal mean age year rang mean bmi rang intraregistr repeat consecut coron align read agre almost loss repeat coron align measur stress maneuv loss follow stanc trial sagitt align measur less repeat overal approxim factor two interregistr agreement limit coron sagitt supin mft angl respect varus valgus stress measur agre within respect agreement limit stand mft angl coron sagitt may reflect variat stanc measur system provid repeat realtim measur coron sagitt knee align number dynam realtim condit offer potenti altern radiograph

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