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McCall B, Rana K, Sugden K, Junaid S. In-vitro external fixation pin-site model proof of concept: A novel approach to studying wound healing in transcutaneous implants. Proc Inst Mech Eng H 2024; 238:403-411. [PMID: 38602217 PMCID: PMC11010558 DOI: 10.1177/09544119241234154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Accepted: 02/05/2024] [Indexed: 04/12/2024]
Abstract
External fixation is an essential surgical technique for treating trauma, limb lengthening and deformity correction, however infection is common, with infection rates ranging from 4.5 to 100% of cases. Throughout the literature researchers and clinicians have highlighted a relationship between excessive movement of the pin and skin and an increase in the patient's risk of infection, however, currently no studies have addressed this role of pin-movement on pin-site wounds. This preliminary study describes a novel in vitro pin-site model, developed using a full-thickness human skin equivalent (HSE) model in conjunction with a bespoke mechanical system which simulates pin-movement. The effect of pin-movement on the wound healing response of the skin equivalents was assessed by measuring the expression of pro-inflammatory cytokines. Six human skin equivalent models were divided into three test groups: no pin as the control, static pin-site wound and dynamic pin-site wound (n = 3). On day 3 concentrations of IL-1α and IL-8 showed a significant increase compared to the control when a static fixation pin was implanted into the skin equivalent (p < 0.05) and (p < 0.005) respectively. Levels of IL-1α and IL-8 increased further in the dynamic sample compared to the static sample (p < 0.05) and (p < 0.0005). This study demonstrates for the first time the application of HSE model to study external-fixation pin-movement in vitro. The results of this study demonstrated pin-movement has a negative effect on soft-tissue wound-healing, supporting the anecdotal evidence reported in the literature, however further analysis of wound heading would be required to verify this hypothesis.
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Affiliation(s)
- Blake McCall
- Biomedical Engineering Research Group, School of Engineering and Applied Science, Aston University, Birmingham, UK
| | - Karan Rana
- Aston Research Centre for Healthy Ageing, School of Life and Health Science, Aston University, Birmingham, UK
| | - Kate Sugden
- Aston Institute of Photonics Technology, College of Engineering and Physical Sciences, Aston University, Birmingham, UK
| | - Sarah Junaid
- Biomedical Engineering Research Group, School of Engineering and Applied Science, Aston University, Birmingham, UK
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2
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Cornish BM, Diamond LE, Saxby DJ, Lloyd DG, Shi B, Lyon J, Abbruzzese K, Gallie P, Maharaj J. Sagittal plane knee kinematics can be measured during activities of daily living following total knee arthroplasty with two IMU. PLoS One 2024; 19:e0297899. [PMID: 38359050 PMCID: PMC10868843 DOI: 10.1371/journal.pone.0297899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2023] [Accepted: 01/16/2024] [Indexed: 02/17/2024] Open
Abstract
Knee function is rarely measured objectively during functional tasks following total knee arthroplasty. Inertial measurement units (IMU) can measure knee kinematics and range of motion (ROM) during dynamic activities and offer an easy-to-use system for knee function assessment post total knee arthroplasty. However, IMU must be validated against gold standard three-dimensional optical motion capture systems (OMC) across a range of tasks if they are to see widespread uptake. We computed knee rotations and ROM from commercial IMU sensor measurements during walking, squatting, sit-to-stand, stair ascent, and stair descent in 21 patients one-year post total knee arthroplasty using two methods: direct computation using segment orientations (r_IMU), and an IMU-driven iCloud-based interactive lower limb model (m_IMU). This cross-sectional study compared computed knee angles and ROM to a gold-standard OMC and inverse kinematics method using Pearson's correlation coefficient (R) and root-mean-square-differences (RMSD). The r_IMU and m_IMU methods estimated sagittal plane knee angles with excellent correlation (>0.95) compared to OMC for walking, squatting, sit-to-stand, and stair-ascent, and very good correlation (>0.90) for stair descent. For squatting, sit-to-stand, and walking, the mean RMSD for r_IMU and m_IMU compared to OMC were <4 degrees, < 5 degrees, and <6 degrees, respectively but higher for stair ascent and descent (~12 degrees). Frontal and transverse plane knee kinematics estimated using r_IMU and m_IMU showed poor to moderate correlation compared to OMC. There were no differences in ROM measurements during squatting, sit-to-stand, and walking across the two methods. Thus, IMUs can measure sagittal plane knee angles and ROM with high accuracy for a variety of tasks and may be a useful in-clinic tool for objective assessment of knee function following total knee arthroplasty.
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Affiliation(s)
- Bradley M. Cornish
- Griffith Centre of Biomedical and Rehabilitation Engineering, Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia
- School of Health Sciences and Social Work, Griffith University, Gold Coast, Queensland, Australia
| | - Laura E. Diamond
- Griffith Centre of Biomedical and Rehabilitation Engineering, Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia
- School of Health Sciences and Social Work, Griffith University, Gold Coast, Queensland, Australia
| | - David John Saxby
- Griffith Centre of Biomedical and Rehabilitation Engineering, Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia
- School of Health Sciences and Social Work, Griffith University, Gold Coast, Queensland, Australia
| | - David G. Lloyd
- Griffith Centre of Biomedical and Rehabilitation Engineering, Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia
- School of Health Sciences and Social Work, Griffith University, Gold Coast, Queensland, Australia
| | - Beichen Shi
- Griffith Centre of Biomedical and Rehabilitation Engineering, Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia
- School of Health Sciences and Social Work, Griffith University, Gold Coast, Queensland, Australia
| | - Jenna Lyon
- Stryker Corporation, Kalamazoo, Michigan, Unites States of America
| | - Kevin Abbruzzese
- Stryker Corporation, Kalamazoo, Michigan, Unites States of America
| | - Price Gallie
- Coast Orthopaedics and Sports Medicine, Gold Coast, Queensland, Australia
| | - Jayishni Maharaj
- Griffith Centre of Biomedical and Rehabilitation Engineering, Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia
- School of Health Sciences and Social Work, Griffith University, Gold Coast, Queensland, Australia
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Pelegrinelli ARM, Catelli DS, Kowalski E, Lamontagne M, Moura FA. Comparing three generic musculoskeletal models to estimate the tibiofemoral reaction forces during gait and sit-to-stand tasks. Med Eng Phys 2023; 122:104074. [PMID: 38092489 DOI: 10.1016/j.medengphy.2023.104074] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 11/19/2023] [Accepted: 11/26/2023] [Indexed: 12/18/2023]
Abstract
The choice of musculoskeletal (MSK) model is crucial for performing MSK estimations to evaluate muscle demands and joint forces. This study compared two previously published generic MSK models and a modified model to estimate tibiofemoral reaction forces (TFRF) during gait, sit-to-stand, and stand-to-sit. The estimated tibiofemoral reaction forces were compared with an in vivo dataset from six patients using an instrumented knee prosthesis. A correlation and root mean square error (RMSE) in the time-series analysis and relative peak error (RPE) were evaluated. The results showed that the three MSK models were similar in estimating the vertical forces, with a large correlation, and RPE was found around 20 % during gait. The RMSE and the RPE indicated that the modified model had lower total and lateral compartment forces errors for sit-to-stand and stand-to-sit, showing the best performance. The shear forces for all tasks and models showed significant errors. Future MSK studies should consider these findings when researching functional tasks. The modified model was found to be more effective in estimating the vertical tibiofemoral joint reaction forces in tasks that impose greater demands on muscle forces and require high knee and hip flexion.
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Affiliation(s)
- Alexandre R M Pelegrinelli
- Laboratory of Applied Biomechanics, State University of Londrina, Brazil; Human Movement Biomechanics Laboratory, University of Ottawa, Canada.
| | - Danilo S Catelli
- Human Movement Biomechanics Laboratory, University of Ottawa, Canada; Department of Movement Sciences, Faculty of Movement and Rehabilitation Sciences, KU Leuven, Belgium
| | - Erik Kowalski
- Human Movement Biomechanics Laboratory, University of Ottawa, Canada
| | - Mario Lamontagne
- Human Movement Biomechanics Laboratory, University of Ottawa, Canada
| | - Felipe A Moura
- Laboratory of Applied Biomechanics, State University of Londrina, Brazil
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Wang W, Li X, Zhang T, Li J, Viellehner J, Komnik I, Wang S, Potthast W. Effects of soft tissue artifacts on the calculated kinematics of the knee during walking and running. J Biomech 2023; 150:111474. [PMID: 36871431 DOI: 10.1016/j.jbiomech.2023.111474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 01/18/2023] [Accepted: 01/27/2023] [Indexed: 02/05/2023]
Abstract
Kinematics of the knee during gait has mostly been studied using optical motion capture systems (MCS). The presence of soft tissue artifacts (STA) between the skin markers and the underlying bone presents a major impediment to obtaining a reliable joint kinematics assessment. In this study, we determined the effects of STA on the calculation of knee joint kinematics during walking and running, through the combination of high-speed dual fluoroscopic imaging system (DFIS) and magnetic resonance imaging technique. Ten adults walked and ran while data was collected simultaneously from MCS and high-speed DFIS. The study showed that measured STA underestimated knee flexion angle, but overestimated knee external and varus rotation. The absolute error values of the skin markers derived from knee flexion-extension angle, internal-external rotation, and varus-valgus rotation during walking were -3.2 ± 4.3 deg, 4.6 ± 3.1 deg, and 4.5 ± 3.2 deg respectively, and during running were -5.8 ± 5.4 deg, 6.6 ± 3.7 deg, and 4.8 ± 2.5 deg respectively. Average errors relative to the DFIS for flexion-extension angle, internal-external rotation, and varus-valgus rotation were 78 %, 271 %, 265 % during walking respectively, and were 43 %, 106 %, 200 % during running respectively. This study offers reference for the kinematic differences between MCS and high-speed DFIS, and will contribute to optimizing methods for analyzing knee kinematics during walking and running.
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Affiliation(s)
- Wenjin Wang
- Institute of Biomechanics and Orthopedics, German Sport University Cologne, Cologne 50933, Germany; Key Laboratory of Exercise and Health Sciences of Ministry of Education, School of Kinesiology, Shanghai University of Sport, Shanghai 200438, China
| | - Xiangming Li
- Key Laboratory of Exercise and Health Sciences of Ministry of Education, School of Kinesiology, Shanghai University of Sport, Shanghai 200438, China
| | - Tianwei Zhang
- The First Physical Institute, University of Cologne, Cologne 50937, Germany
| | - Jixin Li
- Key Laboratory of Exercise and Health Sciences of Ministry of Education, School of Kinesiology, Shanghai University of Sport, Shanghai 200438, China
| | - Josef Viellehner
- Institute of Biomechanics and Orthopedics, German Sport University Cologne, Cologne 50933, Germany
| | - Igor Komnik
- Institute of Biomechanics and Orthopedics, German Sport University Cologne, Cologne 50933, Germany
| | - Shaobai Wang
- Key Laboratory of Exercise and Health Sciences of Ministry of Education, School of Kinesiology, Shanghai University of Sport, Shanghai 200438, China.
| | - Wolfgang Potthast
- Institute of Biomechanics and Orthopedics, German Sport University Cologne, Cologne 50933, Germany.
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Effect of the soft tissue artifact on marker measurements and on the calculation of the helical axis of the knee during a squat movement: A study on the CAMS-Knee dataset. Med Eng Phys 2022; 110:103915. [PMID: 36564140 PMCID: PMC9771824 DOI: 10.1016/j.medengphy.2022.103915] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Revised: 10/19/2022] [Accepted: 10/25/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND Marker-based motion capture recordings of human body segments are often affected by soft tissue artifact (STA). The undesired and uncontrolled motion of the skin may introduce errors in the estimation of motion and position of body segments and, consequently, in the calculation of the relative functional quantities. METHODS This study exploited a recently published dataset consisting of six adult subjects that underwent a total knee arthroplasty. The subject performed squat tasks while the motion was concurrently recorded by passive markers attached to the skin of the lower limbs, an optoelectronic system, and a fluoroscope. The STA of shank and thigh was decomposed in local deformation and rigid motion. Additionally, we studied how the instantaneous helical axis (IHA) calculation is affected by STA. FINDINGS The cluster most affected by STA rigid motion was the thigh. The largest estimated effects were about 7 deg. and about 20 mm. The largest effect of local deformation was about 25 mm, and it was observed on the thigh cluster. INTERPRETATION The STA made the estimation of the IHA unreliable for both position and direction. The choice of the reference configuration influenced the results of the STA analysis.
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Xi X, Ling Z, Wang C, Gu C, Zhan X, Yu H, Lu S, Tsai TY, Yu Y, Cheng L. Lumbar segment-dependent soft tissue artifacts of skin markers during in vivo weight-bearing forward–Backward bending. Front Bioeng Biotechnol 2022; 10:960063. [PMID: 36061441 PMCID: PMC9428558 DOI: 10.3389/fbioe.2022.960063] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Accepted: 07/18/2022] [Indexed: 12/03/2022] Open
Abstract
Traditional optical motion capture (OMC) with retroreflective markers is commonly used to measure joint kinematics but was also reported with unavoidable soft tissue artifacts (STAs) when quantifying the motion of the spine. Additionally, the patterns of the STA on the lumbar spine remain unclear. This study aimed to 1) quantify the in vivo STAs of the human lower back in three-dimensional directions during weight-bearing forward–backward bending and 2) determine the effects of the STAs on the calculated flexion angles between the upper and lower lumbar spines and adjacent vertebrae by comparing the skin marker (SM)- and virtual bone marker (VM)-based measurements. Six healthy volunteers were imaged using a biplanar radiographic system, and thirteen skin markers were mounted on every volunteer’s lower back while performing weight-bearing forward–backward bending. The STAs in the anterior/posterior (AP), medial/lateral (ML), and proximal/distal (PD) directions were investigated. The flexion angles between the upper and lower lumbar segments and adjacent intervertebral segments (L2–L5) throughout the cycle were calculated. For all the participants, STAs continuously increased in the AP direction and exhibited a reciprocal trend in the PD direction. During flexion, the STA at the lower lumbar region (L4–L5: 13.5 ± 6.5 mm) was significantly higher than that at the upper lumbar (L1–L3: 4.0 ± 1.5 mm) in the PD direction (p < 0.01). During extension, the lower lumbar (L4–L5: 2.7 ± 0.7 mm) exhibited significantly less STAs than that exhibited by the upper lumbar region (L1–L3: 6.1 ± 3.3 mm) (p < 0.05). The STA at the spinous process was significantly lower than that on both sides in the AP direction (p < 0.05). The present results on STAs, based on dual fluoroscopic measurements in healthy adult subjects, presented an anatomical direction, marker location, and anatomic segment dependency, which might help describe and quantify STAs for the lumbar spine kinematics and thus help develop location- and direction-specific weighting factors for use in global optimization algorithms aimed at minimizing the effects of STAs on the calculation of lumbar joint kinematics in the future.
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Affiliation(s)
- Xin Xi
- Department of Spine Surgery, Tongji Hospital, School of Medicine, Tongji University, Shanghai, China
- Key Laboratory of Spine and Spinal Cord Injury Repair and Regeneration, Ministry of Education, Department of Spine Surgery, Tongji Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Zhi Ling
- School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, China
| | - Cong Wang
- School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, China
| | - Chunya Gu
- Department of Spinal Rehabilitation, Tongji Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Xuqiang Zhan
- Department of Spine Surgery, Tongji Hospital, School of Medicine, Tongji University, Shanghai, China
- Key Laboratory of Spine and Spinal Cord Injury Repair and Regeneration, Ministry of Education, Department of Spine Surgery, Tongji Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Haixin Yu
- Department of Orthopedic Surgery, Yangpu Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Siqi Lu
- Department of Spine Surgery, Tongji Hospital, School of Medicine, Tongji University, Shanghai, China
- Key Laboratory of Spine and Spinal Cord Injury Repair and Regeneration, Ministry of Education, Department of Spine Surgery, Tongji Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Tsung-Yuan Tsai
- School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, China
- TAOiMAGE Medical Technologies Corporation, Shanghai, China
- *Correspondence: Tsung-Yuan Tsai, ; Yan Yu,
| | - Yan Yu
- Department of Spine Surgery, Tongji Hospital, School of Medicine, Tongji University, Shanghai, China
- Key Laboratory of Spine and Spinal Cord Injury Repair and Regeneration, Ministry of Education, Department of Spine Surgery, Tongji Hospital, School of Medicine, Tongji University, Shanghai, China
- *Correspondence: Tsung-Yuan Tsai, ; Yan Yu,
| | - Liming Cheng
- Department of Spine Surgery, Tongji Hospital, School of Medicine, Tongji University, Shanghai, China
- Key Laboratory of Spine and Spinal Cord Injury Repair and Regeneration, Ministry of Education, Department of Spine Surgery, Tongji Hospital, School of Medicine, Tongji University, Shanghai, China
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Can Anthropometry be Used to Dictate Participant-Specific Thigh Marker Placements Which Minimize Error in Hip Joint Center Estimation? J Appl Biomech 2022; 38:246-254. [PMID: 35894911 DOI: 10.1123/jab.2022-0042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Revised: 04/21/2022] [Accepted: 05/23/2022] [Indexed: 11/18/2022]
Abstract
Specific participant characteristics may be leveraged to dictate marker placements which reduce soft tissue artifact; however, a better understanding of the relationships between participant characteristics and soft tissue artifact are first required. The purpose of this study was to assess the accuracy in which measures of whole-body and thigh anthropometry could predict mislocation error of the hip joint center, tracked using skin-mounted marker clusters. Fifty participants completed squatting and kneeling, while pelvis and lower limb motion were recorded. The effect of soft tissue artifact was estimated from 6 rigid thigh marker clusters by evaluating their ability to track the position of the hip joint center most like the pelvis cluster. Eighteen backward stepwise linear regressions were performed using 10 anthropometric measures as independent variables and the mean of the peak difference between the thigh and pelvis cluster-tracked hip joint centers. Fourteen models significantly predicted error with low to moderate fit (R = .38-.67), explaining 14% to 45% of variation. Partial correlations indicated that soft tissue artifact may increase with soft tissue volume and be altered by local soft tissue composition. However, it is not recommended that marker placement be adjusted based on anthropometry alone.
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A computational approach to determine key anatomic landmarks on pelvis and its application to acetabular orientation assessment and hip computational biomechanics. Med Eng Phys 2022; 105:103824. [DOI: 10.1016/j.medengphy.2022.103824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Revised: 04/07/2022] [Accepted: 05/25/2022] [Indexed: 11/23/2022]
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Baek SY, Ajdaroski M, Shahshahani PM, Beaulieu ML, Esquivel AO, Ashton-Miller JA. A Comparison of Inertial Measurement Unit and Motion Capture Measurements of Tibiofemoral Kinematics during Simulated Pivot Landings. SENSORS (BASEL, SWITZERLAND) 2022; 22:4433. [PMID: 35746217 PMCID: PMC9230913 DOI: 10.3390/s22124433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 06/01/2022] [Accepted: 06/09/2022] [Indexed: 06/15/2023]
Abstract
Injuries are often associated with rapid body segment movements. We compared Certus motion capture and APDM inertial measurement unit (IMU) measurements of tibiofemoral angle and angular velocity changes during simulated pivot landings (i.e., ~70 ms peak) of nine cadaver knees dissected free of skin, subcutaneous fat, and muscle. Data from a total of 852 trials were compared using the Bland-Altman limits of agreement (LoAs): the Certus system was considered the gold standard measure for the angle change measurements, whereas the IMU was considered the gold standard for angular velocity changes. The results show that, although the mean peak IMU knee joint angle changes were slightly underestimated (2.1° for flexion, 0.2° for internal rotation, and 3.0° for valgus), the LoAs were large, ranging from 35.9% to 49.8%. In the case of the angular velocity changes, Certus had acceptable accuracy in the sagittal plane, with LoAs of ±54.9°/s and ±32.5°/s for the tibia and femur. For these rapid motions, we conclude that, even in the absence of soft tissues, the IMUs could not reliably measure these peak 3D knee angle changes; Certus measurements of peak tibiofemoral angular velocity changes depended on both the magnitude of the velocity and the plane of measurement.
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Affiliation(s)
- So Young Baek
- Department of Mechanical Engineering, University of Michigan, Ann Arbor, MI 48109, USA; (P.M.S.); (J.A.A.-M.)
| | - Mirel Ajdaroski
- Department of Mechanical Engineering, University of Michigan-Dearborn, Dearborn, MI 48128, USA; (M.A.); (A.O.E.)
| | - Payam Mirshams Shahshahani
- Department of Mechanical Engineering, University of Michigan, Ann Arbor, MI 48109, USA; (P.M.S.); (J.A.A.-M.)
| | - Mélanie L. Beaulieu
- Department of Orthopedic Surgery, University of Michigan, Ann Arbor, MI 48109, USA;
| | - Amanda O. Esquivel
- Department of Mechanical Engineering, University of Michigan-Dearborn, Dearborn, MI 48128, USA; (M.A.); (A.O.E.)
| | - James A. Ashton-Miller
- Department of Mechanical Engineering, University of Michigan, Ann Arbor, MI 48109, USA; (P.M.S.); (J.A.A.-M.)
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10
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Ancillao A, Aertbeliën E, De Schutter J. Effect of the soft tissue artifact on marker measurements and on the calculation of the helical axis of the knee during a gait cycle: A study on the CAMS-Knee data set. Hum Mov Sci 2021; 80:102866. [PMID: 34509901 PMCID: PMC8631460 DOI: 10.1016/j.humov.2021.102866] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Revised: 08/24/2021] [Accepted: 08/31/2021] [Indexed: 11/26/2022]
Abstract
The soft tissue artifact (STA) is a phenomenon occurring when the motion of bones or anatomical segments is measured by means of skin markers: the biological tissues between the markers and the bone produce a relative motion bone-markers that leads to inaccuracies in the estimation of rigid body poses or kinematics. The aim of this study was to quantify the STA by exploiting a recently published gait analysis dataset. The dataset was composed of six adult subjects with a total knee arthroplasty who underwent gait analysis trials. The motion of the knee was concurrently recorded by means of (i) fluoroscopy imaging and (ii) an optoelectronic system and redundant markers attached to the thigh and shank. The STA was studied by comparing the results calculated on the marker sets with the results obtained from the fluoroscopy data. The stance and swing phases were considered separately. Rigid STA motion and local STA deformation were studied separately. In addition to previous studies, the instantaneous helical axis (IHA) of the knee was calculated and the effect of the STA on its calculation was assessed. The largest rigid-motion STA effect was observed on the thigh cluster (~10 deg. and ~ 18 mm). The shank cluster was mainly affected during the swing phase (~7 deg. and ~ 17 mm). The local STA deformation affected differently the markers. The largest effect was ~16 mm and the lowest was ~4 mm. The estimation of the IHA was not reliable when based only on markers, having an estimation error of ~17 deg. and ~ 25 mm. A high variability of results across subjects was observed.
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Affiliation(s)
- Andrea Ancillao
- Robotics Research Group, Dept. of Mechanical Engineering, KU Leuven, 3001 Leuven, Belgium; Flanders Make, Core Lab ROB, KU Leuven, 3001 Leuven, Belgium.
| | - Erwin Aertbeliën
- Robotics Research Group, Dept. of Mechanical Engineering, KU Leuven, 3001 Leuven, Belgium; Flanders Make, Core Lab ROB, KU Leuven, 3001 Leuven, Belgium
| | - Joris De Schutter
- Robotics Research Group, Dept. of Mechanical Engineering, KU Leuven, 3001 Leuven, Belgium; Flanders Make, Core Lab ROB, KU Leuven, 3001 Leuven, Belgium
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11
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Hu Z, Ren L, Hu D, Gao Y, Wei G, Qian Z, Wang K. Speed-Related Energy Flow and Joint Function Change During Human Walking. Front Bioeng Biotechnol 2021; 9:666428. [PMID: 34136472 PMCID: PMC8201992 DOI: 10.3389/fbioe.2021.666428] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Accepted: 04/26/2021] [Indexed: 11/29/2022] Open
Abstract
During human walking, mechanical energy transfers between segments via joints. Joint mechanics of the human body are coordinated with each other to adapt to speed change. The aim of this study is to analyze the functional behaviors of major joints during walking, and how joints and segments alter walking speed during different periods (collision, rebound, preload, and push-off) of stance phase. In this study, gait experiment was performed with three different self-selected speeds. Mechanical works of joints and segments were determined with collected data. Joint function indices were calculated based on net joint work. The results show that the primary functional behaviors of joints would not change with altering walking speed, but the function indices might be changed slightly (e.g., strut functions decrease with increasing walking speed). Waist acts as strut during stance phase and contributes to keep stability during collision when walking faster. Knee of stance leg does not contribute to altering walking speed. Hip and ankle absorb more mechanical energy to buffer the strike during collision with increasing walking speed. What is more, hip and ankle generate more energy during push-off with greater motion to push distal segments forward with increasing walking speed. Ankle also produces more mechanical energy during push-off to compensate the increased heel-strike collision of contralateral leg during faster walking. Thus, human may utilize the cooperation of hip and ankle during collision and push-off to alter walking speed. These findings indicate that speed change in walking leads to fundamental changes to joint mechanics.
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Affiliation(s)
- Zheqi Hu
- Key Laboratory of Bionic Engineering, Ministry of Education, Jilin University, Changchun, China.,School of Mechanical, Aerospace and Civil Engineering, University of Manchester, Manchester, United Kingdom
| | - Lei Ren
- Key Laboratory of Bionic Engineering, Ministry of Education, Jilin University, Changchun, China.,School of Mechanical, Aerospace and Civil Engineering, University of Manchester, Manchester, United Kingdom
| | - Dan Hu
- School of Mechanical, Aerospace and Automotive Engineering, Coventry University, Coventry, United Kingdom
| | - Yilei Gao
- School of Mechanical, Aerospace and Civil Engineering, University of Manchester, Manchester, United Kingdom
| | - Guowu Wei
- School of Science, Engineering and Environment, University of Salford, Salford, United Kingdom
| | - Zhihui Qian
- Key Laboratory of Bionic Engineering, Ministry of Education, Jilin University, Changchun, China
| | - Kunyang Wang
- Key Laboratory of Bionic Engineering, Ministry of Education, Jilin University, Changchun, China.,School of Mechanical, Aerospace and Civil Engineering, University of Manchester, Manchester, United Kingdom
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12
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Mercader A, Röttinger T, Bigdeli A, Lüth TC, Röttinger H. A patient-specific 3D model of the knee to compare the femoral rollback before and after total knee arthroplasty (TKA). J Exp Orthop 2021; 8:2. [PMID: 33394191 PMCID: PMC7782601 DOI: 10.1186/s40634-020-00319-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Accepted: 12/03/2020] [Indexed: 12/21/2022] Open
Abstract
Purpose Total knee arthroplasty (TKA) is nowadays performed as a standard procedure on a large number of patients suffering from arthrosis. Replacing the knee joint causes changes in the geometry and kinematics of the knee, which are unique to each individual. This research focuses on the method to detect these changes after TKA and on the impact on the knee movement. This approach could reduce complications in patients with post-operative pain and reduce the number of revisions. Methods A 3D model of a patient’s knee was made by measuring the movement with a medically certified infrared stereo camera. This measurement was combined with the 3D model of the patient’s bones, previously segmented from the CT scan. This model is printed in 3D, one part being the mechanism that follows the movement of the patient, and the other part being the 3D copy of the femur and tibia bones. The knee replacement operation is performed directly on the model and the resulting rollback is being measured before and after TKA. Results We observe a difference in the rollback before and after TKA on the 3D printed model. The variation in size and shape of the femoral implant compared to the natural femur condyles is one of the reasons for the changes in the rollback effect. The rollback is half as large after the prosthesis insertion, which confirms the fact that the femoral prosthesis geometry influences the knee kinematics. Conclusions In this study, a first 3D model combining the patient-specific kinematic and the geometry of his bones has been constructed. This model allows the surgeon to validate the plan of the operation, but also to understand the problems and consequences generated by the prosthesis insertion. The rollback is one of the most important motion of the knee joint and this behavior could be quantified, providing comparative analysis of the knee joint before and after the operation. As a future study, the model could be used to analyse more parameters of the TKA such as the impact of different implantation methods. Supplementary Information The online version contains supplementary material available at 10.1186/s40634-020-00319-6.
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Affiliation(s)
- Alexandra Mercader
- Technical University of Munich, Boltzmannstraße 15, 85748, Garching bei München, Germany
| | - Timon Röttinger
- The Munich Center for Arthroplasty, Chirurgisches Klinikum München Süd Am Isarkanal 30, 81379, Munich, Germany
| | - Amir Bigdeli
- The Munich Center for Arthroplasty, Chirurgisches Klinikum München Süd Am Isarkanal 30, 81379, Munich, Germany
| | - Tim C Lüth
- Technical University of Munich, Boltzmannstraße 15, 85748, Garching bei München, Germany
| | - Heinz Röttinger
- The Munich Center for Arthroplasty, Chirurgisches Klinikum München Süd Am Isarkanal 30, 81379, Munich, Germany.
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Wearable sensor validation of sports-related movements for the lower extremity and trunk. Med Eng Phys 2020; 84:144-150. [DOI: 10.1016/j.medengphy.2020.08.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Revised: 07/27/2020] [Accepted: 08/02/2020] [Indexed: 11/23/2022]
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14
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Serrien B, Pataky T, Baeyens JP, Cattrysse E. Bayesian vs. least-squares inverse kinematics: Simulation experiments with models of 3D rigid body motion and 2D models including soft-tissue artefacts. J Biomech 2020; 109:109902. [DOI: 10.1016/j.jbiomech.2020.109902] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Revised: 05/29/2020] [Accepted: 06/16/2020] [Indexed: 01/03/2023]
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15
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Effects of the soft tissue artefact on the hip joint kinematics during unrestricted activities of daily living. J Biomech 2020; 104:109717. [PMID: 32234246 DOI: 10.1016/j.jbiomech.2020.109717] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2019] [Revised: 12/25/2019] [Accepted: 02/18/2020] [Indexed: 11/20/2022]
Abstract
Soft tissue artefact (STA) affects the kinematics retrieved with skin marker-based motion capture, and thus influences the outcomes of biomechanical models that rely on such kinematics. In order to be compensated for, the effects of STA must be characterized across a broad sample population and for different motion activities. In this study, the error introduced by STA on the kinematics of the hip joint and of its individual components, and on the location of the hip joint center (HJC) was quantified for fifteen THA subjects during overground gait, stair descent, chair rise and putting on socks. The error due to STA was computed as the difference between the kinematics measured with motion capture and those measured simultaneously with moving fluoroscopy, a STA-free X-ray technique. The main significant effects of STA were: underestimation of the hip range of motion for all four activities, underestimation of the flexion especially during phases of the motion with higher flexion, overestimation of the internal rotation, and lateral misplacement of the HJC mostly due to the functional calibration. The thigh contributed more to the STA error than the pelvis. The STA error of the thigh appeared to be correlated with the hip flexion angles, with a varying degree of linearity depending on the activity and on the phase of the motion cycle. Future kinematic-driven STA compensation models should take into account the non-linearity of the STA error and its dependency of the phase of the motion cycle.
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3D Sequential Kinematics of the Femoro-Tibial Joint of Normal Knee from Multiple Bi-planar X-rays: Accuracy and Repeatability. Ing Rech Biomed 2018. [DOI: 10.1016/j.irbm.2018.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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17
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Niu K, Homminga J, Sluiter V, Sprengers A, Verdonschot N. Measuring relative positions and orientations of the tibia with respect to the femur using one-channel 3D-tracked A-mode ultrasound tracking system: A cadaveric study. Med Eng Phys 2018; 57:61-68. [PMID: 29759948 DOI: 10.1016/j.medengphy.2018.04.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2017] [Revised: 04/11/2018] [Accepted: 04/30/2018] [Indexed: 11/18/2022]
Abstract
The purpose of this study is to investigate the technical feasibility of measuring relative positions and orientations of the tibia with respect to the femur in an in-vitro experiment by using a 3D-tracked A-mode ultrasound system and to determine its accuracy of angular and translational measurements. As A-mode ultrasound is capable of detecting bone surface through soft tissue in a non-invasive manner, the combination of a single A-mode ultrasound transducer with an optical motion tracking system provides the possibility for digitizing the 3D locations of bony points at different anatomical regions on the thigh and the shank. After measuring bony points over a large area of both the femur and tibia, the bone models of the femur and tibia that were segmented from CT or MRI images were registered to the corresponding bony points. Then the relative position of the tibia with respect to the femur could be obtained and the angular and translational components could also be measured. A cadaveric experiment was conducted to assess its accuracy compared to the reference measurement obtained by optical markers fixed to intra-cortical bone pins placed in the femur and tibia. The results showed that the ultrasound system could achieve 0.49 ± 0.83°, 0.85 ± 1.86° and 1.85 ± 2.78° (mean ± standard deviation) errors for Flexion-Extension, Adduction-Abduction and External-Internal rotations, respectively, and -2.22 ± 3.62 mm, -2.80 ± 2.35 mm and -1.44 ± 2.90 mm errors for Anterior-Posterior, Proximal-Distal and Lateral-Medial translations, respectively. It was concluded that this technique is feasible and facilitates the integration of arrays of A-mode ultrasound transducers with an optical motion tracking system for non-invasive dynamic tibiofemoral kinematics measurement.
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Affiliation(s)
- Kenan Niu
- Laboratory of Biomechanical Engineering, Faculty of Engineering Technology, MIRA Institute, University of Twente, Drienerlolaan 5, 7522 NB Enschede, The Netherlands.
| | - Jasper Homminga
- Laboratory of Biomechanical Engineering, Faculty of Engineering Technology, MIRA Institute, University of Twente, Drienerlolaan 5, 7522 NB Enschede, The Netherlands
| | - Victor Sluiter
- Laboratory of Biomechanical Engineering, Faculty of Engineering Technology, MIRA Institute, University of Twente, Drienerlolaan 5, 7522 NB Enschede, The Netherlands
| | - André Sprengers
- Orthopaedic Research Lab, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Nico Verdonschot
- Laboratory of Biomechanical Engineering, Faculty of Engineering Technology, MIRA Institute, University of Twente, Drienerlolaan 5, 7522 NB Enschede, The Netherlands; Orthopaedic Research Lab, Radboud University Medical Center, Nijmegen, The Netherlands
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18
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In situ comparison of A-mode ultrasound tracking system and skin-mounted markers for measuring kinematics of the lower extremity. J Biomech 2018; 72:134-143. [PMID: 29573792 DOI: 10.1016/j.jbiomech.2018.03.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2017] [Revised: 02/26/2018] [Accepted: 03/03/2018] [Indexed: 11/24/2022]
Abstract
Skin-mounted marker based motion capture systems are widely used in measuring the movement of human joints. Kinematic measurements associated with skin-mounted markers are subject to soft tissue artifacts (STA), since the markers follow skin movement, thus generating errors when used to represent motions of underlying bone segments. We present a novel ultrasound tracking system that is capable of directly measuring tibial and femoral bone surfaces during dynamic motions, and subsequently measuring six-degree-of-freedom (6-DOF) tibiofemoral kinematics. The aim of this study is to quantitatively compare the accuracy of tibiofemoral kinematics estimated by the ultrasound tracking system and by a conventional skin-mounted marker based motion capture system in a cadaveric experimental scenario. Two typical tibiofemoral joint models (spherical and hinge models) were used to derive relevant kinematic outcomes. Intra-cortical bone pins equipped with optical markers were inserted in the tibial and femoral bones to serve as a reference to provide ground truth kinematics. The ultrasound tracking system resulted in lower kinematic errors than the skin-mounted markers (the ultrasound tracking system: maximum root-mean-square (RMS) error 3.44° for rotations and 4.88 mm for translations, skin-mounted markers with the spherical joint model: 6.32° and 6.26 mm, the hinge model: 6.38° and 6.52 mm). Our proposed ultrasound tracking system has the potential of measuring direct bone kinematics, thereby mitigating the influence and propagation of STA. Consequently, this technique could be considered as an alternative method for measuring 6-DOF tibiofemoral kinematics, which may be adopted in gait analysis and clinical practice.
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19
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Normal Knee Kinematics After TKA—A Reality? Tech Orthop 2018. [DOI: 10.1097/bto.0000000000000268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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20
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Clément J, de Guise JA, Fuentes A, Hagemeister N. Comparison of soft tissue artifact and its effects on knee kinematics between non-obese and obese subjects performing a squatting activity recorded using an exoskeleton. Gait Posture 2018; 61:197-203. [PMID: 29353745 DOI: 10.1016/j.gaitpost.2018.01.009] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2017] [Revised: 01/09/2018] [Accepted: 01/11/2018] [Indexed: 02/02/2023]
Abstract
BACKGROUND Rigid attachment systems are one of the methods used to compensate for soft tissue artifact (STA) inherent in joint motion analyses. RESEARCH QUESTION The goal of this study was to quantify STA of an exoskeleton design to reduce STA at the knee, and to assess the accuracy of 3D knee kinematics recorded with the exoskeleton in non-obese and obese subjects during quasi-static weight-bearing squatting activity using biplane radiography. METHODS Nine non-obese and eight obese subjects were recruited. The exoskeleton was calibrated on each subject before they performed a quasistatic squatting activity in the EOS® imaging system. 3D models of exoskeleton markers and knee bones were reconstructed from EOS® radiographs; they served to quantify STA and to evaluate differences between the markers and bones knee kinematics during the squatting activity. RESULTS The results showed that STA observed at the femur was larger in non-obese subjects than in obese subjects in frontal rotation (p = 0.004), axial rotation (p = 0.000), medio-lateral displacement (p = 0.000) and antero-posterior displacement (p = 0.019), while STA observed at the tibia was lower in non-obese subjects than in obese subjects for the three rotations (p < 0.05) and medio-lateral displacement (p = 0.015). Differences between the markers and bones knee kinematics increased with knee flexion and were similar in both groups, except for abduction-adduction: 4.9° for non-obese subjects against 2.3° for obese subjects (p = 0.011). SIGNIFICANCE This study demonstrated that STA at the femur and its impact on knee abduction-adduction using a specific exoskeleton were greater among non-obese subjects than obese subjects, which is encouraging for future biomechanical studies on pathologies such as osteoarthritis.
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Affiliation(s)
- Julien Clément
- Laboratoire de recherche en imagerie et orthopédie, École de technologie supérieur, CRCHUM, 900 Rue Saint-Denis, Montréal, Que H2X 0A9, Canada.
| | - Jaques A de Guise
- Laboratoire de recherche en imagerie et orthopédie, École de technologie supérieur, CRCHUM, 900 Rue Saint-Denis, Montréal, Que H2X 0A9, Canada; École de Technologie Supérieure, Département du génie de la production automatisée, 1100 rue Notre-Dame Ouest, Montréal, Que H2L 2W5, Canada.
| | - Alexandre Fuentes
- Centre du genou EMOVI, 3095 Laval Autoroute West, Laval, Que H7P 4W5, Canada.
| | - Nicola Hagemeister
- Laboratoire de recherche en imagerie et orthopédie, École de technologie supérieur, CRCHUM, 900 Rue Saint-Denis, Montréal, Que H2X 0A9, Canada; École de Technologie Supérieure, Département du génie de la production automatisée, 1100 rue Notre-Dame Ouest, Montréal, Que H2L 2W5, Canada.
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21
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The precision and repeatability of a custom-made pointer device for determination of virtual landmarks in canine three-dimensional kinematics. Vet Comp Orthop Traumatol 2017; 25:102-8. [DOI: 10.3415/vcot-11-05-0069] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2011] [Accepted: 11/09/2011] [Indexed: 11/17/2022]
Abstract
SummaryPlacement of markers on anatomical landmarks represents a large source of error in three-dimensional kinematics. Our objectives were to test the accuracy and precision of a custom-made pointer and compare it to conventional skin markers in dogs. The pointer was first assessed by pointing at the surface of a spherical marker of known dimensions and position in space. Secondly, a point located cranio-distally to the lateral epicondyle was marked in 12 canine elbows with a Steinmann pin and reflective markers. Ability to locate a landmark was compared between the pointer and skin-mounted marker. The distance between experimental and true locations was compared between the two methods. A sphere was mathematically fitted through 29 collected points on the spherical marker. Centre, diameter and volume overlap of the fitted sphere were compared to that of the marker. A 0.729 mm bias was found indicating good accuracy. Residual values were small indicating good precision. The average distance between the true and experimental position of the anatomical landmarks were 9.55 ± 4.20 mm and 9.32 ± 3.28 mm for the pointer and the marker respectively. No significant differences were observed between the two methods. The pointer proved to be accurate and reliable for localizing virtual points and was at least equivalent to skin mounted markers for the detection of anatomical landmarks in the dog. It should prove useful in the localization of anatomical landmarks for kinematic analysis.
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22
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Geiger SM, Reich E, Böttcher P, Grund S, Hagen J. Validation of biplane high‐speed fluoroscopy combined with two different noninvasive tracking methodologies for measuring
in vivo
distal limb kinematics of the horse. Equine Vet J 2017; 50:261-269. [DOI: 10.1111/evj.12717] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2016] [Accepted: 07/09/2017] [Indexed: 11/28/2022]
Affiliation(s)
- S. M. Geiger
- Institute of Veterinary Anatomy, Histology and Embryology, Faculty of Veterinary Medicine Leipzig University Leipzig Germany
| | - E. Reich
- Institute of Veterinary Anatomy, Histology and Embryology, Faculty of Veterinary Medicine Leipzig University Leipzig Germany
| | - P. Böttcher
- Small Animal Clinic Department of Veterinary Medicine Freie Universität Berlin Berlin Germany
| | - S. Grund
- Institute of Veterinary Anatomy, Histology and Embryology, Faculty of Veterinary Medicine Leipzig University Leipzig Germany
| | - J. Hagen
- Institute of Veterinary Anatomy, Histology and Embryology, Faculty of Veterinary Medicine Leipzig University Leipzig Germany
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Stentz-Olesen K, Nielsen ET, De Raedt S, Jørgensen PB, Sørensen OG, Kaptein BL, Andersen MS, Stilling M. Validation of static and dynamic radiostereometric analysis of the knee joint using bone models from CT data. Bone Joint Res 2017; 6:376-384. [PMID: 28600383 PMCID: PMC5492337 DOI: 10.1302/2046-3758.66.bjr-2016-0113.r3] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2016] [Accepted: 03/13/2017] [Indexed: 11/05/2022] Open
Abstract
Objectives Static radiostereometric analysis (RSA) using implanted markers is considered the most accurate system for the evaluation of prosthesis migration. By using CT bone models instead of markers, combined with a dynamic RSA system, a non-invasive measurement of joint movement is enabled. This method is more accurate than current 3D skin marker-based tracking systems. The purpose of this study was to evaluate the accuracy of the CT model method for measuring knee joint kinematics in static and dynamic RSA using the marker method as the benchmark. Methods Bone models were created from CT scans, and tantalum beads were implanted into the tibia and femur of eight human cadaver knees. Each specimen was secured in a fixture, static and dynamic stereoradiographs were recorded, and the bone models and marker models were fitted to the stereoradiographs. Results Results showed a mean difference between the two methods in all six degrees of freedom for static RSA to be within -0.10 mm/° and 0.08 mm/° with a 95% limit of agreement (LoA) ranging from ± 0.49 to 1.26. Dynamic RSA had a slightly larger range in mean difference of -0.23 mm/° to 0.16 mm/° with LoA ranging from ± 0.75 to 1.50. Conclusions In a laboratory-controlled setting, the CT model method combined with dynamic RSA may be an alternative to previous marker-based methods for kinematic analyses. Cite this article: K. Stentz-Olesen, E. T. Nielsen, S. De Raedt, P. B. Jørgensen, O. G. Sørensen, B. L. Kaptein, M. S. Andersen, M. Stilling. Validation of static and dynamic radiostereometric analysis of the knee joint using bone models from CT data. Bone Joint Res 2017;6:376–384. DOI: 10.1302/2046-3758.66.BJR-2016-0113.R3.
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Affiliation(s)
- K Stentz-Olesen
- Orthopaedic Research Group, Department of Orthopaedic Surgery, Aarhus University Hospital, Tage-Hansens Gade 2, Building 10A, Office 15, 8000 Aarhus C, Denmark
| | - E T Nielsen
- Orthopaedic Research Group, Department of Orthopaedic Surgery, Aarhus University Hospital, Tage-Hansens Gade 2, Building 10A, Office 15, 8000 Aarhus C, Denmark
| | - S De Raedt
- Nordisk Røntgen Teknik, Birkegårdsvej 16, 8361 Hesselager, Denmark
| | - P B Jørgensen
- Orthopaedic Research Group, Department of Orthopaedic Surgery, Aarhus University Hospital, Tage-Hansens Gade 2, Building 9A, 8000 Aarhus C, Denmark
| | - O G Sørensen
- Orthopaedic Research Group, Department of Orthopaedic Surgery, Aarhus University Hospital, Tage-Hansens Gade 2, Building 10A, Office 15, 8000 Aarhus C, Denmark
| | - B L Kaptein
- Biomechanics and Imaging Group, Department of Orthopaedic Surgery, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, The Netherland
| | - M S Andersen
- Department of Mechanical Engineering and Manufacturing, Aalborg University, Fibigerstræde 16, 9220 Aalborg East, Denmark
| | - M Stilling
- Orthopaedic Research Group, Departments of Orthopaedic Surgery and Clinical Medicine, Aarhus University Hospital, University of Aarhus, Tage-Hansens Gade 2, Building 10A, 8000 Aarhus C, Denmark
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Li JD, Lu TW, Lin CC, Kuo MY, Hsu HC, Shen WC. Soft tissue artefacts of skin markers on the lower limb during cycling: Effects of joint angles and pedal resistance. J Biomech 2017; 62:27-38. [PMID: 28410738 DOI: 10.1016/j.jbiomech.2017.03.018] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2016] [Revised: 03/20/2017] [Accepted: 03/24/2017] [Indexed: 10/19/2022]
Abstract
Soft tissue artefacts (STA) are a major error source in skin marker-based measurement of human movement, and are difficult to eliminate non-invasively. The current study quantified in vivo the STA of skin markers on the thigh and shank during cycling, and studied the effects of knee angles and pedal resistance by using integrated 3D fluoroscopy and stereophotogrammetry. Fifteen young healthy adults performed stationary cycling with and without pedal resistance, while the marker data were measured using a motion capture system, and the motions of the femur and tibia/fibula were recorded using a bi-plane fluoroscopy-to-CT registration method. The STAs with respect to crank and knee angles over the pedaling cycle, as well as the within-cycle variations, were obtained and compared between resistance conditions. The thigh markers showed greater STA than the shank ones, the latter varying linearly with adjacent joint angles, the former non-linearly with greater within-cycle variability. Both STA magnitudes and within-cycle variability were significantly affected by pedal resistance (p<0.05). The STAs appeared to be composed of one component providing the stable and consistent STA patterns and another causing their variations. Mid-segment markers experienced smaller STA ranges than those closer to a joint, but tended to have greater variations primarily associated with pedal resistance and muscle contractions. The current data will be helpful for a better choice of marker positions for data collection, and for developing methods to compensate for both stable and variation components of the STA.
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Affiliation(s)
- Jia-Da Li
- Institute of Biomedical Engineering, National Taiwan University, Taiwan, ROC
| | - Tung-Wu Lu
- Institute of Biomedical Engineering, National Taiwan University, Taiwan, ROC; Department of Orthopaedic Surgery, School of Medicine, National Taiwan University, Taiwan, ROC.
| | - Cheng-Chung Lin
- Institute of Biomedical Engineering, National Taiwan University, Taiwan, ROC; Department of Electrical Engineering, Fu Jen Catholic University, Taiwan, ROC
| | - Mei-Ying Kuo
- Department of Physical Therapy, China Medical University, Taiwan, ROC
| | - Horng-Chaung Hsu
- Department of Orthopaedics, China Medical University, Taiwan, ROC; Department of Orthopaedic Surgery, School of Medicine, China Medical University, Taiwan, ROC
| | - Wu-Chung Shen
- Department of Radiology, China Medical University Hospital, Taichung, Taiwan, ROC; Department of Biomedical Imaging and Radiological Science, College of Health Care, China Medical University, Taichung, Taiwan, ROC
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Richard V, Lamberto G, Lu TW, Cappozzo A, Dumas R. Knee Kinematics Estimation Using Multi-Body Optimisation Embedding a Knee Joint Stiffness Matrix: A Feasibility Study. PLoS One 2016; 11:e0157010. [PMID: 27314586 PMCID: PMC4912111 DOI: 10.1371/journal.pone.0157010] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2015] [Accepted: 05/23/2016] [Indexed: 11/18/2022] Open
Abstract
The use of multi-body optimisation (MBO) to estimate joint kinematics from stereophotogrammetric data while compensating for soft tissue artefact is still open to debate. Presently used joint models embedded in MBO, such as mechanical linkages, constitute a considerable simplification of joint function, preventing a detailed understanding of it. The present study proposes a knee joint model where femur and tibia are represented as rigid bodies connected through an elastic element the behaviour of which is described by a single stiffness matrix. The deformation energy, computed from the stiffness matrix and joint angles and displacements, is minimised within the MBO. Implemented as a "soft" constraint using a penalty-based method, this elastic joint description challenges the strictness of "hard" constraints. In this study, estimates of knee kinematics obtained using MBO embedding four different knee joint models (i.e., no constraints, spherical joint, parallel mechanism, and elastic joint) were compared against reference kinematics measured using bi-planar fluoroscopy on two healthy subjects ascending stairs. Bland-Altman analysis and sensitivity analysis investigating the influence of variations in the stiffness matrix terms on the estimated kinematics substantiate the conclusions. The difference between the reference knee joint angles and displacements and the corresponding estimates obtained using MBO embedding the stiffness matrix showed an average bias and standard deviation for kinematics of 0.9±3.2° and 1.6±2.3 mm. These values were lower than when no joint constraints (1.1±3.8°, 2.4±4.1 mm) or a parallel mechanism (7.7±3.6°, 1.6±1.7 mm) were used and were comparable to the values obtained with a spherical joint (1.0±3.2°, 1.3±1.9 mm). The study demonstrated the feasibility of substituting an elastic joint for more classic joint constraints in MBO.
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Affiliation(s)
- Vincent Richard
- Univ Lyon, Université Claude Bernard Lyon 1, IFSTTAR, UMR_T9406, LBMC, F69622, Lyon, France
- Università degli Studi di Roma – Foro Italico, Department of Movement, Human, and Health Sciences, Rome, Italy
| | - Giuliano Lamberto
- University of Sheffield, Department of Mechanical Engineering and INSIGNEO Institute for in Silico Medicine, Sheffield, United Kingdom
| | - Tung-Wu Lu
- National Taiwan University, Institute of Biomedical Engineering, Taipei, Taiwan
- National Taiwan University, Department of Orthopaedic Surgery, Taipei, Taiwan
| | - Aurelio Cappozzo
- Università degli Studi di Roma – Foro Italico, Department of Movement, Human, and Health Sciences, Rome, Italy
| | - Raphaël Dumas
- Univ Lyon, Université Claude Bernard Lyon 1, IFSTTAR, UMR_T9406, LBMC, F69622, Lyon, France
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Accuracy of Functional and Predictive Methods to Calculate the Hip Joint Center in Young Non-pathologic Asymptomatic Adults with Dual Fluoroscopy as a Reference Standard. Ann Biomed Eng 2015; 44:2168-80. [PMID: 26645080 DOI: 10.1007/s10439-015-1522-1] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2015] [Accepted: 11/24/2015] [Indexed: 10/22/2022]
Abstract
Predictions from biomechanical models of gait may be sensitive to joint center locations. Most often, the hip joint center (HJC) is derived from locations of reflective markers adhered to the skin. Here, predictive techniques use regression equations of pelvic anatomy to estimate the HJC, whereas functional methods track motion of markers placed at the pelvis and femur during a coordinated motion. Skin motion artifact may introduce errors in the estimate of HJC for both techniques. Quantifying the accuracy of these methods is an area of open investigation. In this study, we used dual fluoroscopy (DF) (a dynamic X-ray imaging technique) and three-dimensional reconstructions from computed tomography images, to measure HJC locations in vivo. Using dual fluoroscopy as the reference standard, we then assessed the accuracy of three predictive and two functional methods. Eleven non-pathologic subjects were imaged with DF and reflective skin marker motion capture. Additionally, DF-based solutions generated virtual markers placed on bony landmarks, which were input to the predictive and functional methods to determine if estimates of the HJC improved. Using skin markers, functional methods had better mean agreement with the HJC measured by DF (11.0 ± 3.3 mm) than predictive methods (18.1 ± 9.5 mm); estimates from functional and predictive methods improved when using the DF-based solutions (1.3 ± 0.9 and 17.5 ± 8.6 mm, respectively). The Harrington method was the best predictive technique using both skin markers (13.2 ± 6.5 mm) and DF-based solutions (10.6 ± 2.5 mm). The two functional methods had similar accuracy using skin makers (11.1 ± 3.6 and 10.8 ± 3.2 mm) and DF-based solutions (1.2 ± 0.8 and 1.4 ± 1.0 mm). Overall, functional methods were superior to predictive methods for HJC estimation. However, the improvements observed when using the DF-based solutions suggest that skin motion artifact is a large source of error for the functional methods.
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Bonci T, Camomilla V, Dumas R, Chèze L, Cappozzo A. Rigid and non-rigid geometrical transformations of a marker-cluster and their impact on bone-pose estimation. J Biomech 2015; 48:4166-4172. [PMID: 26555716 DOI: 10.1016/j.jbiomech.2015.10.031] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2015] [Revised: 10/19/2015] [Accepted: 10/21/2015] [Indexed: 10/22/2022]
Abstract
When stereophotogrammetry and skin-markers are used, bone-pose estimation is jeopardised by the soft tissue artefact (STA). At marker-cluster level, this can be represented using a modal series of rigid (RT; translation and rotation) and non-rigid (NRT; homothety and scaling) geometrical transformations. The NRT has been found to be smaller than the RT and claimed to have a limited impact on bone-pose estimation. This study aims to investigate this matter and comparatively assessing the propagation of both STA components to bone-pose estimate, using different numbers of markers. Twelve skin-markers distributed over the anterior aspect of a thigh were considered and STA time functions were generated for each of them, as plausibly occurs during walking, using an ad hoc model and represented through the geometrical transformations. Using marker-clusters made of four to 12 markers affected by these STAs, and a Procrustes superimposition approach, bone-pose and the relevant accuracy were estimated. This was done also for a selected four marker-cluster affected by STAs randomly simulated by modifying the original STA NRT component, so that its energy fell in the range 30-90% of total STA energy. The pose error, which slightly decreased while increasing the number of markers in the marker-cluster, was independent from the NRT amplitude, and was always null when the RT component was removed. It was thus demonstrated that only the RT component impacts pose estimation accuracy and should thus be accounted for when designing algorithms aimed at compensating for STA.
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Affiliation(s)
- T Bonci
- Department of Movement, Human and Health Sciences, Università degli Studi di Roma ''Foro Italico'', Rome, Italy; Université de Lyon, F-69622 Lyon, France; Université Claude Bernard Lyon 1, Villeurbanne, France; IFSTTAR, UMR_T9406, Laboratoire de Biomécanique et Mécanique des Chocs (LBMC), F-69675 Bron, France; Interuniversity Centre of Bioengineering of the Human Neuromusculoskeletal System, Università degli Studi di Roma "Foro Italico", Rome, Italy
| | - V Camomilla
- Department of Movement, Human and Health Sciences, Università degli Studi di Roma ''Foro Italico'', Rome, Italy; Interuniversity Centre of Bioengineering of the Human Neuromusculoskeletal System, Università degli Studi di Roma "Foro Italico", Rome, Italy.
| | - R Dumas
- Université de Lyon, F-69622 Lyon, France; Université Claude Bernard Lyon 1, Villeurbanne, France; IFSTTAR, UMR_T9406, Laboratoire de Biomécanique et Mécanique des Chocs (LBMC), F-69675 Bron, France; Interuniversity Centre of Bioengineering of the Human Neuromusculoskeletal System, Università degli Studi di Roma "Foro Italico", Rome, Italy
| | - L Chèze
- Université de Lyon, F-69622 Lyon, France; Université Claude Bernard Lyon 1, Villeurbanne, France; IFSTTAR, UMR_T9406, Laboratoire de Biomécanique et Mécanique des Chocs (LBMC), F-69675 Bron, France; Interuniversity Centre of Bioengineering of the Human Neuromusculoskeletal System, Università degli Studi di Roma "Foro Italico", Rome, Italy
| | - A Cappozzo
- Department of Movement, Human and Health Sciences, Università degli Studi di Roma ''Foro Italico'', Rome, Italy; Interuniversity Centre of Bioengineering of the Human Neuromusculoskeletal System, Università degli Studi di Roma "Foro Italico", Rome, Italy
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Assessment of Knee Cartilage Stress Distribution and Deformation Using Motion Capture System and Wearable Sensors for Force Ratio Detection. COMPUTATIONAL AND MATHEMATICAL METHODS IN MEDICINE 2015; 2015:963746. [PMID: 26417382 PMCID: PMC4568355 DOI: 10.1155/2015/963746] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/19/2014] [Revised: 12/19/2014] [Accepted: 01/16/2015] [Indexed: 11/18/2022]
Abstract
Knowledge about the knee cartilage deformation ratio as well as the knee cartilage stress distribution is of particular importance in clinical studies due to the fact that these represent some of the basic indicators of cartilage state and that they also provide information about joint cartilage wear so medical doctors can predict when it is necessary to perform surgery on a patient. In this research, we apply various kinds of sensors such as a system of infrared cameras and reflective markers, three-axis accelerometer, and force plate. The fluorescent marker and accelerometers are placed on the patient's hip, knee, and ankle, respectively. During a normal walk we are recording the space position of markers, acceleration, and ground reaction force by force plate. Measured data are included in the biomechanical model of the knee joint. Geometry for this model is defined from CT images. This model includes the impact of ground reaction forces, contact force between femur and tibia, patient body weight, ligaments, and muscle forces. The boundary conditions are created for the finite element method in order to noninvasively determine the cartilage stress distribution.
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Fukui T, Otake Y, Kondo T. In which direction does skin move during joint movement? Skin Res Technol 2015; 22:181-8. [DOI: 10.1111/srt.12248] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/17/2015] [Indexed: 11/26/2022]
Affiliation(s)
- T. Fukui
- Health Care Science; Graduate School; Bunkyo Gakuin University; Tokyo Japan
| | - Y. Otake
- Health Care Science; Graduate School; Bunkyo Gakuin University; Tokyo Japan
| | - T. Kondo
- Health Care Science; Graduate School; Bunkyo Gakuin University; Tokyo Japan
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Masum MA, Pickering M, Lambert A, Scarvell J, Smith P. Accuracy assessment of Tri-plane B-mode ultrasound for non-invasive 3D kinematic analysis of knee joints. Biomed Eng Online 2014; 13:122. [PMID: 25159051 PMCID: PMC4162952 DOI: 10.1186/1475-925x-13-122] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2014] [Accepted: 08/01/2014] [Indexed: 11/17/2022] Open
Abstract
Background Currently the clinical standard for measuring the motion of the bones in knee joints with sufficient precision involves implanting tantalum beads into the bones. These beads appear as high intensity features in radiographs and can be used for precise kinematic measurements. This procedure imposes a strong coupling between accuracy and invasiveness. In this paper, a tri-plane B-mode ultrasound (US) based non-invasive approach is proposed for use in kinematic analysis of knee joints in 3D space. Methods The 3D analysis is performed using image processing procedures on the 2D US slices. The novelty of the proposed procedure and its applicability to the unconstrained 3D kinematic analysis of knee joints is outlined. An error analysis for establishing the method’s feasibility is included for different artificial compositions of a knee joint phantom. Some in-vivo and in-vitro scans are presented to demonstrate that US scans reveal enough anatomical details, which further supports the experimental setup used using knee bone phantoms. Results The error between the displacements measured by the registration of the US image slices and the true displacements of the respective slices measured using the precision mechanical stages on the experimental apparatus is evaluated for translation and rotation in two simulated environments. The mean and standard deviation of errors are shown in tabular form. This method provides an average measurement precision of less than 0.1 mm and 0.1 degrees, respectively. Conclusion In this paper, we have presented a novel non-invasive approach to measuring the motion of the bones in a knee using tri-plane B-mode ultrasound and image registration. In our study, the image registration method determines the position of bony landmarks relative to a B-mode ultrasound sensor array with sub-pixel accuracy. The advantages of our proposed system over previous techniques are that it is non-invasive, does not require the use of ionizing radiation and can be used conveniently if miniaturized.
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Affiliation(s)
- Md Abdullah Masum
- School of Engineering & IT, UNSW Canberra, Northcott Drive, Campbell, Canberra, Australia.
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Zemp R, List R, Gülay T, Elsig JP, Naxera J, Taylor WR, Lorenzetti S. Soft tissue artefacts of the human back: comparison of the sagittal curvature of the spine measured using skin markers and an open upright MRI. PLoS One 2014; 9:e95426. [PMID: 24748013 PMCID: PMC3991691 DOI: 10.1371/journal.pone.0095426] [Citation(s) in RCA: 64] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2013] [Accepted: 03/01/2014] [Indexed: 11/18/2022] Open
Abstract
Soft tissue artefact affects the determination of skeletal kinematics. Thus, it is important to know the accuracy and limitations of kinematic parameters determined and modelled based on skin marker data. Here, the curvature angles, as well as the rotations of the lumbar and thoracic segments, of seven healthy subjects were determined in the sagittal plane using a skin marker set and compared to measurements taken in an open upright MRI scanner in order to understand the influence of soft tissue artefact at the back. The mean STA in the flexed compared to the extended positions were 10.2±6.1 mm (lumbar)/9.3±4.2 mm (thoracic) and 10.7±4.8 mm (lumbar)/9.2±4.9 mm (thoracic) respectively. A linear regression of the lumbar and thoracic curvatures between the marker-based measurements and MRI-based measurements resulted in coefficients of determination, R2, of 0.552 and 0.385 respectively. Skin marker measurements therefore allow for the assessment of changes in the lumbar and thoracic curvature angles, but the absolute values suffer from uncertainty. Nevertheless, this marker set appears to be suitable for quantifying lumbar and thoracic spinal changes between quasi-static whole body postural changes.
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Affiliation(s)
- Roland Zemp
- Institute for Biomechanics, ETH Zurich, Zurich, Switzerland
| | - Renate List
- Institute for Biomechanics, ETH Zurich, Zurich, Switzerland
| | - Turgut Gülay
- Institute for Biomechanics, ETH Zurich, Zurich, Switzerland
| | | | | | | | - Silvio Lorenzetti
- Institute for Biomechanics, ETH Zurich, Zurich, Switzerland
- * E-mail:
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Bergmann JHM, Langdon PM, Mayagoitia RE, Howard N. Exploring the use of sensors to measure behavioral interactions: an experimental evaluation of using hand trajectories. PLoS One 2014; 9:e88080. [PMID: 24516583 PMCID: PMC3917885 DOI: 10.1371/journal.pone.0088080] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2013] [Accepted: 01/04/2014] [Indexed: 01/25/2023] Open
Abstract
Humans appear to be sensitive to relative small changes in their surroundings. These changes are often initially perceived as irrelevant, but they can cause significant changes in behavior. However, how exactly people’s behavior changes is often hard to quantify. A reliable and valid tool is needed in order to address such a question, ideally measuring an important point of interaction, such as the hand. Wearable-body-sensor systems can be used to obtain valuable, behavioral information. These systems are particularly useful for assessing functional interactions that occur between the endpoints of the upper limbs and our surroundings. A new method is explored that consists of computing hand position using a wearable sensor system and validating it against a gold standard reference measurement (optical tracking device). Initial outcomes related well to the gold standard measurements (r = 0.81) showing an acceptable average root mean square error of 0.09 meters. Subsequently, the use of this approach was further investigated by measuring differences in motor behavior, in response to a changing environment. Three subjects were asked to perform a water pouring task with three slightly different containers. Wavelet analysis was introduced to assess how motor consistency was affected by these small environmental changes. Results showed that the behavioral motor adjustments to a variable environment could be assessed by applying wavelet coherence techniques. Applying these procedures in everyday life, combined with correct research methodologies, can assist in quantifying how environmental changes can cause alterations in our motor behavior.
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Affiliation(s)
- Jeroen H. M. Bergmann
- Brain Sciences Foundation, Providence, Rhode Island, United States of America
- Centre of Human & Aerospace Physiological Sciences, King’s College London, London, United Kingdom
- Synthetic Intelligence Lab, Massachusetts Institute of Technology, Boston, Massachusetts, United States of America
- * E-mail:
| | - Patrick M. Langdon
- Department of Engineering, The University of Cambridge, Cambridge, United Kingdom
| | - Ruth E. Mayagoitia
- Division of Health & Social Care Research, King’s College London, London, United Kingdom
| | - Newton Howard
- Brain Sciences Foundation, Providence, Rhode Island, United States of America
- Synthetic Intelligence Lab, Massachusetts Institute of Technology, Boston, Massachusetts, United States of America
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Novak AC, Mayich DJ, Perry SD, Daniels TR, Brodsky JW. Gait analysis for foot and ankle surgeons-- topical review, part 2: approaches to multisegment modeling of the foot. Foot Ankle Int 2014; 35:178-91. [PMID: 24334310 DOI: 10.1177/1071100713511435] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Affiliation(s)
- Alison C Novak
- iDAPT Centre for Rehabilitation Research, Toronto Rehabilitation Institute-UHN, Toronto, Canada
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Grimpampi E, Camomilla V, Cereatti A, de Leva P, Cappozzo A. Metrics for Describing Soft-Tissue Artefact and Its Effect on Pose, Size, and Shape of Marker Clusters. IEEE Trans Biomed Eng 2014; 61:362-7. [DOI: 10.1109/tbme.2013.2279636] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Hara R, Sangeux M, Baker R, McGinley J. Quantification of pelvic soft tissue artifact in multiple static positions. Gait Posture 2014; 39:712-7. [PMID: 24220204 DOI: 10.1016/j.gaitpost.2013.10.001] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2013] [Revised: 07/19/2013] [Accepted: 10/01/2013] [Indexed: 02/02/2023]
Abstract
Soft tissue artifact (STA) has been identified as the most critical source of error in clinical gait analysis. Multiple calibration is a technique to reduce the impact of STA on kinematic data, which involves several static calibrations through the range of motion of the joint of interest. This study investigated how skin markers at the pelvis were displaced in relation to anatomical body landmarks in multiple static calibration positions. The magnitude and direction of the pelvic marker displacement was assessed in nine different body positions including 90° and 45° hip flexion, maximum hip extension, and pelvic tilt in 20 healthy young adults. ASIS markers were found to be more susceptible to relative displacement than PSIS markers, with displacement particularly evident in positions where the hip was flexed (up to 17 mm). A strong correlation was found between the hip flexion angle and marker displacement (r(2) = 0.70). While the estimated impact of pelvic STA on gait kinematics was relatively small, the findings suggest that activities with large hip flexion would cause larger STA with a greater impact on pelvic kinematics. The skin surface located over the ASIS differed by a mean of 17 mm between standing and supine positions, which could affect the inter-ASIS distance and the location of hip joint center (HJC) by up to 20mm and 10mm, respectively.
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Affiliation(s)
- Reiko Hara
- Department of Physiotherapy, The University of Melbourne, Melbourne, Australia; Hugh Williamson Gait Analysis Laboratory, Royal Children's Hospital, Melbourne, Australia.
| | - Morgan Sangeux
- Hugh Williamson Gait Analysis Laboratory, Royal Children's Hospital, Melbourne, Australia; School of Engineering, The University of Melbourne, Melbourne, Australia; Murdoch Childrens Research Institute, Melbourne, Australia
| | | | - Jennifer McGinley
- Department of Physiotherapy, The University of Melbourne, Melbourne, Australia; Murdoch Childrens Research Institute, Melbourne, Australia
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Barre A, Thiran JP, Jolles BM, Theumann N, Aminian K. Soft Tissue Artifact Assessment During Treadmill Walking in Subjects With Total Knee Arthroplasty. IEEE Trans Biomed Eng 2013; 60:3131-40. [DOI: 10.1109/tbme.2013.2268938] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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Baka N, Kaptein BL, Giphart JE, Staring M, de Bruijne M, Lelieveldt BPF, Valstar E. Evaluation of automated statistical shape model based knee kinematics from biplane fluoroscopy. J Biomech 2013; 47:122-9. [PMID: 24207131 DOI: 10.1016/j.jbiomech.2013.09.022] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2013] [Revised: 09/25/2013] [Accepted: 09/26/2013] [Indexed: 11/18/2022]
Abstract
State-of-the-art fluoroscopic knee kinematic analysis methods require the patient-specific bone shapes segmented from CT or MRI. Substituting the patient-specific bone shapes with personalizable models, such as statistical shape models (SSM), could eliminate the CT/MRI acquisitions, and thereby decrease costs and radiation dose (when eliminating CT). SSM based kinematics, however, have not yet been evaluated on clinically relevant joint motion parameters. Therefore, in this work the applicability of SSMs for computing knee kinematics from biplane fluoroscopic sequences was explored. Kinematic precision with an edge based automated bone tracking method using SSMs was evaluated on 6 cadaveric and 10 in-vivo fluoroscopic sequences. The SSMs of the femur and the tibia-fibula were created using 61 training datasets. Kinematic precision was determined for medial-lateral tibial shift, anterior-posterior tibial drawer, joint distraction-contraction, flexion, tibial rotation and adduction. The relationship between kinematic precision and bone shape accuracy was also investigated. The SSM based kinematics resulted in sub-millimeter (0.48-0.81mm) and approximately 1° (0.69-0.99°) median precision on the cadaveric knees compared to bone-marker-based kinematics. The precision on the in-vivo datasets was comparable to that of the cadaveric sequences when evaluated with a semi-automatic reference method. These results are promising, though further work is necessary to reach the accuracy of CT-based kinematics. We also demonstrated that a better shape reconstruction accuracy does not automatically imply a better kinematic precision. This result suggests that the ability of accurately fitting the edges in the fluoroscopic sequences has a larger role in determining the kinematic precision than that of the overall 3D shape accuracy.
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Affiliation(s)
- Nora Baka
- Biomechanics and Imaging Group, Department of Orthopedic Surgery, Leiden University Medical Center, P.O. Box 9600, 2300 RC Leiden, The Netherlands.
| | - Bart L Kaptein
- Biomechanics and Imaging Group, Department of Orthopedic Surgery, Leiden University Medical Center, P.O. Box 9600, 2300 RC Leiden, The Netherlands.
| | - J Erik Giphart
- Department of Bio-Medical Engineering, Steadman Philippon Research Institute, Vail, USA
| | - Marius Staring
- Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Marleen de Bruijne
- Departments of Medical Informatics and Radiology, Erasmus Medical Center, Rotterdam, The Netherlands; Department of Computer Science, University of Copenhagen, Denmark
| | | | - Edward Valstar
- Biomechanics and Imaging Group, Department of Orthopedic Surgery, Leiden University Medical Center, P.O. Box 9600, 2300 RC Leiden, The Netherlands; Department of Biomechanical Engineering, Faculty of Mechanical, Maritime, and Materials Engineering, Delft University of Technology, The Netherlands
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Wolf EJ, Everding VQ, Linberg AA, Czerniecki JM, Gambel JM. Comparison of the Power Knee and C-Leg during step-up and sit-to-stand tasks. Gait Posture 2013; 38:397-402. [PMID: 23375018 DOI: 10.1016/j.gaitpost.2013.01.007] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2012] [Revised: 01/02/2013] [Accepted: 01/03/2013] [Indexed: 02/02/2023]
Abstract
For U.S. military service members with transfemoral amputations there are different prosthetic knee systems available that function differently. For example the C-Leg(®) (C-Leg, Otto Bock Healthcare, GmbH, Duderstadt, Germany) is a passive microprocessor knee, and the Power Knee™ (PK, Ossur, Reykjavík, Iceland) provides active positive power generation at the knee joint. This study examined both step-up and sit-to-stand tasks performed by service members using C-Leg and PK systems to determine if the addition of positive power generation to a prosthetic knee can improve symmetry and reduce impact to the remaining joints. For both tasks, average peak sagittal knee powers and vertical ground reaction forces (GRFs) were greater for the intact limb versus the amputated limb across PK and C-Leg groups. For the sit-to-stand task, peak knee power of the amputated limb was greater for PK users versus C-Leg users. Vertical GRFs of the intact limb were greater for the C-Leg versus the PK. The performance of the PK relative to the C-Leg during a STS task illustrated few differences between components and no effect on the intact limb.
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Affiliation(s)
- Erik J Wolf
- Walter Reed National Military Medical Center, Department of Orthopaedics and Rehabilitation, Bethesda, MD 20889, United States.
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Seehaus F, Emmerich J, Kaptein BL, Windhagen H, Hurschler C. Dependence of model-based RSA accuracy on higher and lower implant surface model quality. Biomed Eng Online 2013; 12:32. [PMID: 23587251 PMCID: PMC3637620 DOI: 10.1186/1475-925x-12-32] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2013] [Accepted: 04/12/2013] [Indexed: 11/10/2022] Open
Abstract
Background Model-based Roentgen Stereophotogrammetric Analysis (MBRSA) allows the accurate in vivo measurement of the relative motion between an implant and the surrounding bone (migration), using pose-estimation algorithms and three dimensional geometric surface models of the implant. The goal of this study was thus to investigate the effect of surface model resolution on the accuracy of the MBRSA method. Methods Four different implant geometries (knee femoral and tibial components, and two different hip stems) were investigated, for each of which two reversed engineering (RE) models of differing spatial digitizing resolution were generated. Accuracy of implant migration measurement using MBRSA was assessed in dependence on surface model resolution using an experimental phantom-model set up. Results When using the lower quality RE models, the worst bias observed ranged from -0.048 to 0.037 mm, and -0.057 to 0.078 deg for translation and rotation respectively. For higher quality reverse engineering models, bias ranged from -0.042 to 0.048 mm, and -0.449 to 0.029 deg. The pair-wise comparisons of digitizing resolution (higher vs. lower quality) within the different implant type revealed significant differences only for the hip stems (p < 0.001). Conclusion The data suggest that the application of lower resolution RE models for MBRSA is a viable alternative method for the in vivo measurement of implant migration, in particular for implants with non symmetrical geometries (total knee arthroplasty). Implants with larger length to width aspect ratio (total hip arthroplasty) may require high resolution RE models in order to achieve acceptable accuracy. Conversely, for some axis the bias for translation are clearly worse for translation, and are marginally better for rotations using the lower resolution RE models instead of the higher ones. However, performed box plots ranges were well within what has been reported in the literature. The observed lower accuracy and precision of the measurements for hip stem components for rotations about the superior-inferior direction is presumably the result of the nature of the MBRSA method. This well known effect within MBRSA for rotations about the axis of symmetry of axially-symmetric objects do not change the contour of the projected image to as large a degree as motion about a non-symmetric axes. It is not possible to detected this small motion as accurately using pose-estimation methods. This may affect the “higher” accuracy for the applied lower resolution RE models.
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Abstract
The purposes of this article are to discuss key factors for assessing joint function, to present some recent findings, and to address the future directions for evaluating the function of the anterior cruciate ligament-injured/reconstructed knees. Well-designed studies, using state-of-the art tools to assess knee kinematics under in vivo, dynamic, high-loading conditions, are necessary to evaluate the relative performance of different procedures for restoring normal joint motion.
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Henak CR, Anderson AE, Weiss JA. Subject-specific analysis of joint contact mechanics: application to the study of osteoarthritis and surgical planning. J Biomech Eng 2013; 135:021003. [PMID: 23445048 PMCID: PMC3705883 DOI: 10.1115/1.4023386] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2012] [Revised: 01/03/2013] [Accepted: 01/18/2013] [Indexed: 11/08/2022]
Abstract
Advances in computational mechanics, constitutive modeling, and techniques for subject-specific modeling have opened the door to patient-specific simulation of the relationships between joint mechanics and osteoarthritis (OA), as well as patient-specific preoperative planning. This article reviews the application of computational biomechanics to the simulation of joint contact mechanics as relevant to the study of OA. This review begins with background regarding OA and the mechanical causes of OA in the context of simulations of joint mechanics. The broad range of technical considerations in creating validated subject-specific whole joint models is discussed. The types of computational models available for the study of joint mechanics are reviewed. The types of constitutive models that are available for articular cartilage are reviewed, with special attention to choosing an appropriate constitutive model for the application at hand. Issues related to model generation are discussed, including acquisition of model geometry from volumetric image data and specific considerations for acquisition of computed tomography and magnetic resonance imaging data. Approaches to model validation are reviewed. The areas of parametric analysis, factorial design, and probabilistic analysis are reviewed in the context of simulations of joint contact mechanics. Following the review of technical considerations, the article details insights that have been obtained from computational models of joint mechanics for normal joints; patient populations; the study of specific aspects of joint mechanics relevant to OA, such as congruency and instability; and preoperative planning. Finally, future directions for research and application are summarized.
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Affiliation(s)
- Corinne R. Henak
- Department of Bioengineering,University of Utah,Salt Lake City, UT 84112;Scientific Computing and Imaging Institute,University of Utah,Salt Lake City, UT 84112
| | - Andrew E. Anderson
- Department of Bioengineering,University of Utah,Salt Lake City, UT;Scientific Computing and Imaging Institute,University of Utah,Salt Lake City, UT;Department of Orthopaedics,University of Utah,Salt Lake City, UT 84108;Department of Physical Therapy,University of Utah,Salt Lake City, UT 84108
| | - Jeffrey A. Weiss
- Department of Bioengineering,University of Utah,Salt Lake City, UT 84108;Scientific Computing and Imaging Institute,University of Utah,Salt Lake City, UT 84108;Department of Orthopaedics,University of Utah,Salt Lake City, UT 84108e-mail:
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Tersi L, Barré A, Fantozzi S, Stagni R. In vitro quantification of the performance of model-based mono-planar and bi-planar fluoroscopy for 3D joint kinematics estimation. Med Biol Eng Comput 2012; 51:257-65. [DOI: 10.1007/s11517-012-0987-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2012] [Accepted: 10/29/2012] [Indexed: 10/27/2022]
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Kinematic differences between optical motion capture and biplanar videoradiography during a jump-cut maneuver. J Biomech 2012; 46:567-73. [PMID: 23084785 DOI: 10.1016/j.jbiomech.2012.09.023] [Citation(s) in RCA: 86] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2012] [Revised: 09/12/2012] [Accepted: 09/18/2012] [Indexed: 11/24/2022]
Abstract
Jumping and cutting activities are investigated in many laboratories attempting to better understand the biomechanics associated with non-contact ACL injury. Optical motion capture is widely used; however, it is subject to soft tissue artifact (STA). Biplanar videoradiography offers a unique approach to collecting skeletal motion without STA. The goal of this study was to compare how STA affects the six-degrees-of-freedom motion of the femur and tibia during a jump-cut maneuver associated with non-contact ACL injury. Ten volunteers performed a jump-cut maneuver while their landing leg was imaged using optical motion capture (OMC) and biplanar videoradiography. The within-bone motion differences were compared using anatomical coordinate systems for the femur and tibia, respectively. The knee joint kinematic measurements were compared during two periods: before and after ground contact. Over the entire activity, the within-bone motion differences between the two motion capture techniques were significantly lower for the tibia than the femur for two of the rotational axes (flexion/extension, internal/external) and the origin. The OMC and biplanar videoradiography knee joint kinematics were in best agreement before landing. Kinematic deviations between the two techniques increased significantly after contact. This study provides information on the kinematic discrepancies between OMC and biplanar videoradiography that can be used to optimize methods employing both technologies for studying dynamic in vivo knee kinematics and kinetics during a jump-cut maneuver.
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44
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Wolterbeek N, Garling EH, van der Linden HMJ, Nelissen RGHH, Valstar ER. Integrated assessment techniques for linking kinematics, kinetics and muscle activation to early migration: a pilot study. Gait Posture 2012; 36:394-8. [PMID: 22555064 DOI: 10.1016/j.gaitpost.2012.03.022] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2010] [Revised: 03/08/2012] [Accepted: 03/27/2012] [Indexed: 02/02/2023]
Abstract
The goal of this pilot study was to develop and test an integrated method to assess kinematics, kinetics and muscle activation of total knee prostheses during dynamic activities, by integrating fluoroscopic measurements with force plate, electromyography and external motion registration measurements. Subsequently, this multi-instrumental analysis was then used to assess the relationship between kinematics, kinetics and muscle activation and early migration of the tibial component of total knee prostheses. This pilot study showed that it is feasible to integrate fluoroscopic, kinematic and kinetic measurements and relate findings to early migration data. Results showed that there might be an association between deviant kinematics and early migration in patients with a highly congruent mobile-bearing total knee prosthesis. Patients that showed high levels of coactivation, diverging axial rotations of the insert and a deviant pivot point showed increased migration and might be at higher risk for tibial component loosening. In the future, to confirm our findings, the same integrated measurements have to be performed in larger patient groups and different prosthesis designs.
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Affiliation(s)
- Nienke Wolterbeek
- Biomechanics and Imaging Group, Department of Orthopaedics, Leiden University Medical Center, Leiden PO box 9600, 2300 RC Leiden, The Netherlands.
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45
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Kratzenstein S, Kornaropoulos EI, Ehrig RM, Heller MO, Pöpplau BM, Taylor WR. Effective marker placement for functional identification of the centre of rotation at the hip. Gait Posture 2012; 36:482-6. [PMID: 22672896 DOI: 10.1016/j.gaitpost.2012.04.011] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2011] [Revised: 03/16/2012] [Accepted: 04/22/2012] [Indexed: 02/02/2023]
Abstract
The accuracy and precision of quantifying musculoskeletal kinematics, and particularly determining the centre of rotation (CoR) at the hip joint, using skin marker based motion analysis is limited by soft tissue artefact (STA). We posed the question of whether the contribution of individual markers towards improving the precision of the functional joint centre using marker based methods could be assessed, and then utilised to allow effective marker placement for determination of the CoR at the hip. Sixty-three retro-reflective skin markers were placed to encompass the thighs of seven healthy subjects, together with a set of sixteen markers on the pelvis. The weighted optimal common shape technique (wOCST) was then applied to determine the weighting, or importance, of each marker for identifying the centre of rotation at the hip. The markers with the highest weightings over all subjects and measurements were determined that identified the HJC with the highest precision. The use of six markers in selected regions (two anterior, two lateral and two posterior) allowed the HJC to be determined with a similar precision to the complete set of 63 markers, with the determined regions predominantly distant from the hip joint, excluding areas associated with the bellies of large muscles and therefore large motion artefact from muscle activity. The novel approach presented here allows an understanding of each marker's contribution towards a precise joint determination, and therefore enables the targeted placement of markers for reliable assessment of musculoskeletal kinematics.
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Affiliation(s)
- S Kratzenstein
- Julius Wolff Institute, Charité-Universitätsmedizin Berlin, Center for Sports Science and Sports Medicine Berlin, Philippstr. 13, Haus 11, 10115 Berlin, Germany
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46
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Kaptein BL, Shelburne KB, Torry MR, Erik Giphart J. A comparison of calibration methods for stereo fluoroscopic imaging systems. J Biomech 2011; 44:2511-5. [DOI: 10.1016/j.jbiomech.2011.07.001] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2010] [Revised: 07/01/2011] [Accepted: 07/04/2011] [Indexed: 10/18/2022]
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47
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Tsai TY, Lu TW, Kuo MY, Lin CC. Effects of soft tissue artifacts on the calculated kinematics and kinetics of the knee during stair-ascent. J Biomech 2011; 44:1182-8. [PMID: 21296352 DOI: 10.1016/j.jbiomech.2011.01.009] [Citation(s) in RCA: 60] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2010] [Revised: 01/10/2011] [Accepted: 01/10/2011] [Indexed: 11/27/2022]
Abstract
Biomechanics of the knee during stair-ascent has mostly been studied using skin-marker-based motion analysis techniques, but no study has reported a complete assessment of the soft tissue artifacts (STA) and their effects on the calculated joint center translation, angles and moments at the knee in normal subjects during this activity. This study aimed to bridge the gap. Twelve young adults walked up a three-step stair while data were acquired simultaneously from a three-dimensional motion capture system, a force plate and a dynamic fluoroscopy system. The "gold standards" of poses of the knee were obtained using a 3D fluoroscopy method. The STA of the markers on the thigh and shank were then calculated, together with their effects on the calculated joint center translations, angles and moments at the knee. The STA of the thigh markers were greater than those on the shank, leading to significantly underestimated flexion and extensor moments, but overestimated joint center translations during the first half of the stance phase. The results will be useful for a better understanding of the normal biomechanics of the knee during stair-ascent, as a baseline for future clinical applications and for developing a compensation method to correct for the effects of STA.
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Affiliation(s)
- Tsung-Yuan Tsai
- Institute of Biomedical Engineering, National Taiwan University, No. 1, Section 1, Jen-Ai Road, Taipei 100, Taiwan, ROC
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48
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Ehrig RM, Heller MO, Kratzenstein S, Duda GN, Trepczynski A, Taylor WR. The SCoRE residual: A quality index to assess the accuracy of joint estimations. J Biomech 2011; 44:1400-4. [DOI: 10.1016/j.jbiomech.2010.12.009] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2010] [Revised: 12/08/2010] [Accepted: 12/08/2010] [Indexed: 11/26/2022]
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49
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Worsley P, Stokes M, Taylor M. Predicted knee kinematics and kinetics during functional activities using motion capture and musculoskeletal modelling in healthy older people. Gait Posture 2011; 33:268-73. [PMID: 21169022 DOI: 10.1016/j.gaitpost.2010.11.018] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2010] [Revised: 11/19/2010] [Accepted: 11/23/2010] [Indexed: 02/02/2023]
Abstract
Knowledge of joint forces and moments is essential for comparisons between healthy people and those with pathological conditions, with observed changes at joints providing basis for a particular intervention. Currently the literature analysing both kinematics and kinetics at the knee has been limited to small samples, typically of young subjects or those who have undergone joint arthroplasty. In this study, we examined tibiofemoral joint (TFJ) kinematics and kinetics during gait, sit-stand-sit, and step-descent in 20 healthy older subjects (aged 53-79 years) using motion capture data and inverse dynamic musculoskeletal models. Mean peak distal-proximal force in the TFJ were 3.1, 1.6, and 3.5 times body weight (N/BW) for gait, sit-stand, and step-descent respectively. There were also significant posterior-anterior forces, with sit-stand activity peaking at 1.6 N/BW. Moments about the TFJ peaked at a mean of 0.07 Nm/BW during the sit-stand activity. One of the most important findings of this study was variability found across the subjects, who spanned a wide age range, showing large standard deviations in all of the activities for both kinematics and kinetics. These data have provided an initial prediction for assessing kinematics and kinetics in the older population. Larger studies are needed to refine the database, in particular to reduce the variability in the results by studying sub-populations, to enable more robust comparisons between healthy and pathological TFJ kinematics and kinetics.
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Affiliation(s)
- Peter Worsley
- Bioengineering Science Research Group, School of Engineering Sciences, University of Southampton, Southampton, Hampshire SO17 1BJ, UK.
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50
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Zürcher AW, Wolterbeek N, Valstar ER, Nelissen RGHH, Pöll RG, Harlaar J. The Femoral Epicondylar Frame to track femoral rotation in optoelectronic gait analysis. Gait Posture 2011; 33:306-8. [PMID: 21146411 DOI: 10.1016/j.gaitpost.2010.11.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2010] [Revised: 09/06/2010] [Accepted: 11/17/2010] [Indexed: 02/02/2023]
Abstract
Relative movement of skin markers to underlying bone limits a valid interpretation of axial femorotibial rotation in noninvasive optoelectronic gait analysis. A distal femoral clamp is a practical solution for thigh marker placement, however, existing devices are still susceptible to measurement errors at increased angles of knee flexion. We developed the Femoral Epicondylar Frame (FEF), which should result in less femoral rotational measurement error due to its anatomic fitting and controlled pressure adjustment. Seven subjects with a total knee replacement in situ, mean age 71 years, mean body mass index 28, were equipped with the frame mounted with a set of tantalum markers. Fluoroscopic data was collected during a step-up motion. A three-dimensional model fitting technique was used to compare the in vivo position and orientation of the frame and the femoral prosthesis component of the prosthesis. The frame rotational measurement error appeared to be linearly dependent on the knee flexion angle. When considering knee flexion angles lower than 40° of flexion, the highest measurement error was 3.3° on average, with an absolute extreme of 6.2°. It is concluded that the accuracy of the FEF is sufficient to evaluate axial knee rotation with optoelectronic gait analysis at group level in clinical studies.
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Affiliation(s)
- A W Zürcher
- Department of Orthopaedics, Diakonessen Hospital, Utrecht, The Netherlands.
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