- 期刊
- OpenAccess
Use of a 3-D CT reconstruction image to locate the adductor tubercle and to measure the joint-line distance in knee arthroplasty
摘要
Background: There are difficulties in locating the adductor tubercle (AT) to measure the joint line distance on a radiograph because of landmark identification and the geographic magnification associated with the use of the radiograph. Purpose: The objective of this study was to determine if employing a three-dimensional computed tomography (3-D CT) image could overcome these disadvantages, making the AT an eligible image landmark. Methods: First, initial validation of the 3-D CT measurement was performed using a bone specimen study, where the AT to the joint line distance (ATJL) was measured on each of 10 femoral bone specimens physically and also on respective 3-D CT images. Second, 40 clinical 3-D CT images were employed to analyze the intraobserver and inter-observer reliability in the clinical setting. Lastly, these clinical 3-D CT data were compared to the intraoperative ATJL measurement in our previous publication, using statistical analysis to seek for further validation. Results: The intraclass correlation coefficient (ICC) for the bone specimen study was 0.95, which implied a high agreement between the measurement made by the caliper and on the 3-D CT image. In the clinical study, the statistical analysis showed an excellent intra-observer and inter-observer reliability for ATJL measurements (ICC: 0.964 and 0.939). When compared to the data of the intra-operative ATJL measurement in our previous publication, the Kolmogorov- Smirnov test showed the similarity of the two techniques. Conclusion: The accuracy and reliability of measurement of the ATJL on the 3-D CT image have been well demonstrated in this study. We suggest using this technique to plan the joint line position before surgery in revision knee arthroplasty involving significant bone loss.
延伸閱讀
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