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Automatic string generation for estimating in vivo length changes of the medial patellofemoral ligament during knee flexion

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Abstract

Modeling ligaments as three-dimensional strings is a popular method for in vivo estimation of ligament length. The purpose of this study was to develop an algorithm for automated generation of non-penetrating strings between insertion points and to evaluate its feasibility for estimating length changes of the medial patellofemoral ligament during normal knee flexion. Three-dimensional knee models were generated from computed tomography (CT) scans of 10 healthy subjects. The knee joint under weight-bearing was acquired in four flexion positions (0°–120°). The path between insertion points was computed in each position to quantify string length and isometry. The average string length was maximal in 0° of flexion (64.5 ± 3.9 mm between femoral and proximal patellar point; 62.8 ± 4.0 mm between femoral and distal patellar point). It was minimal in 30° (60.0 ± 2.6 mm) for the proximal patellar string and in 120° (58.7 ± 4.3 mm) for the distal patellar string. The insertion points were considered to be isometric in 4 of the 10 subjects. The proposed algorithm appears to be feasible for estimating string lengths between insertion points in an automatic fashion. The length measurements based on CT images acquired under physiological loading conditions may give further insights into knee kinematics.

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Conflict of interest

The authors declared that they have no conflicts of interests in the authorship and publication of this contribution.

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Authors and Affiliations

  1. Computer Assisted Research and Development Group, University Hospital Balgrist, University of Zurich, Forchstrasse 340, 8008, Zurich, Switzerland

    Matthias Graf, Lazaros Vlachopoulos & Philipp Fürnstahl

  2. Computer Vision Laboratory, ETH Zurich, Zurich, Switzerland

    Salomon Diether

  3. Department of Orthopedic Surgery, University Hospital Balgrist, University of Zurich, Zurich, Switzerland

    Sandro Fucentese

Authors
  1. Matthias Graf
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  2. Salomon Diether
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  3. Lazaros Vlachopoulos
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  4. Sandro Fucentese
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  5. Philipp Fürnstahl
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Correspondence to Philipp Fürnstahl.

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Graf, M., Diether, S., Vlachopoulos, L. et al. Automatic string generation for estimating in vivo length changes of the medial patellofemoral ligament during knee flexion. Med Biol Eng Comput 52, 511–520 (2014). https://doi.org/10.1007/s11517-014-1156-8

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  • DOI: https://doi.org/10.1007/s11517-014-1156-8

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