@article{AkbariShandizBoulosSavarssonetal.2017, author = {Akbari Shandiz, Mohsen and Boulos, Paul and S{\ae}varsson, Stefan and Ramm, Heiko and Fu, Chun Kit and Miller, Stephen and Zachow, Stefan and Anglin, Carolyn}, title = {Changes in Knee Shape and Geometry Resulting from Total Knee Arthroplasty}, series = {Journal of Engineering in Medicine}, volume = {232}, journal = {Journal of Engineering in Medicine}, number = {1}, doi = {10.1177/0954411917743274}, pages = {67 -- 79}, year = {2017}, abstract = {Changes in knee shape and geometry resulting from total knee arthroplasty can affect patients in numerous important ways: pain, function, stability, range of motion, and kinematics. Quantitative data concerning these changes have not been previously available, to our knowledge, yet are essential to understand individual experiences of total knee arthroplasty and thereby improve outcomes for all patients. The limiting factor has been the challenge of accurately measuring these changes. Our study objective was to develop a conceptual framework and analysis method to investigate changes in knee shape and geometry, and prospectively apply it to a sample total knee arthroplasty population. Using clinically available computed tomography and radiography imaging systems, the three-dimensional knee shape and geometry of nine patients (eight varus and one valgus) were compared before and after total knee arthroplasty. All patients had largely good outcomes after their total knee arthroplasty. Knee shape changed both visually and numerically. On average, the distal condyles were slightly higher medially and lower laterally (range: +4.5 mm to -4.4 mm), the posterior condyles extended farther out medially but not laterally (range: +1.8 to -6.4 mm), patellofemoral distance increased throughout flexion by 1.8-3.5 mm, and patellar thickness alone increased by 2.9 mm (range: 0.7-5.2 mm). External femoral rotation differed preop and postop. Joint line distance, taking cartilage into account, changed by +0.7 to -1.5 mm on average throughout flexion. Important differences in shape and geometry were seen between pre-total knee arthroplasty and post-total knee arthroplasty knees. While this is qualitatively known, this is the first study to report it quantitatively, an important precursor to identifying the reasons for the poor outcome of some patients. Using the developed protocol and visualization techniques to compare patients with good versus poor clinical outcomes could lead to changes in implant design, implant selection, component positioning, and surgical technique. Recommendations based on this sample population are provided. Intraoperative and postoperative feedback could ultimately improve patient satisfaction.}, language = {en} } @inproceedings{EhlkeFrenzelRammetal., author = {Ehlke, Moritz and Frenzel, Thomas and Ramm, Heiko and Shandiz, Mohsen Akbari and Anglin, Carolyn and Zachow, Stefan}, title = {Towards Robust Measurement Of Pelvic Parameters From AP Radiographs Using Articulated 3D Models}, series = {Computer Assisted Radiology and Surgery (CARS)}, booktitle = {Computer Assisted Radiology and Surgery (CARS)}, abstract = {Patient-specific parameters such as the orientation of the acetabulum or pelvic tilt are useful for custom planning for total hip arthroplasty (THA) and for evaluating the outcome of surgical interventions. The gold standard in obtaining pelvic parameters is from three-dimensional (3D) computed tomography (CT) imaging. However, this adds time and cost, exposes the patient to a substantial radiation dose, and does not allow for imaging under load (e.g. while the patient is standing). If pelvic parameters could be reliably derived from the standard anteroposterior (AP) radiograph, preoperative planning would be more widespread, and research analyses could be applied to retrospective data, after a postoperative issue is discovered. The goal of this work is to enable robust measurement of two surgical parameters of interest: the tilt of the anterior pelvic plane (APP) and the orientation of the natural acetabulum. We present a computer-aided reconstruction method to determine the APP and natural acetabular orientation from a single, preoperative X-ray. It can easily be extended to obtain other important preoperative and postoperative parameters solely based on a single AP radiograph.}, language = {en} } @misc{EhlkeFrenzelRammetal., author = {Ehlke, Moritz and Frenzel, Thomas and Ramm, Heiko and Shandiz, Mohsen Akbari and Anglin, Carolyn and Zachow, Stefan}, title = {Towards Robust Measurement of Pelvic Parameters from AP Radiographs using Articulated 3D Models}, issn = {1438-0064}, url = {http://nbn-resolving.de/urn:nbn:de:0297-zib-53707}, abstract = {Patient-specific parameters such as the orientation of the acetabulum or pelvic tilt are useful for custom planning for total hip arthroplasty (THA) and for evaluating the outcome of surgical interventions. The gold standard in obtaining pelvic parameters is from three-dimensional (3D) computed tomography (CT) imaging. However, this adds time and cost, exposes the patient to a substantial radiation dose, and does not allow for imaging under load (e.g. while the patient is standing). If pelvic parameters could be reliably derived from the standard anteroposterior (AP) radiograph, preoperative planning would be more widespread, and research analyses could be applied to retrospective data, after a postoperative issue is discovered. The goal of this work is to enable robust measurement of two surgical parameters of interest: the tilt of the anterior pelvic plane (APP) and the orientation of the natural acetabulum. We present a computer-aided reconstruction method to determine the APP and natural acetabular orientation from a single, preoperative X-ray. It can easily be extended to obtain other important preoperative and postoperative parameters solely based on a single AP radiograph.}, language = {en} } @misc{EhlkeFrenzelRammetal., author = {Ehlke, Moritz and Frenzel, Thomas and Ramm, Heiko and Lamecker, Hans and Akbari Shandiz, Mohsen and Anglin, Carolyn and Zachow, Stefan}, title = {Robust Measurement of Natural Acetabular Orientation from AP Radiographs using Articulated 3D Shape and Intensity Models}, issn = {1438-0064}, url = {http://nbn-resolving.de/urn:nbn:de:0297-zib-49824}, language = {en} }