Blomquist Matthew B, Roth Joshua D
Department of Biomedical Engineering University of Wisconsin-Madison Madison Wisconsin USA.
Department of Orthopedics and Rehabilitation University of Wisconsin-Madison Madison Wisconsin USA.
J Exp Orthop. 2024 Jun 6;11(3):e12050. doi: 10.1002/jeo2.12050. eCollection 2024 Jul.
Measuring joint kinematics in the clinic is important for diagnosing injuries, tracking healing and guiding treatments; however, current methods are limited by accuracy and/or feasibility of widespread clinical adoption. Therefore, the purpose of this study was to develop and validate an ultrasound (US)-based method for measuring knee kinematics during clinical assessments.
We mimicked four clinical laxity assessments (i.e., anterior, posterior, varus, valgus) on five human cadaver knees using our robotic testing system. We simultaneously collected B-mode cine loops with an US transducer. We computed the errors in kinematics between those measured using our bone-tracking algorithm, which cross-correlated regions of interest across frames of the cine loops, and those measured using optical motion capture with bone pins. Additionally, we conducted studies to determine the effects of loading rate and transducer placement on kinematics measured using our US-based bone tracking.
Pooling the trials at experimental speeds and those downsampled to replicate clinical laxity assessments, the maximum root-mean-square errors of knee kinematics using our bone-tracking algorithm were 2.2 mm and 1.3° for the anterior-posterior and varus-valgus laxity assessments, respectively. Repeated laxity assessments proved to have good-to-excellent repeatability (intraclass correlation coefficients [ICCs] of 0.81-0.99), but ICCs from repositioning the transducer varied more widely, ranging from poor-to-good reproducibility (0.19-0.89).
Our results demonstrate that US is capable of tracking knee kinematics during dynamic movement. Because US is a safe and commonly used imaging modality, when paired with our bone-tracking algorithm, US has the potential to assess dynamic knee kinematics across a wide variety of applications in the clinic.
Not applicable.
在临床中测量关节运动学对于诊断损伤、跟踪愈合情况和指导治疗非常重要；然而，目前的方法受到广泛临床应用的准确性和/或可行性的限制。因此，本研究的目的是开发并验证一种基于超声（US）的方法，用于在临床评估期间测量膝关节运动学。
我们使用机器人测试系统在五具人体尸体膝关节上模拟了四种临床松弛度评估（即前向、后向、内翻、外翻）。我们同时使用超声换能器收集B模式电影环。我们计算了使用我们的骨跟踪算法测量的运动学误差（该算法通过电影环各帧之间的感兴趣区域互相关）与使用带有骨针的光学运动捕捉测量的运动学误差之间的差异。此外，我们进行了研究以确定加载速率和换能器放置对使用我们基于超声的骨跟踪测量的运动学的影响。
汇总实验速度下的试验以及下采样以复制临床松弛度评估的试验，使用我们的骨跟踪算法进行前后向和内翻-外翻松弛度评估时，膝关节运动学的最大均方根误差分别为2.2毫米和1.3°。重复的松弛度评估证明具有良好至优秀的重复性（组内相关系数[ICC]为0.81 - 0.99），但换能器重新定位后的ICC变化范围更广，从差到良好的再现性（0.19 - 0.89）。
我们的结果表明，超声能够在动态运动期间跟踪膝关节运动学。由于超声是一种安全且常用的成像方式，与我们的骨跟踪算法配合使用时，超声有潜力在临床的各种应用中评估动态膝关节运动学。
不适用。
