Department of Mechanical, Robotics and Energy Engineering, Dongguk University-Seoul, 30 Pildong-ro 1-gil, Jung-gu, Seoul, 04620, Republic of Korea.
Department of Mechanical, Robotics and Energy Engineering, Dongguk University-Seoul, 30 Pildong-ro 1-gil, Jung-gu, Seoul, 04620, Republic of Korea.
Comput Biol Med. 2023 Sep;163:107229. doi: 10.1016/j.compbiomed.2023.107229. Epub 2023 Jul 1.
Osteoarthritis knee can be restored by total knee arthroplasty (TKA). Imageless TKA requires several anatomical points to construct a reference coordinate system to measure bone resections and implant placement. Inaccuracies in the definition of the coordinate system lead to malalignment and failure of the implant. While the surgical transepicondylar axis (sTEA) is a reliable anatomical axis to define the lateromedial axis for the femoral coordinate system (FCS), the presence of the collateral ligaments and deterioration of the medial sulcus (MS) make the registration of sTEA a challenging task. In this work, sTEA is assigned using the articular surfaces of the femoral condyles, independent of the lateral epicondyle (LE) and MS. A single 3D arc is marked on each condyle, which is transformed into a 2D arc to get the best-fit curve according to the profile of condyles. The turning point of each best-fit curve, when transformed back to 3D, defines an axis parallel to sTEA. The condyles-based sTEA is measured experimentally on a 3D-printed bone using an Optitrack tracking setup. Using the proposed method, the angle between the aTEA, sTEA, and Whiteside's line was (3.77, 0.55, and 92.72)°, respectively. The proposed method provides the same level of accuracy and improves the anatomical points registration efficiency, as there is no need to register the LE or MS.
骨关节炎膝关节可以通过全膝关节置换术（TKA）来修复。无影像 TKA 需要几个解剖学要点来构建参考坐标系，以测量骨切除和植入物放置。坐标系定义不准确会导致对线不良和植入物失败。虽然外科髁间轴（sTEA）是定义股骨坐标系（FCS）的内外轴的可靠解剖轴，但侧副韧带的存在和内侧沟（MS）的恶化使得 sTEA 的注册成为一项具有挑战性的任务。在这项工作中，sTEA 使用股骨髁的关节面来分配，而不依赖于外侧髁（LE）和 MS。在每个髁上标记一个单独的 3D 弧，然后将其转换为 2D 弧，根据髁的轮廓获得最佳拟合曲线。每个最佳拟合曲线的转折点，在转换回 3D 时，定义了一条与 sTEA 平行的轴。在使用 Optitrack 跟踪设置的 3D 打印骨上对基于髁的 sTEA 进行了实验测量。使用所提出的方法，aTEA、sTEA 和 Whiteside 线之间的夹角分别为（3.77、0.55 和 92.72）°。该方法提供了相同的精度水平，并提高了解剖点注册效率，因为无需注册 LE 或 MS。
