title: Automating the design of resection guides specific to patient anatomy in knee replacement surgery by enhanced 3D curvature and surface modeling of distal femur shape models.
abstract: Personalized resection guides (PRG) have been recently proposed in the domain of knee replacement, demonstrating clinical outcome similar or even superior to both manual and navigated interventions. Among the mandatory pre-surgical steps for PRG prototyping, the measurement of clinical landmarks (CL) on the bony surfaces is recognized as a key issue due to lack of standardized methodologies, operator-dependent variability and time expenditure. In this paper, we focus on the reliability and repeatability of an anterior-posterior axis, also known as Whiteside line (WL), of the distal femur proposing automatic surface processing and modeling methods aimed at overcoming some of the major concerns related to the manual identification of such CL on 2D images and 3D models. We show that the measurement of WL, exploiting the principle of mean-shifting surface curvature, is highly repeatable and coherent with clinical knowledge.
authors.affiliation: Department of Electronics, Information and Bioengineering, Politecnico di Milano, via Ponzio 34/5, 20133 Milano, Italy. Electronic address: pietro.cerveri@polimi.it.
authors.forename: Pietro
authors.initials: P
authors.lastname: Cerveri
authors.affiliation: Ist Orthopaedic Department, C.T.O. Hospital, Istituti Clinici di Perfezionamento, Milano, Italy.
authors.forename: Alfonso
authors.initials: A
authors.lastname: Manzotti
authors.affiliation: Ist Orthopaedic Department, C.T.O. Hospital, Istituti Clinici di Perfezionamento, Milano, Italy.
authors.forename: Norberto
authors.initials: N
authors.lastname: Confalonieri
authors.affiliation: Department of Electronics, Information and Bioengineering, Politecnico di Milano, via Ponzio 34/5, 20133 Milano, Italy.
authors.forename: Guido
authors.initials: G
authors.lastname: Baroni
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019645:Arthroplasty, Replacement, Knee / Q000379:methods*; D003198:Computer Simulation; D005260:Female; D005269:Femur / Q000033:anatomy & histology / Q000000981:diagnostic imaging* / Q000601:surgery*; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods*; D007719:Knee Joint / Q000033:anatomy & histology / Q000000981:diagnostic imaging* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D008954:Models, Biological; D010363:Pattern Recognition, Automated / Q000379:methods; D017755:Prosthesis Fitting / Q000379:methods; D011856:Radiographic Image Enhancement / Q000379:methods; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D025321:Surgery, Computer-Assisted / Q000379:methods*
keywords: Distal femur surface; Hyperbolic paraboloid fitting; Intercondylar fossa; Knee replacement; Patient-specific resection guides; Whiteside line