Apparatus and method for calibrating an x-ray image of a knee of a patient
An x-ray calibration apparatus includes a radiolucent knee alignment jig configured to receive a knee of a patient and a radiolucent cushion configured to hold a patient's knee at a fixed angle of flexion. The x-ray calibration apparatus also includes a number of radio-opaque fiducial markers positioned within the radiolucent knee alignment jig.
1. A method of generating an image for use in the fabrication of a customized patient-specific orthopaedic knee instrument, comprising:
positioning a patient's knee on a radiolucent cushion of an x-ray calibration apparatus at a fixed angle of flexion, the x-ray calibration apparatus having a plurality of radio-opaque fiducial markers positioned at fixed distances such that each of the plurality of radio-opaque fiducial markers are distinct from one another when viewed in x-ray images taken (i) in a direction anterior to the patient's knee, and (ii) in a direction lateral to the patient's knee,
taking a first x-ray image in a direction anterior to the patient's knee such that representations of at least some of the plurality of radio-opaque fiducial markers are visible in the first x-ray image,
taking a second x-ray image perpendicularly to a lateral sidewall of the x-ray calibration apparatus in a direction lateral to the patient's knee such that representations of at least some of the plurality of radio-opaque fiducial markers are visible in the second x-ray image,
registering the first and second x-ray images onto one another using the representations of the plurality of radio-opaque fiducial markers visible in the first and second x-ray images,
wherein the at least some of the plurality of radio-opaque fiducial markers visible in the second x-ray image include (i) an upper plurality of radio-opaque fiducial markers that appear above an upper ridge of the radiolucent cushion and (ii) a lower plurality of radio-opaque fiducial markers that appear below the upper ridge of the radiolucent cushion.
2. The method of claim 1 , wherein registering the first and second x-ray images comprises aligning the first and second x-ray images using the representations of the plurality of radio-opaque fiducial markers visible in the first and second x-ray images.
3. The method of claim 1 , further comprising:
calculating an x-ray scaling factor by (i) measuring the distances between two or more of the representations of the plurality of radio-opaque fiducial markers visible in one or both of the first and second x-ray images, and (ii) comparing the distances between the two or more of the representations of the plurality of radio-opaque fiducial markers visible in one or both of the first and second x-ray images to the distances between the corresponding fiducial markers positioned in the x-ray calibration apparatus.
4. The method of claim 1 , further comprising:
calculating a beam angle by (i) measuring the distances between two or more sets of representations of the plurality of radio-opaque fiducial markers visible in one or both of the first and second x-ray images, and (ii) comparing the distances between the two or more of the representations of the plurality of radio-opaque fiducial markers visible in one or both of the first and second x-ray images to the distances between the corresponding fiducial markers positioned in the x-ray calibration apparatus.
5. The method of claim 1 , further comprising:
calculating an x-ray scaling factor by (i) measuring the distance between a first representation of a first of the plurality of radio-opaque fiducial markers visible in the first x-ray image and a second representation of a second of the plurality of radio-opaque fiducial markers visible in the first x-ray image, and (ii) comparing the distance between the first and second representations to the distance between the first fiducial marker positioned in the x-ray calibration apparatus and the second fiducial marker positioned in the x-ray calibration apparatus.
6. The method of claim 1 , further comprising:
calculating an x-ray scaling factor by (i) measuring the distance between a first representation of a first of the plurality of radio-opaque fiducial markers visible in the second x-ray image and a second representation of a second of the plurality of radio-opaque fiducial markers visible in the second x-ray image, and (ii) comparing the distance between the first and second representations to the distance between the first fiducial marker positioned in the x-ray calibration apparatus and the second fiducial marker positioned in the x-ray calibration apparatus.
7. The method of claim 1 , further comprising:
calculating a beam angle by (i) measuring the distances between two or more sets of representations of the plurality of radio-opaque fiducial markers visible in the first x-ray image, and (ii) comparing the distances between the two or more of the representations of the plurality of radio-opaque fiducial markers visible in the first x-ray image to the distances between the corresponding fiducial markers positioned in the x-ray calibration apparatus.
8. The method of claim 1 , further comprising:
calculating a beam angle by (i) measuring the distances between two or more sets of representations of the plurality of radio-opaque fiducial markers visible in the second x-ray image, and (ii) comparing the distances between the two or more of the representations of the plurality of radio-opaque fiducial markers visible in the second x-ray image to the distances between the corresponding fiducial markers positioned in the x-ray calibration apparatus.
9. The method of claim 1 , further comprising generating a design of the customized, patient-specific orthopaedic knee instrument based on the registered first and second x-ray images.