Calibration and optimization of a biplane fluoroscopy system for quantifying foot and ankle biomechanics

Abstract

Joint pain or loss of function manifests in subtle changes in kinematics and the biomechanical behavior of the articulating surfaces, the ligaments, and tendons acting as soft tissue constraints. Understanding the relationships between anatomic morphology and healthy joint function, and how conservative and surgical treatments affect symptomatic behavior in vivo, will inform clinicians’ practice. Clinically motivated research studies benefit greatly from the increased spatial and temporal resolution afforded by biplanar fluoroscopic systems, but the kinematic data generated from these studies come at high computational cost and radiation exposure to test subjects and operators. Additionally, there is no off-the-shelf software or hardware solution available currently for foot and ankle gait biplanar fluoroscopic systems. The imaging chains and software processing pipelines are modified and repurposed versions of stock fluoroscopic equipment. By altering this hardware chain, image quality and automated processing, and thus the accuracy and throughput of the system, are diminished. Therefore, the goal of this thesis is to dissect the custom hardware and software pipelines in our laboratory in order to understand, characterize, and attempt to mitigate sources of error while balancing kinematic accuracy, subject safety, and processing throughput.