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Bone Tunnel Placement Determination Method for 3D Images and Its Evaluation for Anterior Cruciate Ligament Reconstruction

[ Vol. 16 , Issue. 5 ]

Author(s):

Kento Morita*, Manabu Nii, Min-Sung Koh, Kaori Kashiwa, Hiroshi Nakayama, Shunichiro Kambara, Shinichi Yoshiya and Syoji Kobashi   Pages 491 - 498 ( 8 )

Abstract:


Background: Anterior cruciate ligament (ACL) injury causes knee instability which affects sports activity involving cutting and twisting motions. The ACL reconstruction surgery replaces the damaged ACL with artificial one which is fixed to the bone tunnels opened by the surgeon. The outcome of the ACL reconstruction is strongly related to the placement of the bone tunnels, therefore, the optimization of tunnel drilling technique is an important factor to obtain satisfactory surgical results.

Aims: The quadrant method is used for the post-operative evaluation of the ACL reconstruction surgery, which evaluates the bone tunnel opening sites on the lateral 2D X-ray radiograph.

Methods: For the purpose of applying the quadrant method to the pre-operative knee MRI, we have synthesized the pseudo lateral 2D X-ray radiograph from the patients' knee MRI. This paper proposes a computer-aided surgical planning system for the ACL reconstruction. The proposed system estimates appropriate bone tunnel opening sites on the pseudo lateral 2D X-ray radiograph synthesized from the pre-operative knee MRI.

Results: In the experiment, the proposed method was applied to 98 subjects including subjects with osteoarthritis. The experimental results showed that the proposed method can estimate the bone tunnel opening sites accurately. The other experiment using 36 healthy patients showed that the proposed method is robust to the knee shape deformation caused by disease.

Conclusion: It is verified that the proposed method can be applied to subjects with osteoarthritis.

Keywords:

Pre-operative surgical planning system, computer-aided diagnosis, anterior cruciate ligament reconstruction, magnetic resonance image, quadrant method, blumensaat's line.

Affiliation:

Graduate School of Engineering, University of Hyogo, Himeji, Graduate School of Engineering, University of Hyogo, Himeji, School of Computing and Engineering Sciences, Eastern Washington University, Cheney, WA, Department of Orthopaedics, Hyogo College of Medicine, Nishinomiya, Department of Orthopaedics, Hyogo College of Medicine, Nishinomiya, Department of Orthopaedics, Hyogo College of Medicine, Nishinomiya, Department of Orthopaedics, Hyogo College of Medicine, Nishinomiya, Graduate School of Engineering, University of Hyogo, Himeji

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