Measuring Dynamic In-Vivo Elbow Kinematics: Description of Technique and Estimation of Accuracy

Background: The objectives of this study were to characterize the translational and rotational accuracy of a model-based tracking technique for quantifying elbow kinematics and to demonstrate its in vivo application. Method of Approach: The accuracy of a model-based tracking technique for quantifying elbow kinematics was determined in an in vitro experiment. Biplane X-ray images of a cadaveric elbow were acquired as it was manually moved through flexion-extension. The 3D position and orientation of each bone was determined using model-based tracking. For comparison, the position and orientation of each bone was also determined by tracking the position of implanted beads with dynamic radiostereometric analysis. Translations and rotations were calculated for both the ulnohumeral and radiohumeral joints, and compared between measurement techniques. To demonstrate the in vivo application of this technique, biplane X-ray images were acquired as a human subject extended their elbow from full flexion to full extension. Results: The in vitro validation demonstrated that the model-based tracking technique is capable of accurately measuring elbow motion, with reported errors averaging less than ±1.0 mm and ±1.0 deg. For the in vivo application, the carrying angle changed from an 8.3 ± 0.5 deg varus position in full flexion to an 8.4 ± 0.5 deg valgus position in full extension. Conclusions: Model-based tracking is an accurate technique for measuring in vivo, 3D, dynamic elbow motion. It is anticipated that this experimental approach will enhance our understanding of elbow motion under normal and pathologic conditions.