Dataset Information

Accuracy and feasibility of high-speed dual fluoroscopy and model-based tracking to measure in vivo ankle arthrokinematics.

ABSTRACT: The relationship between altered tibiotalar and subtalar kinematics and development of ankle osteoarthritis is unknown, as skin marker motion analysis cannot measure articulations of each joint independently. Here, we quantified the accuracy and demonstrated the feasibility of high-speed dual fluoroscopy (DF) to measure and visualize the three-dimensional articulation (i.e., arthrokinematics) of the tibiotalar and subtalar joints. Metal beads were implanted in the tibia, talus and calcaneus of two cadavers. Three-dimensional surface models of the cadaver and volunteer bones were reconstructed from computed tomography images. A custom DF system was positioned adjacent to an instrumented treadmill. DF images of the cadavers were acquired during maximal rotation about three axes (dorsal-plantar flexion, inversion-eversion, internal-external rotation) and simulated gait (treadmill at 0.5 and 1.0 m/s). Positions of implanted beads were tracked using dynamic radiostereometric analysis (DRSA). Bead locations were also calculated using model-based markerless tracking (MBT) and compared, along with joint angles and translations, to DRSA results. The mean positional difference between DRSA and MBT for all frames defined bias; standard deviation of the difference defined precision. The volunteer was imaged with DF during treadmill gait. From these movements, joint kinematics and tibiotalar and subtalar bone-to-bone distance were calculated. The mean positional and rotational bias (±standard deviation) of MBT was 0.03±0.35 mm and 0.25±0.81°, respectively. Mean translational and rotational precision was 0.30±0.12 mm and 0.63±0.28°, respectively. With excellent measurement accuracy, DF and MBT may elucidate the kinematic pathways responsible for osteoarthritis of the tibiotalar and subtalar joints in living subjects.

SUBMITTER: Wang B

PROVIDER: S-EPMC6643275 | biostudies-literature | 2015 May

REPOSITORIES: biostudies-literature

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Accuracy and feasibility of high-speed dual fluoroscopy and model-based tracking to measure in vivo ankle arthrokinematics.

Wang Bibo B Roach Koren E KE Kapron Ashley L AL Fiorentino Niccolo M NM Saltzman Charles L CL Singer Madeline M Anderson Andrew E AE

Gait & posture 20150321 4

The relationship between altered tibiotalar and subtalar kinematics and development of ankle osteoarthritis is unknown, as skin marker motion analysis cannot measure articulations of each joint independently. Here, we quantified the accuracy and demonstrated the feasibility of high-speed dual fluoroscopy (DF) to measure and visualize the three-dimensional articulation (i.e., arthrokinematics) of the tibiotalar and subtalar joints. Metal beads were implanted in the tibia, talus and calcaneus of t ...[more]

PMID: 25864769

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Project description:BackgroundIschiofemoral impingement (IFI) is a dynamic process, but its diagnosis is often based on static, supine images.PurposeTo couple 3-dimensional (3D) computed tomography (CT) models with dual fluoroscopy (DF) images to quantify in vivo hip motion and the ischiofemoral space (IFS) in asymptomatic participants during weightbearing activities and evaluate the relationship of dynamic measurements with sex, hip kinematics, and the IFS measured from axial magnetic resonance imaging (MRI).Study designCross-sectional study; Level of evidence, 3.MethodsEleven young, asymptomatic adults (5 female) were recruited. 3D reconstructions of the femur and pelvis were generated from MRI and CT. The axial and 3D IFS were measured from supine MRI. In vivo hip motion during weightbearing activities was quantified using DF. The bone-to-bone distance between the lesser trochanter and ischium was measured dynamically. The minimum and maximum IFS were determined and evaluated against hip joint angles using a linear mixed-effects model.ResultsThe minimum IFS occurred during external rotation for 10 of 11 participants. The IFS measured from axial MRI (mean, 23.7 mm [95% CI, 19.9-27.9]) was significantly greater than the minimum IFS observed during external rotation (mean, 10.8 mm [95% CI, 8.3-13.7]; P < .001), level walking (mean, 15.5 mm [95% CI, 11.4-19.7]; P = .007), and incline walking (mean, 15.8 mm [95% CI, 11.6-20.1]; P = .004) but not for standing. The IFS was reduced with extension (β = 0.66), adduction (β = 0.22), and external rotation (β = 0.21) ( P < .001 for all) during the dynamic activities observed. The IFS was smaller in female than male participants for standing (mean, 20.9 mm [95% CI, 19.3-22.3] vs 30.4 mm [95% CI, 27.2-33.8], respectively; P = .034), level walking (mean, 8.8 mm [95% CI, 7.5-9.9] vs 21.1 mm [95% CI, 18.7-23.6], respectively; P = .001), and incline walking (mean, 9.1 mm [95% CI, 7.4-10.8] vs 21.3 mm [95% CI, 18.8-24.1], respectively; P = .003). Joint angles between the sexes were not significantly different for any of the dynamic positions of interest.ConclusionThe minimum IFS during dynamic activities was smaller than axial MRI measurements. Compared with male participants, the IFS in female participants was reduced during standing and walking, despite a lack of kinematic differences between the sexes. The relationship between the IFS and hip joint angles suggests that the hip should be placed into greater extension, adduction, and external rotation in clinical examinations and imaging, as the IFS measured from static images, especially in a neutral orientation, may not accurately represent the minimum IFS during dynamic motion. Nevertheless, this statement must be interpreted with caution, as only asymptomatic participants were analyzed herein.

Project description:BackgroundSeveral multi-segment foot models have been developed to evaluate foot and ankle motion using skin-marker motion analysis. However, few multi-segment models have been evaluated against a reference standard to establish kinematic accuracy.Research questionHow accurately do skin-markers estimate foot and ankle motion for the modified Shriners Hospitals for Children Greenville (mSHCG) multi-segment foot model when compared against the reference standard, dual fluoroscopy (DF), during gait, in asymptomatic participants?MethodsFive participants walked overground as full-body skin-marker trajectory data and DF images of the foot and shank were simultaneously acquired. Using the mSHCG model, ankle and midfoot angles were calculated throughout stance for both motion analysis techniques. Statistical parametric mapping assessed differences in joint angles and marker positions between skin-marker and DF motion analysis techniques. Paired t tests, and linear regression models were used to compare joint angles and range of motion (ROM) calculated from the two techniques.ResultsIn the coronal plane, the skin-marker model significantly overestimated ROM (p = 0.028). Further, the DF model midfoot ROM was significantly positively related to differences between DF and skin-marker midfoot angles (p = 0.035, adjusted R2 = 0.76). In the sagittal plane, skin-markers underestimated ankle angles by as much as 7.26°, while midfoot angles were overestimated by as much as 9.01°. However, DF and skin-marker joint angles were not significantly different over stance. Skin-markers on the tibia, calcaneus, and fifth metatarsal had significantly different positions than the DF markers along the direction of walking for isolated portions that were less than 10 % of stance. Euclidean distances between DF and skin-markers positions were less than 9.36 mm.SignificanceAs the accuracy of the mSHCG model was formerly unknown, the results of this study provide ranges of confidence for key angles calculated by this model.

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Dataset Information

Accuracy and feasibility of high-speed dual fluoroscopy and model-based tracking to measure in vivo ankle arthrokinematics.

Publications

Accuracy and feasibility of high-speed dual fluoroscopy and model-based tracking to measure in vivo ankle arthrokinematics.

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