SLAM-TKA: Real-time Intra-operative Measurement of Tibial Resection Plane in Conventional Total Knee Arthroplasty

TL;DR

This paper introduces a real-time intra-operative SLAM-based system to accurately measure the tibial resection plane during conventional total knee arthroplasty, aiming to improve implant positioning accuracy.

Contribution

The study presents a novel SLAM approach that uses intra-operative X-ray images and pre-operative CT-based models to precisely evaluate tibial resection in real-time, minimally disrupting standard procedures.

Findings

Demonstrated robustness in simulation and in-vivo tests.

Achieved accurate intra-operative measurement of tibial resection plane.

Potential to reduce implant misalignment and revision rates.

Abstract

Total knee arthroplasty (TKA) is a common orthopaedic surgery to replace a damaged knee joint with artificial implants. The inaccuracy of achieving the planned implant position can result in the risk of implant component aseptic loosening, wear out, and even a joint revision, and those failures most of the time occur on the tibial side in the conventional jig-based TKA (CON-TKA). This study aims to precisely evaluate the accuracy of the proximal tibial resection plane intra-operatively in real-time such that the evaluation processing changes very little on the CON-TKA operative procedure. Two X-ray radiographs captured during the proximal tibial resection phase together with a pre-operative patient-specific tibia 3D mesh model segmented from computed tomography (CT) scans and a trocar pin 3D mesh model are used in the proposed simultaneous localisation and mapping (SLAM) system to estimate the proximal tibial resection plane. Validations using both simulation and in-vivo datasets are performed to demonstrate the robustness and the potential clinical value of the proposed algorithm.