Medical imaging of knee kinematics after joint replacement

关节置换后膝关节运动学的医学成像

• 批准号: 350822-2008
• 负责人: Anglin, Carolyn
• 金额: $ 2.93万
• 依托单位: University of Calgary
• 依托单位国家: 加拿大
• 项目类别: Collaborative Health Research Projects
• 财政年份: 2010
• 资助国家: 加拿大
• 起止时间: 2010-01-01 至 2011-12-31
• 项目状态: 已结题
• 来源: https://www.nserc-crsng.gc.ca/ase-oro/Details-Detailles_eng.asp?id=459233
• 关键词: Medical; imaging; knee; kinematics; after

The primary reason for someone to get a knee replacement is to reduce his or her pain due to arthritis. Unfortunately, some people still have considerable pain after the surgery, often in the region of the kneecap (called anterior knee pain). Frequently this pain is attributed to incorrect tracking of the kneecap (patella) on the thigh bone (femur) due to improper component design, incorrect placement of the components, excessively tight soft tissues or poor surgical technique. Currently, the only method most surgeons use to 'look inside' the knee is X-rays, which are two-dimensional images at a single angle of knee flexion. These provide inadequate information to study the movements of the bones. We are proposing to develop a new method to measure the three-dimensional positions of both the bones and components after knee replacement surgery at different flexion angles, using computed tomography (CT). CT produces a 3D image of the patient's knees. The metal components create streaks on the image, making it difficult to identify the bones and components accurately, however we are proposing several ways to address this. We will validate the protocol using reference arrays inserted into cadaveric knee specimens. We will then apply the protocol to patients in order to judge whether or not a recent implant design improves kneecap motion; subsequently, we will compare patients with and without pain. In addition, and in contrast, to CT, we will develop a protocol for two-dimensional fluoroscopic imaging, which is dynamic (i.e. captures a video of movement), inexpensive, widely available and could be applied in

有人替换膝盖的主要原因是减轻因关节炎引起的疼痛。 不幸的是，手术后，有些人通常在膝盖腹肌（称为前膝盖疼痛）中会出现相当大的疼痛。这种疼痛通常归因于由于成分设计不当，组件的放置不正确，软组织过度或较差的手术技术而导致大腿骨（股骨）上膝盖骨（patella）的不正确跟踪。目前，大多数外科医生用来“看”膝盖的唯一方法是X射线，它们是二维图像，单次膝盖屈曲。这些提供了不充分的信息来研究骨骼的运动。 我们建议使用计算机断层扫描（CT）开发一种新方法，以在不同屈曲角度以不同的屈曲角度来衡量骨骼和成分的三维位置。 CT产生患者膝盖的3D图像。金属组件在图像上产生条纹，因此难以准确识别骨骼和成分，但是我们提出了几种解决此问题的方法。我们将使用插入尸体膝关节样本中的参考阵列来验证协议。然后，我们将将该方案应用于患者，以判断最近的植入物设计是否改善了KNEECAP运动；随后，我们将比较有和没有疼痛的患者。此外，与CT相比，我们将开发一种用于二维荧光影像成像的协议，该协议是动态的（即捕获运动视频），廉价，可广泛可用，可以在