Isocentric 3-dimensional C-arm imaging of component alignments in total knee arthroplasty with potential intraoperative and postoperative applications.

Journal of Arthroplasty

PubMedID: 22810011

Amiri S, Wilson DR, Anglin C, Van Houwelingen A, Masri BA. Isocentric 3-dimensional C-arm imaging of component alignments in total knee arthroplasty with potential intraoperative and postoperative applications. J Arthroplasty. 2013;28(2):248-54.
An intraoperative imaging tool for total knee arthroplasty could help avoid poor clinical outcomes related to malalignment. We investigated the feasibility of using isocentric (ISO-C) fluoroscopic imaging for this purpose. Three-dimensional ISO-C and computed tomographic (CT) images were acquired from 6 cadaveric specimens implanted with standard knee arthroplasty components and analyzed to determine rotational alignments. In comparison with standard CT measures, the ISO-C-based measures had overall accuracies (determined as root mean square error) of 0.8° and 1.3° and corresponding SDs of 1.3° and 1.4° for the femoral and tibial components, respectively. With ISO-C imaging, it is possible to measure rotational alignment in knee arthroplasty with accuracy and repeatability comparable with CT. Isocentric imaging has strong potential as an intraoperative tool to accurately align arthroplasty components.