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3D analysis of the misalignment fo the lower extremity, a pre, per and postoperative study

Abstract : Knee arthroplasty is widely used nowadays and concerns younger and younger patients. Gonarthrosis, i.e. knee arthrosis, is the most common indication for arthroplasty. The angular alteration of the leg alignment (gonometry) is quantified by means of frontal X-rays analysis allowing for surgical planning. Previously published studies show that this analysis restricted to the frontal plane is far from being the optimum one. The present study is based on an existing technique: three dimensional reconstruction of the knee from stereoradiography. In order to tranfer this new technique in routine clinical practice, we defined and evaluated a series of measurement and analysis tools, allowing for a three dimensional quantification of the evolution of the leg alignment alterations pre-, per- and post-operatively. The results show that the knee three dimensional reconstruction protocol from stereoradiography may be used in clinical practice. The inter observer mean reproducibility error is less than 1 mm for the femur and tibia morphometry. As for the 3D morphology, for 95 % of the test, the error is inferior or equal to 1.6°, except for a few measurements based on hardly identifiable anatomical landmarks. 14 arthroplasties have been done with the computer navigation system. This system has allowed the surgeon to follow and to determine axial alignment during surgery, the navigation remains a interoperative measurement tool. Finally, the present study also provides three dimensional postoperative gonometry from stereoradiography. A pre-, per-, postoperative three dimensional analysis protocol is now available for the quantification of the leg alignment alterations and was evaluated in a clinical environment on pathologic knees.
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https://pastel.archives-ouvertes.fr/pastel-00000981
Contributor : Ecole Arts Et Métiers Paristech <>
Submitted on : Monday, January 17, 2005 - 8:00:00 AM
Last modification on : Monday, October 19, 2020 - 11:11:45 AM
Long-term archiving on: : Thursday, September 30, 2010 - 6:15:16 PM

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  • HAL Id : pastel-00000981, version 1

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Laurent Nodé-Langlois. 3D analysis of the misalignment fo the lower extremity, a pre, per and postoperative study. Engineering Sciences [physics]. Arts et Métiers ParisTech, 2003. English. ⟨NNT : 2003ENAM0021⟩. ⟨pastel-00000981⟩

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