Maximum Total Point Motion of Five Points Versus All Points in Assessing Tibial Baseplate Stability
Abstract Maximum total point motion (MTPM), the point on a baseplate that migrates the most, has been used to assess the risk of tibial baseplate loosening using radiostereometric analysis (RSA). Two methods for determining MTPM for model-based RSA are to use either 5 points distributed around the perimeter of the baseplate or to use all points on the 3D model. The objectives were to quantify the mean difference in MTPM using 5 points vs. all points, compute the percent error relative to the 6-month stability limit for groups of patients, and to determine the dependency of differences in MTPM on baseplate size and shape. A dataset of 10,000 migration values was generated using the mean and standard deviation of migration in six degrees of freedom at 6 months from an RSA study. The dataset was used to simulate migration of 3D models (two baseplate shapes and two baseplate sizes) and calculate the difference in MTPM using 5 virtual points vs. all points and the percent error (i.e. difference in MTPM/stability limit) relative to the 6-month stability limit. The difference in MTPM was about 0.02 mm, or 4% percent relative to the 6-month stability limit, which is not clinically important. Furthermore, results were not affected by baseplate shape or size. Researchers can decide whether to use 5 points or all points when computing MTPM for model-based RSA. The authors recommend using 5 points to maintain consistency with marker-based RSA.