Knowledge of anterior–posterior (A-P) tibial contact locations provides an objective assessment of the relative motion of the tibia on the femur following total knee arthroplasty (TKA), which can be used to compare the effects of different components, surgical techniques, and alignment goals on knee function in vivo. Both the lowest point method and the penetration method have been used to calculate A-P tibial contact locations using three-dimensional (3D) model to two-dimensional (2D) image registration. The primary objective of this study was to quantify errors in calculating the A-P tibial contact location using the lowest point and penetration methods because the errors in calculating the A-P tibial contact locations using these two methods are unknown. The A-P tibial contact locations were calculated with the two methods and simultaneously measured with a tibial force sensor in ten fresh-frozen cadaveric knee specimens with a TKA. Single-plane radiographs of the knee specimens were acquired at 0 deg, 30 deg, 60 deg, and 90 deg of flexion in neutrally, internally, and externally rotated orientations. While the radiographs were exposed, reference A-P tibial contact locations were simultaneously collected using the tibial force sensor to be compared to the calculated A-P tibial contact locations. The overall root-mean-squared-errors (RMSEs) in the A-P tibial contact location calculated with the lowest point method, the penetration method with penetration, and penetration method without penetration were 5.5 mm, 3.6 mm, and 8.9 mm, respectively. The overall RMSE was lowest for the penetration method with penetration, making it the superior method for calculating A-P tibial contact locations.

References

References
1.
Kurtz
,
S.
,
Ong
,
K.
,
Lau
,
E.
,
Mowat
,
F.
, and
Halpern
,
M.
,
2007
, “
Projections of Primary and Revision Hip and Knee Arthroplasty in the United States From 2005 to 2030
,”
J. Bone Jt. Surg. Am.
,
89
(
4
), pp.
780
785
.
2.
Baker
,
P. N.
,
van der Meulen
,
J. H.
,
Lewsey
,
J.
, and
Gregg
,
P. J.
,
2007
, “
The Role of Pain and Function in Determining Patient Satisfaction After Total Knee Replacement. Data From the National Joint Registry for England and Wales
,”
J. Bone Jt. Surg.
,
89
(
7
), pp.
893
900
.
3.
Bourne
,
R. B.
,
Chesworth
,
B. M.
,
Davis
,
A. M.
,
Mahomed
,
N. N.
, and
Charron
,
K. D. J.
,
2010
, “
Patient Satisfaction After Total Knee Arthroplasty: Who Is Satisfied and Who Is Not?
,”
Clin. Orthop. Relat. Res.
,
468
(
1
), pp.
57
63
.
4.
Noble
,
P. C.
,
Conditt
,
M. A.
,
Cook
,
K. F.
, and
Mathis
,
K. B.
,
2006
, “
The John Insall Award: Patient Expectations Affect Satisfaction With Total Knee Arthroplasty
,”
Clin. Orthop. Relat. Res.
,
452
, pp.
35
43
.
5.
Banks
,
S. A.
, and
Hodge
,
W. A.
,
1996
, “
Accurate Measurement of Three-Dimensional Knee Replacement Kinematics Using Single-Plane Fluoroscopy
,”
IEEE Trans. Biomed. Eng.
,
43
(
6
), pp.
638
649
.
6.
Blunn
,
G. W.
,
Walker
,
P. S.
,
Joshi
,
A.
, and
Hardinge
,
K.
,
1991
, “
The Dominance of Cyclic Sliding in Producing Wear in Total Knee Replacements
,”
Clin. Orthop. Relat. Res.
,
273
, pp.
253
260
.
7.
Meccia
,
B.
,
Komistek
,
R. D.
,
Mahfouz
,
M.
, and
Dennis
,
D.
,
2014
, “
Abnormal Axial Rotations in TKA Contribute to Reduced Weightbearing Flexion
,”
Clin. Orthop. Relat. Res.
,
472
(
1
), pp.
248
253
.
8.
Komistek
,
R. D.
,
Dennis
,
D. A.
, and
Mahfouz
,
M.
,
2003
, “
In Vivo Fluoroscopic Analysis of the Normal Human Knee
,”
Clin. Orthop. Relat. Res.
,
410
, pp.
69
81
.
9.
Banks
,
S.
,
Bellemans
,
J.
,
Nozaki
,
H.
,
Whiteside
,
L. A.
,
Harman
,
M.
, and
Hodge
,
W. A.
,
2003
, “
Knee Motions During Maximum Flexion in Fixed and Mobile-Bearing Arthroplasties
,”
Clin. Orthop. Relat. Res.
,
410
, pp.
131
138
.
10.
Victor
,
J.
,
Banks
,
S.
, and
Bellemans
,
J.
,
2005
, “
Kinematics of Posterior Cruciate Ligament-Retaining and -Substituting Total Knee Arthroplasty: A Prospective Randomised Outcome Study
,”
J. Bone Jt. Surg.
,
87
(
5
), pp.
646
655
.
11.
Victor
,
J.
,
Mueller
,
J. K.
,
Komistek
,
R. D.
,
Sharma
,
A.
,
Nadaud
,
M. C.
, and
Bellemans
,
J.
,
2010
, “
In Vivo Kinematics After a Cruciate-Substituting TKA
,”
Clin. Orthop. Relat. Res.
,
468
(
3
), pp.
807
814
.
12.
Howell
,
S. M.
,
Hodapp
,
E. E.
,
Vernace
,
J. V.
,
Hull
,
M. L.
, and
Meade
,
T. D.
,
2013
, “
Are Undesirable Contact Kinematics Minimized After Kinematically Aligned Total Knee Arthroplasty? An Intersurgeon Analysis of Consecutive Patients
,”
Knee Surg. Sports Traumatol. Arthroscopy
,
21
(
10
), pp.
2281
2287
.
13.
Acker
,
S.
,
Li
,
R.
,
Murray
,
H.
,
John
,
P. S.
,
Banks
,
S.
,
Mu
,
S.
,
Wyss
,
U.
, and
Deluzio
,
K.
,
2011
, “
Accuracy of Single-Plane Fluoroscopy in Determining Relative Position and Orientation of Total Knee Replacement Components
,”
J. Biomech.
,
44
(
4
), pp.
784
787
.
14.
Mahfouz
,
M. R.
,
Hoff
,
W. A.
,
Komistek
,
R. D.
, and
Dennis
,
D. A.
,
2003
, “
A Robust Method for Registration of Three-Dimensional Knee Implant Models to Two-Dimensional Fluoroscopy Images
,”
IEEE Trans. Med. Imaging
,
22
(
12
), pp.
1561
1574
.
15.
Li
,
G.
,
Van de Velde
,
S. K.
, and
Bingham
,
J. T.
,
2008
, “
Validation of a Non-Invasive Fluoroscopic Imaging Technique for the Measurement of Dynamic Knee Joint Motion
,”
J. Biomech.
,
41
(
7
), pp.
1616
1622
.
16.
Dennis
,
D. A.
,
Komistek
,
R. D.
,
Mahfouz
,
M. R.
,
Haas
,
B. D.
, and
Stiehl
,
J. B.
,
2003
, “
Conventry Award Paper: Multicenter Determination of In Vivo Kinematics After Total Knee Arthroplasty
,”
Clin. Orthop. Relat. Res.
,
416
, pp.
37
57
.
17.
Banks
,
S. A.
,
Markovich
,
G. D.
, and
Hodge
,
W. A.
,
1997
, “
In Vivo Kinematics of Cruciate-Retaining and -Substituting Knee Arthroplasties
,”
J. Arthroplasty
,
12
(
3
), pp.
297
304
.
18.
Banks
,
S. A.
, and
Hodge
,
W. A.
,
2004
, “
Implant Design Affects Knee Arthroplasty Kinematics During Stair-Stepping
,”
Clin. Orthop. Relat. Res.
,
426
, pp.
187
193
.
19.
Incavo
,
S. J.
,
Mullins
,
E. R.
,
Coughlin
,
K. M.
,
Banks
,
S.
,
Banks
,
A.
, and
Beynnon
,
B. D.
,
2004
, “
Tibiofemoral Kinematic Analysis of Kneeling After Total Knee Arthroplasty
,”
J. Arthroplasty
,
19
(
7
), pp.
906
910
.
20.
Kitagawa
,
A.
,
Tsumura
,
N.
,
Chin
,
T.
,
Gamada
,
K.
,
Banks
,
S. A.
, and
Kurosaka
,
M.
,
2010
, “
In Vivo Comparison of Knee Kinematics Before and After High-Flexion Posterior Cruciate-Retaining Total Knee Arthroplasty
,”
J. Arthroplasty
,
25
(
6
), pp.
964
969
.
21.
Kuroyanagi
,
Y.
,
Mu
,
S.
,
Hamai
,
S.
,
Robb
,
W. J.
, and
Banks
,
S. A.
,
2012
, “
In Vivo Knee Kinematics During Stair and Deep Flexion Activities in Patients With Bicruciate Substituting Total Knee Arthroplasty
,”
J. Arthroplasty
,
27
(
1
), pp.
122
128
.
22.
Okamoto
,
N.
,
Breslauer
,
L.
,
Hedley
,
A. K.
,
Mizuta
,
H.
, and
Banks
,
S. A.
,
2011
, “
In Vivo Knee Kinematics in Patients With Bilateral Total Knee Arthroplasty of 2 Designs
,”
J. Arthroplasty
,
26
(
6
), pp.
914
918
.
23.
Scott
,
G.
,
Imam
,
M.
,
Eifert
,
A.
,
Freeman
,
M.
,
Pinskerova
,
V.
,
Field
,
R.
,
Skinner
,
J.
, and
Banks
,
S.
,
2016
, “
Can a Total Knee Arthroplasty Be Both Rotationally Unconstrained and Anteroposteriorly Stabilised?
,”
Bone Jt. Res.
,
5
(
3
), pp.
80
86
.
24.
Dennis
,
D. A.
,
Komistek
,
R. D.
,
Hoff
,
W. A.
, and
Gabriel
,
S. M.
,
1996
, “
In Vivo Knee Kinematics Derived Using an Inverse Perspective Technique
,”
Clin. Orthop. Relat. Res.
,
331
, pp.
107
117
.
25.
Li
,
G.
,
Suggs
,
J.
,
Hanson
,
G.
,
Durbhakula
,
S.
,
Johnson
,
T.
, and
Freiberg
,
A.
,
2006
, “
Three-Dimensional Tibiofemoral Articular Contact Kinematics of a Cruciate-Retaining Total Knee Arthroplasty
,”
J. Bone Jt. Surg. Am.
,
88
(
2
), pp.
395
402
.
26.
DeFrate
,
L. E.
,
Sun
,
H.
,
Gill
,
T. J.
,
Rubash
,
H. E.
, and
Li
,
G.
,
2004
, “
In Vivo Tibiofemoral Contact Analysis Using 3D MRI-Based Knee Models
,”
J. Biomech.
,
37
(
10
), pp.
1499
1504
.
27.
Howell
,
S. M.
,
Papadopoulos
,
S.
,
Kuznik
,
K. T.
, and
Hull
,
M. L.
,
2013
, “
Accurate Alignment and High Function After Kinematically Aligned TKA Performed With Generic Instruments
,”
Knee Surg. Sports Traumatol. Arthroscopy
,
21
(
10
), pp.
2271
2280
.
28.
Merican
,
A. M.
,
Ghosh
,
K. M.
,
Deehan
,
D. J.
, and
Amis
,
A. A.
,
2009
, “
The Transpatellar Approach for the Knee in the Laboratory
,”
J. Orthop. Res.
,
27
(
3
), pp.
330
334
.
29.
Roth
,
J. D.
,
Howell
,
S. M.
, and
Hull
,
M. L.
,
2017
, “
An Improved Tibial Force Sensor to Compute Contact Forces and Contact Locations In Vitro After Total Knee Arthroplasty
,”
ASME J. Biomech. Eng.
,
139
(
4
), p.
041001
.
30.
Blankevoort
,
L.
,
Huiskes
,
R.
, and
de Lange
,
A.
,
1988
, “
The Envelope of Passive Knee Joint Motion
,”
J. Biomech.
,
21
(
9
), pp.
705
720
.
31.
Prins
,
A. H.
,
Kaptein
,
B. L.
,
Stoel
,
B. C.
,
Reiber
,
J. H.
, and
Valstar
,
E. R.
,
2010
, “
Detecting Femur-Insert Collisions to Improve Precision of Fluoroscopic Knee Arthroplasty Analysis
,”
J. Biomech.
,
43
(
4
), pp.
694
700
.
32.
Howell
,
S. M.
, and
Hull
,
M. L.
,
2012
, “
Kinematic Alignment in Total Knee Arthroplasty
,”
Surgery of the Knee
,
W. N.
Scott
and
J. N.
Insall
, eds.,
Elsevier
,
Philadelphia, PA
, pp.
1255
1268
.
33.
Howell
,
S. M.
,
Hull
,
M. L.
, and
Mahfouz
,
M. R.
,
2017
, “
Kinematic Alignment in Total Knee Arthroplasty
,”
Insall and Scott Surgery of the Knee
,
S.
Scott
, ed.,
Elsevier
,
Philadelphia, PA
.
34.
Taylor
,
J. R.
,
1997
,
An Introduction to Error Analysis
,
University Science Books
,
Sausalito, CA
.
35.
Efron
,
B.
, and
Tibshirani
,
R.
,
1986
, “
Bootstrap Methods for Standard Errors, Confidence Intervals, and Other Measures of Statistical Accuracy
,”
Stat. Sci.
,
1
(
1
), pp.
54
75
.
36.
Liau
,
J. J.
,
Cheng
,
C. K.
,
Huang
,
C. H.
, and
Lo
,
W. H.
,
2002
, “
The Effect of Malalignment on Stresses in Polyethylene Component of Total Knee Prostheses—A Finite Element Analysis
,”
Clin. Biomech.
,
17
(
2
), pp.
140
146
.
37.
D'Lima
,
D. D.
,
Patil
,
S.
,
Steklov
,
N.
, and
Colwell
,
C. W.
, Jr.
,
2011
, “
The 2011 ABJS Nicolas Andry Award: ‘Lab’-in-a-Knee: In Vivo Knee Forces, Kinematics, and Contact Analysis
,”
Clin. Orthop. Relat. Res.
,
469
(
10
), pp.
2953
2970
.
38.
Banks
,
S. A.
,
2017
, personal communication.
39.
Kretzer
,
J. P.
,
Jakubowitz
,
E.
,
Sonntag
,
R.
,
Hofmann
,
K.
,
Heisel
,
C.
, and
Thomsen
,
M.
,
2010
, “
Effect of Joint Laxity on Polyethylene Wear in Total Knee Replacement
,”
J. Biomech.
,
43
(
6
), pp.
1092
1096
.
You do not currently have access to this content.