Three-dimensional reconstruction of the lower limb from biplanar calibrated radiographs.

Three-dimensional (3D) reconstruction of lower limbs is essential for surgical planning and clinical outcome evaluation. 3D reconstruction from biplanar calibrated radiographs may be an alternative to irradiation issues of CT-scan. A previous study proposed a two-step reconstruction method based on parametric models and statistical inferences leading to a fast Initial Solution (IS) followed by manual adjustments. This study aims to improve the IS using a new 3D database, a novel parametric model of the tibia and a different regression approach. The IS was evaluated in terms of shape accuracy on 9 lower limbs and reproducibility of clinical measurements on 22 lower limbs. Reconstruction time was also evaluated. Comparison to the previous method showed an improvement of the IS in terms of shape accuracy (1.3 vs. 1.6 and 2 mm respectively for both femur and tibia) and reproducibility of clinical measurements (i.e. 3.1° vs. 8.3° for neck-shaft-angle; 4.2° and 5° vs. 5° and 6° for tibial and femoral torsion respectively). The proposed approach constitutes a considerable step towards an automatic 3D reconstruction of lower limb.