Evidence map›Paper›PMID 40576921›Full record

ArticleInternational journal of computer assisted radiology and surgery2025

Automation in tibial implant loosening detection using deep-learning segmentation.

C Magg, M A Ter Wee, G S Buijs, A J Kievit, M U Schafroth, J G G Dobbe, G J Streekstra, C I Sánchez, L Blankevoort

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Article in International journal of computer assisted radiology and surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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1citing papers in PubMed
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1 · What the graph read from it

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2 · The registry

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3 · Its place in the literature

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1 citing paper in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

9 authors.

C MaggQuantitative Healthcare Analysis (QurAI) Group, Informatics Institute, University of Amsterdam, Amsterdam, The Netherlands. c.magg@amsterdamumc.nl.ORCID http://orcid.org/0009-0008-5592-2586
M A Ter WeeBiomedical Engineering and Physics, Amsterdam UMC Location University of Amsterdam, Amsterdam, The Netherlands.
G S BuijsDepartment of Orthopedic Surgery and Sports Medicine, Amsterdam UMC Location University of Amsterdam, Amsterdam, The Netherlands.
A J KievitDepartment of Orthopedic Surgery and Sports Medicine, Amsterdam UMC Location University of Amsterdam, Amsterdam, The Netherlands.
M U SchafrothDepartment of Orthopedic Surgery and Sports Medicine, Amsterdam UMC Location University of Amsterdam, Amsterdam, The Netherlands.
J G G DobbeBiomedical Engineering and Physics, Amsterdam UMC Location University of Amsterdam, Amsterdam, The Netherlands.
G J StreekstraBiomedical Engineering and Physics, Amsterdam UMC Location University of Amsterdam, Amsterdam, The Netherlands.
C I SánchezQuantitative Healthcare Analysis (QurAI) Group, Informatics Institute, University of Amsterdam, Amsterdam, The Netherlands.
L BlankevoortDepartment of Orthopedic Surgery and Sports Medicine, Amsterdam UMC Location University of Amsterdam, Amsterdam, The Netherlands.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposePatients with recurrent complaints after total knee arthroplasty may suffer from aseptic implant loosening. Current imaging modalities do not quantify looseness of knee arthroplasty components. A recently developed and validated workflow quantifies the tibial component displacement relative to the bone from CT scans acquired under valgus and varus load. The 3D analysis approach includes segmentation and registration of the tibial component and bone. In the current approach, the semi-automatic segmentation requires user interaction, adding complexity to the analysis. The research question is whether the segmentation step can be fully automated while keeping outcomes indifferent.

methodsIn this study, different deep-learning (DL) models for fully automatic segmentation are proposed and evaluated. For this, we employ three different datasets for model development (20 cadaveric CT pairs and 10 cadaveric CT scans) and evaluation (72 patient CT pairs). Based on the performance on the development dataset, the final model was selected, and its predictions replaced the semi-automatic segmentation in the current approach. Implant displacement was quantified by the rotation about the screw-axis, maximum total point motion, and mean target registration error.

resultsThe displacement parameters of the proposed approach showed a statistically significant difference between fixed and loose samples in a cadaver dataset, as well as between asymptomatic and loose samples in a patient dataset, similar to the outcomes of the current approach. The methodological error calculated on a reproducibility dataset showed values that were not statistically significant different between the two approaches. The results of the proposed and current approaches showed excellent reliability for one and three operators on two datasets.

conclusionThe conclusion is that a full automation in knee implant displacement assessment is feasible by utilizing a DL-based segmentation model while maintaining the capability of distinguishing between fixed and loose implants.

Indexed as

Arthroplasty, Replacement, KneeDeep LearningKnee ProsthesisProsthesis FailureTibiaTomography, X-Ray ComputedCadaverHumansImaging, Three-DimensionalAseptic looseningDeep learningSegmentationTotal knee arthroplasty

Identifiers

PMID40576921
PMCPMC12518389

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.