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Assessing the patellar tracking pattern before versus after total knee arthroplasty using dynamic computed tomography : a cadaveric study

Brekel, A. van den (2021) Assessing the patellar tracking pattern before versus after total knee arthroplasty using dynamic computed tomography : a cadaveric study.

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Abstract:Purpose: Up to 30% of patients experience anterior knee pain after Total Knee Arthroplasty (TKA). It is thought that a change in the patellar tracking pattern after TKA might lead to anterior knee pain. To clarify this relationship, there is need for a technique to directly assess the patellar tracking pattern before versus after TKA. This study investigated to what extent dynamic Computed Tomography (CT) can be used to assess the patellar tracking pattern before versus after TKA. Materials and methods: Static and dynamic CT images with different acquisition and reconstruction parameters were obtained of two human cadaveric knees before and after TKA. Qualitative and quantitative image analysis and radiation dose calculations were performed to find the most suitable dynamic CT imaging method. The patellar tracking pattern before and after TKA was assessed from these dynamic CT images in terms of patellar flexion, tilt, rotation and shift. Results: CT images obtained at the highest tube voltage and tube current, reconstructed without a metal artifact reduction algorithm and with a bone reconstruction kernel provided the best image quality. These images were used to assess the patellar tracking pattern. With the developed method, differences were found between the pre and post TKA patellar tracking pattern. Conclusion: A method for the assessment of the patellar tracking pattern before versus after TKA using dynamic CT was successfully developed. Once automated, the developed method can be used to clarify the relationship between a change in the patellar tracking pattern after TKA and anterior knee pain. This may potentially guide orthopaedic surgeons in their surgical approach, ultimately improving TKA outcomes.
Item Type:Essay (Master)
Faculty:TNW: Science and Technology
Subject:44 medicine, 50 technical science in general
Programme:Technical Medicine MSc (60033)
Link to this item:http://purl.utwente.nl/essays/86575
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