[Truncated abstract] Measuring the kinematics of joints and implants following orthopaedic surgery is important since joint motion directly influences the functional outcome of the patient and the longevity of the implant. Radiostereometric Analysis (RSA) has been used to assess the motion over time of various joints and implant designs following corrective orthopaedic and joint replacement surgery for more than 20 years in more than 10,000 patients around the world. While the use of RSA reduces the risk of implanting potentially inferior prostheses on a large scale, conventional methodological procedures are based on the acquisition of static, stereographic x-ray images that are not suitable for measuring skeletal kinematics in a dynamic manner. The purpose of this thesis was to design, validate and test a novel technique for dynamically assessing the skeletal motion of human subjects using RSA and single-plane digital x-ray video fluoroscopy. The validation procedure utilised two in-vitro phantom models of human joints capable of simulating normal kinematic motion. These phantom models were supplied with realistic spatial displacement protocols derived from cadaveric specimens. The spatial positions of a series of tantalum markers that were implanted in each skeletal segment were measured using RSA. Skeletal motion was determined in x-ray fluoroscopy images by minimising the difference between the markers measured and projected in the single image plane. Accuracy was determined in terms of bias and precision by analysing the deviation between the applied displacement protocol and measured pose estimates. ... The RSA and low dose single-plane fluoroscopy technique developed, validated and tested in this thesis is capable of dynamically measuring the kinematics of any joint in the human body, following the implantation of small metallic markers in the surrounding bone during corrective orthopaedic surgery. The kinematics of joints with replacement prostheses, such as the total knee replacement (TKR), can be analysed in addition to the kinematics of joints without replacement prostheses, such as the sacroiliac joint. The technique may be used in the future on groups of human subjects enrolled in controlled trials that are designed to analyse the kinematics of the shoulder, spine, hip, knee, patella or ankle joints for the purposes of quantitatively comparing the kinematics of different prosthesis designs and various corrective orthopaedic procedures.
| Identifer | oai:union.ndltd.org:ADTP/221252 |
| Date | January 2006 |
| Creators | Ioppolo, James |
| Publisher | University of Western Australia. Orthopaedics Unit |
| Source Sets | Australiasian Digital Theses Program |
| Language | English |
| Detected Language | English |
| Rights | Copyright James Ioppolo, http://www.itpo.uwa.edu.au/UWA-Computer-And-Software-Use-Regulations.html |
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