A new method for estimating three-dimensional movement of the patella using a surface mapping method and computed tomography

Introduction: A previous study reported a method called the 2D-3D registration technique to examine threedimensional movement of the patella. However, that method requires a biplane fluoroscopy system. In the present study, the aim was to establish a new method (CT-based surface mapping method) to estimate three-dimensional positions and angles of the patella with a motion capture system and CT. Methods: In Study 1, the most appropriate parameters for the CT-based surface mapping method (i.e., target edge length, threshold of thickness of the soft tissue, and minimum distance between markers) were explored and determined. In Study 2, three-dimensional movement (i.e., positions and angles) of the patella using the CT-based surface mapping method and the most appropriate parameters were determined, and they were compared with the true positions and angles obtained by CT. Results: The results of Study 1 showed that the most appropriate conditions were as follows: (1) target edge length, 3 mm; (2) threshold of thickness of the soft tissue, 0-20 mm; and (3) minimum distance between markers, 10 mm. The results of Study 2 showed that the errors of the positions and angles were less than approximately 10 mm and 10 degrees at most, respectively (both supine and sitting positions). Conclusion: The CT-based surface mapping method may be useful for a future study to clarify differences in three-dimensional movements of the patella between patients with patellar tendinitis and healthy subjects.