title: Software-based matching of x-ray images and 3D models of knee prostheses.
abstract: BACKGROUND
  Revision joint replacements are challenging surgical tasks. Knowing the exact type of primary prosthesis is essential to avoid long preoperative organisation, long operation times, and especially loss of bone and soft-tissue during operation. In daily routine there is often no information about the primary prosthesis.
  
  
  OBJECTIVE
  We are developing methods for identifying implanted prostheses from x-ray images by means of matching template images generated from prosthesis CAD data.
  
  
  METHODS
  The application is separated into three major components: The "Template Image Generation" adds 3d models of endoprostheses to a database. The "X-ray Image Segmentation" extracts endoprostheses from provided sets of x-ray images. The "Template Matching" finds the best matching prosthesis types in the data base. At the current stage, one prosthesis model (Corin, Knee ProthesisUniglide) was used for evaluating these algorithms.
  
  
  RESULTS
  Very accurate identifications with accuracies of about 90% for lateral and over 70% for frontal images could be achieved.
  
  
  CONCLUSIONS
  The current results of this feasibility study are very promising. A reliable and fast prosthesis identification process seems realistic to support the surgeon when planning and performing revision arthroplasty. Further improvements of segmentation accuracies and extending the prosthesis data base are intended next steps towards this goal.
authors.affiliation: Department of Orthopaedic and Trauma Surgery, University of Cologne, Hannover, Germany.
authors.forename: Jan
authors.initials: J
authors.lastname: Bredow
authors.affiliation: Department of Orthopaedic and Trauma Surgery, University of Cologne, Hannover, Germany.
authors.forename: Birte
authors.initials: B
authors.lastname: Wenk
authors.affiliation: Institute for Robotics and Process Control, Technical University of Braunschweig, Braunschweig, Germany.
authors.forename: Ralf
authors.initials: R
authors.lastname: Westphal
authors.affiliation: Institute for Robotics and Process Control, Technical University of Braunschweig, Braunschweig, Germany.
authors.forename: Friedrich
authors.initials: F
authors.lastname: Wahl
authors.affiliation: Department of Orthopaedic Surgery, Annastift Hospital, Hannover Medical School, Hannover, Germany.
authors.forename: Stefan
authors.initials: S
authors.lastname: Budde
authors.affiliation: Department of Orthopaedic and Trauma Surgery, University of Cologne, Hannover, Germany.
authors.forename: Peer
authors.initials: P
authors.lastname: Eysel
authors.affiliation: Department of Orthopaedic and Trauma Surgery, University of Cologne, Hannover, Germany.
authors.forename: Johannes
authors.initials: J
authors.lastname: Oppermann
mesh_terms: D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods*; D007719:Knee Joint / Q000000981:diagnostic imaging*; D007720:Knee Prosthesis; D011859:Radiography; D012984:Software
keywords: Revision arthroplasty; image segmentation; prosthesis; template matching; x-ray