Morita Kento, Nii Manabu, Koh Min-Sung, Kashiwa Kaori, Nakayama Hiroshi, Kambara Shunichiro, Yoshiya Shinichi, Kobashi Syoji
Graduate School of Engineering, University of Hyogo, Himeji, Japan.
School of Computing and Engineering Sciences, Eastern Washington University, Cheney, WA, United States.
Curr Med Imaging. 2020;16(5):491-498. doi: 10.2174/1573405614666181030125846.
Anterior cruciate ligament (ACL) injury causes knee instability which affects sports activity involving cutting and twisting motions. The ACL reconstruction surgery replaces the damaged ACL with artificial one which is fixed to the bone tunnels opened by the surgeon. The outcome of the ACL reconstruction is strongly related to the placement of the bone tunnels, therefore, the optimization of tunnel drilling technique is an important factor to obtain satisfactory surgical results.
The quadrant method is used for the post-operative evaluation of the ACL reconstruction surgery, which evaluates the bone tunnel opening sites on the lateral 2D X-ray radiograph.
For the purpose of applying the quadrant method to the pre-operative knee MRI, we have synthesized the pseudo lateral 2D X-ray radiograph from the patients' knee MRI. This paper proposes a computer-aided surgical planning system for the ACL reconstruction. The proposed system estimates appropriate bone tunnel opening sites on the pseudo lateral 2D X-ray radiograph synthesized from the pre-operative knee MRI.
In the experiment, the proposed method was applied to 98 subjects including subjects with osteoarthritis. The experimental results showed that the proposed method can estimate the bone tunnel opening sites accurately. The other experiment using 36 healthy patients showed that the proposed method is robust to the knee shape deformation caused by disease.
It is verified that the proposed method can be applied to subjects with osteoarthritis.
前交叉韧带（ACL）损伤会导致膝关节不稳定，影响涉及急停和扭转动作的体育活动。ACL重建手术用人工韧带替换受损的ACL，人工韧带固定在外科医生钻出的骨隧道中。ACL重建的结果与骨隧道的位置密切相关，因此，优化隧道钻孔技术是获得满意手术效果的重要因素。
象限法用于ACL重建手术的术后评估，该方法在二维X线侧位片上评估骨隧道开口位置。
为了将象限法应用于术前膝关节MRI，我们从患者的膝关节MRI合成了伪二维X线侧位片。本文提出了一种用于ACL重建的计算机辅助手术规划系统。该系统在由术前膝关节MRI合成的伪二维X线侧位片上估计合适的骨隧道开口位置。
在实验中，该方法应用于98名受试者，包括骨关节炎患者。实验结果表明，该方法能够准确估计骨隧道开口位置。另一项对36名健康患者的实验表明，该方法对疾病引起的膝关节形状变形具有鲁棒性。
验证了该方法可应用于骨关节炎患者。
