Clinical validation of model-based RSA for a total knee prosthesis.
Roentgen stereophotogrammetric analysis generally is accepted as the most accurate method to measure prosthesis migration. A disadvantage of the method is it requires markers in the bone and the prosthesis. Model-based roentgen stereophotogrammetric analysis circumvents the need for markers on prostheses by fitting virtual projections of a three-dimensional surface model of a prosthesis to its actual projections in the roentgen image. We confirmed a model-based roentgen stereophotogrammetric analysis for a tibial component. Using implants with attached markers, we compared model-based roentgen stereophotogrammetric analysis with marker-based roentgen stereophotogrammetric analysis. In addition, we assessed precision of the model-based roentgen stereophotogrammetric analysis with a phantom experiment. The precisions for translations of marker-based and model-based roentgen stereophotogrammetric analysis were 0.06 and 0.11 mm, respectively, and for rotations, the precisions were 0.20 degree and 0.23 degree, respectively. The precisions of model-based roentgen stereophotogrammetric analysis calculated from the phantom data were 0.08 mm for translations and 0.13 degree for rotations. Although model-based roentgen stereophotogrammetric analysis is less precise than marker-based roentgen stereophotogrammetric analysis, its precision is still acceptable for most clinical applications, especially where marker-based roentgen stereophotogrammetric analysis has practical limitations.


METHODS
Level II, prognostic study. See the Guidelines for Authors for a complete description of levels of evidence.
Department of Orthopaedics, Leiden University Medical Center, Leiden, The Netherlands. B.L.Kaptein@lumc.nl
Bart L
BL
Kaptein
Edward R
ER
Valstar
Berend C
BC
Stoel
Hans C
HC
Reiber
Rob G
RG
Nelissen
D019645:Arthroplasty, Replacement, Knee; D006801:Humans; D007720:Knee Prosthesis; D008954:Models, Biological; D019047:Phantoms, Imaging; D010780:Photogrammetry / Q000592:standards*; D011475:Prosthesis Failure; D011857:Radiographic Image Interpretation, Computer-Assisted / Q000592:standards*