title: Marker-based technique for visualizing radiolucent implant components in radiographic imaging.
abstract: Radiography is the predominant imaging modality used for the in-vivo analysis of orthopaedic implants. A major disadvantage of radiography is that the articulating joint components that are composed of radiolucent polyethylene cannot be directly visualized. Current strategies attempt to circumvent this limitation by estimating component positions and simplifying the joint system, however, these approaches lead to a number of associated errors. Thus, this study provides a method to enable the visualization of the polyethylene component of total knee replacements in radiographic images. This was achieved through the repeatable insertion of markers and accompanying registration process, which were evaluated in this study for reproducibility and accuracy. An insertion guide was developed to insert tantalum beads into polyethylene tibial surface liners. The bead-inserted liners were micro-CT scanned to obtain 3D surface geometries. An in-vivo mimicking phantom RSA experiment was then used to test the 3D to 2D registration process. The guide positioned the beads consistently to ±0.21 mm. The 3D to 2D registration demonstrated a repeatability of -0.014 ± 0.008 mm. Registration of different bead-inserted tibial liners to the phantom revealed an average error of 0.026 ± 0.047 mm for this visualization method. This visualization approach provides greatly improved registration and inter-component measurements than current alternative strategies. This process is suitable for a number of other joints and would greatly benefit procedures that analyze component interactions and implant performance over time. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 35:2017-2022, 2017.
authors.affiliation: Department of Medical Biophysics, Schulich School of Medicine and Dentistry, Western University, 1151 Richmond Street, London, N6A 3K7, Ontario, Canada.
authors.forename: Kimberley
authors.initials: K
authors.lastname: Lam-Tin-Cheung
authors.affiliation: Imaging Research Laboratories, Robarts Research Institute, Schulich School of Medicine and Dentistry, Western University, 1151 Richmond St. N., London, N6A 5B7, Ontario, Canada.
authors.forename: Xunhua
authors.initials: X
authors.lastname: Yuan
authors.affiliation: Imaging Research Laboratories, Robarts Research Institute, Schulich School of Medicine and Dentistry, Western University, 1151 Richmond St. N., London, N6A 5B7, Ontario, Canada.
authors.forename: Hristo N
authors.initials: HN
authors.lastname: Nikolov
authors.affiliation: Division of Orthopaedic Surgery, Department of Surgery, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada.
authors.forename: Brent A
authors.initials: BA
authors.lastname: Lanting
authors.affiliation: Division of Orthopaedic Surgery, Department of Surgery, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada.
authors.forename: Douglas D
authors.initials: DD
authors.lastname: Naudie
authors.affiliation: Department of Medical Biophysics, Schulich School of Medicine and Dentistry, Western University, 1151 Richmond Street, London, N6A 3K7, Ontario, Canada.|Imaging Research Laboratories, Robarts Research Institute, Schulich School of Medicine and Dentistry, Western University, 1151 Richmond St. N., London, N6A 5B7, Ontario, Canada.|Division of Orthopaedic Surgery, Department of Surgery, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada.|Surgical Innovation Program, Lawson Health Research Institute, 339 Windermere Road, London, N6A 5A5, ON, Canada.
authors.forename: Matthew G
authors.initials: MG
authors.lastname: Teeter
mesh_terms: D021621:Imaging, Three-Dimensional; D020959:Polyethylene; D019736:Prostheses and Implants; D011859:Radiography / Q000379:methods*; D055114:X-Ray Microtomography
chemical_list: D020959:Polyethylene
keywords: polyethylene visualization; radiographic imaging; radiostereometric analysis; three-dimensional registration; total knee replacement