Akhbari Bardiya, Morton Amy M, Moore Douglas C, Weiss Arnold-Peter C, Wolfe Scott W, Crisco Joseph J
Department of Biomedical Engineering,Brown University,Providence, RI 02912e-mail:
Department of Orthopedics,Alpert Medical School of Brown Universityand Rhode Island Hospital,Providence, RI 02912e-mail:
J Biomech Eng. 2019 Apr 1;141(4):0445031-7. doi: 10.1115/1.4042769.
Total wrist arthroplasty (TWA) for improving the functionality of severe wrist joint pathology has not had the same success, in parameters such as motion restoration and implant survival, as hip, knee, and shoulder arthroplasty. These other arthroplasties have been studied extensively, including the use of biplane videoradiography (BVR) that has allowed investigators to study the in vivo motion of the total joint replacement during dynamic activities. The wrist has not been a previous focus, and utilization of BVR for wrist arthroplasty presents unique challenges due to the design characteristics of TWAs. Accordingly, the aims of this study were (1) to develop a methodology for generating TWA component models for use in BVR and (2) to evaluate the accuracy of model-image registration in a single cadaveric model. A model of the carpal component was constructed from a computed tomography (CT) scan, and a model of the radial component was generated from a surface scanner. BVR was acquired for three anatomical tasks from a cadaver specimen. Optical motion capture (OMC) was used as the gold standard. BVR's bias in flexion/extension, radial/ulnar deviation, and pronosupination was less than 0.3 deg, 0.5 deg, and 0.6 deg. Translation bias was less than 0.2 mm with a standard deviation of less than 0.4 mm. This BVR technique achieved a kinematic accuracy comparable to the previous studies on other total joint replacements. BVR's application to the study of TWA function in patients could advance the understanding of TWA, and thus, the implant's success.
全腕关节置换术（TWA）用于改善严重腕关节病变的功能，在运动恢复和植入物存活等参数方面，并未像髋关节、膝关节和肩关节置换术那样取得成功。其他这些关节置换术已经得到了广泛研究，包括使用双平面视频放射成像（BVR），这使得研究人员能够在动态活动期间研究全关节置换的体内运动。腕关节此前并非研究重点，由于TWA的设计特点，将BVR应用于腕关节置换术存在独特挑战。因此，本研究的目的是：（1）开发一种生成用于BVR的TWA组件模型的方法；（2）在单个尸体模型中评估模型-图像配准的准确性。腕骨组件模型由计算机断层扫描（CT）构建，桡骨组件模型由表面扫描仪生成。从一具尸体标本获取了三个解剖任务的BVR。光学运动捕捉（OMC）用作金标准。BVR在屈伸、桡尺偏斜和旋前/旋后方面的偏差小于0.3°、0.5°和0.6°。平移偏差小于0.2毫米，标准差小于0.4毫米。这种BVR技术实现的运动学准确性与先前关于其他全关节置换的研究相当。BVR在患者TWA功能研究中的应用可能会增进对TWA的理解，从而提高植入物的成功率。
