Cilt 14, Sayı 2, Sayfalar 71 - 78 2010-12-14

Thermal Imaging as a Noninvasive Diagnostic Tool for Anterior Knee Pain Following Implantation of Artificial Knee Joints

Mathias Glehr [1] , Alexander Stibor [2] , Patrick Sadoghi [3] , Christian Schuster [4] , Franz Quehenberger [5] , Gerald Gruber [6] , Andreas Leithner [7] , Reinhard Windhager [8]

81 120

The variety of radiographic diagnostic used to diagnose pain localised close to metal implants is still limited. Especially magnetic resonance results can not be analysed because of artefacts. In this article we present for the first time a direct correlation between an increase in skin temperature and existent anterior knee pain after total knee arthroplasty (TKA) measured with thermography.

In a standardised way 26 knees were analysed. Thermographic photos were taken from frontal, medial and lateral directions with a computer-assisted infrared thermograph. In medial location (median 0.95 °C, p=0.0043), as well as in lateral location (median 0.5 °C, p=0.032) temperatures in locations with pain were significantly higher compared to the reference field. Median temperature difference between pain localization and localizations without pain was 0.7 °C and ranged from 0.1 °C to 1.7 °C on the side of the pain. In the ROC analysis the sensitivity of this method was 1.0 and specificity was 0.917. The evidence of a significant increase in skin temperature on the painful sites opened up the possibility to localize and assess pain more precisely in patients with total knee prosthesis. We consider this novel, rapid, inexpensive and non-invasive technology to posses the potential to become a useful and objective tool for diagnosis of pain and inflammation and to generate digital data that can be stored and analysed in clinical practice.

Thermography; Total Knee Arthroplasty; Objective Pain Evaluation
  • Arora N, Martins D, Ruggerio D, Tousimis E, Swistel AJ, Osborne MP, and Simmons RM. (2008).
  • Effectiveness of a noninvasive digital infrared thermal imaging system in the detection of breast cancer. Am J Surg, 196(4), pp.523-526
  • Barrack RL, Schrader T, Bertot AJ, Wolfe MW, and Myers L. (2001). Component rotation and anterior knee pain after total knee arthroplasty. Clin Orthop Relat Res, (392), pp.46-55.
  • Bennell K, Hodges P, Mellor R, Bexander C, and Souvlis T. (2004). The nature of anterior knee pain following injection of hypertonic saline into the infrapatellar fat pad. J Orthop Res, 22(1), pp.116-121.
  • Berend ME, Small SR, Ritter MA, Buckley CA, Merk JC, and Dierking WK. (2010). Effects of femoral component size on proximal tibial strain with anatomic graduated components total knee arthroplasty. J Arthroplasty, 25(1), pp.58-63.
  • Bjorkstrom S, and Goldie IF. (1980). A study of the arterial supply of the patella in the normal state, in chondromalacia patellae and in osteoarthrosis. Acta Orthop Scand, 51(1), pp.63-70.
  • Boas NF. (1964). Thermography in Rheumatoid Arthritis. Ann N Y Acad Sci, 121pp.223-234.
  • Brenner M, Braun C, Oster M, and Gulko PS. (2006). Thermal signature analysis as a novel method for evaluating inflammatory arthritis activity. Ann Rheum Dis, 65(3), pp.306-311.
  • Bruehl S, Lubenow TR, Nath H, and Ivankovich O. (1996). Validation of thermography in the diagnosis of reflex sympathetic dystrophy. Clin J Pain, 12(4), pp.316-325.
  • Calvisi V, Camillieri G, and Lupparelli S. (2009). Resurfacing versus nonresurfacing the patella in total knee arthroplasty: a critical appraisal of the available evidence. Arch Orthop Trauma Surg, 129(9), pp.1261-1270.
  • Chikura B, Moore T, Manning J, Vail A, and Herrick AL. (2010). Thumb involvement in Raynaud's phenomenon as an indicator of underlying connective tissue disease. J Rheumatol, 37(4), pp.783-786.
  • Classen T, Wegner A, Muller RD, and Von Knoch M. (2010). Femoral component rotation and Laurin angle after total knee arthroplasty. Acta Orthop Belg, 76(1), pp.69-73.
  • Craciunescu OI, Stauffer PR, Soher BJ, Wyatt CR, Arabe O, Maccarini P, Das SK, Cheng KS, Wong TZ, Jones EL et al. . (2009). Accuracy of real time noninvasive temperature measurements using magnetic resonance thermal imaging in patients treated for high grade extremity soft tissue sarcomas. Med Phys, 36(11), pp.4848-4858.
  • Dalury DF, Mulliken BD, Adams MJ, Lewis C, Sauder RR, and Bushey JA. (2009). Early recovery after total knee arthroplasty performed with and without patellar eversion and tibial translation. A prospective randomized study. J Bone Joint Surg Am, 91(6), pp.1339-1343.
  • Devereaux MD, Parr GR, Lachmann SM, Thomas DP, and Hazleman BL. (1986). Thermographic diagnosis in athletes with patellofemoral arthralgia. J Bone Joint Surg Br, 68(1), pp.42-44.
  • EtehadTavakol M, Sadri S, and Ng EY. (2010). Application of K- and fuzzy c-means for color segmentation of thermal infrared breast images. J Med Syst, 34(1), pp.35-42.
  • Fernandez-Duenas V, Ciruela F, Gandia J, Sanchez S, Planas E, and Poveda R. (2010). Histamine H3 receptor activation potentiates peripheral opioidmediated antinociception: substance P role in peripheral inflammation in mice. Eur J Pharmacol, 638(1-3), pp.72-77.
  • Fikackova H, and Ekberg E. (2004). Can infrared thermography be a diagnostic tool for arthralgia of the temporomandibular joint? Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 98(6), pp.643-650.
  • Friedman MS. (1994). The use of thermography in sympathetically maintained pain. Iowa Orthop J, 14pp.141-147.
  • Gescheit IM, Dayan A, Ben-David M, and Gannot I. (2010). Minimal-invasive thermal imaging of a malignant tumor: a simple model and algorithm. Med Phys, 37(1), pp.211-216.
  • Ghosh KM, Merican AM, Iranpour F, Deehan DJ, and Amis AA. (2010). The effect of femoral component rotation on the extensor retinaculum of the knee. J Orthop Res 28(9),pp.1136-1141.
  • Gravius S, Belei P, de la Fuente M, Radermacher K, and Mumme T. (2010). Evaluation of a new fluoroscopybased navigation system in the placement of the femoral component in hip resurfacing. Proc Inst Mech Eng H, 224(4), pp.565-576.
  • Han SS, Jung CH, Lee SC, Jung HJ, and Kim YH. (2010). Does skin temperature difference as measured by infrared thermography within 6 months of acute herpes zoster infection correlate with pain level? Skin Res Technol, 16(2), pp.198-201.
  • IACT. (2002). Thermography guidelines, Standards and Protocols in Clinical Thermographic Imaging wwwiact-orgorg/professionals/thermogguidelineshtml, International Academy of Clinical Thermology.
  • Infernuso T, Loughin CA, Marino DJ, Umbaugh SE, and Solt PS. (2010). Thermal Imaging of Normal and Cranial Cruciate Ligament-Deficient Stifles in Dogs. Vet Surg. 39(4),pp.410-417.
  • Kastberger G, and Stachl R. (2003). Infrared imaging technology and biological applications. Behav Res Methods Instrum Comput, 35(3), pp.429-439.
  • Kessler O, Patil S, Colwell CW, Jr., and D'Lima DD. (2008). The effect of femoral component malrotation on patellar biomechanics. J Biomech, 41(16), pp.3332-3339.
  • Krumova EK, Frettloh J, Klauenberg S, Richter H, Wasner G, and Maier C. (2008). Long-term skin temperature measurements - a practical diagnostic tool in complex regional pain syndrome. Pain, 140(1), pp.8-22.
  • Leclaire R, Esdaile JM, Jequier JC, Hanley JA, Rossignol M, and Bourdouxhe M. (1996). Diagnostic accuracy of technologies used in low back pain assessment. Thermography, triaxial dynamometry, spinoscopy, and clinical examination. Spine (Phila Pa 1976), 21(11), pp.1325-1331.
  • Mahoney OM, and Kinsey T. (2010). Overhang of the femoral component in total knee arthroplasty: risk factors and clinical consequences. J Bone Joint Surg Am, 92(5), pp.1115-1121.
  • Moon YW, Seo JG, Lim SJ, and Yang JH. (2010). Variability in femoral component rotation reference axes measured during navigation-assisted total knee arthroplasty using gap technique. J Arthroplasty, 25(2), pp.238-243.
  • Muoneke HE, Khan AM, Giannikas KA, Hagglund E, and Dunningham TH. (2003). Secondary resurfacing of the patella for persistent anterior knee pain after primary knee arthroplasty. J Bone Joint Surg Br, 85(5), pp.675-678.
  • Ng EY-K. (2009). A review of thermography as promising non-invasive detection modality for breast tumor. International Journal of Thermal Sciences, 48(5), pp.849-859.
  • Niehof SP, Beerthuizen A, Huygen FJ, and Zijlstra FJ. (2008). Using skin surface temperature to differentiate between complex regional pain syndrome type 1 patients after a fracture and control patients with various complaints after a fracture. Anesth Analg, 106(1), pp.270-277.
  • Niehof SP, Huygen FJ, van der Weerd RW, Westra M, and Zijlstra FJ. (2006). Thermography imaging during static and controlled thermoregulation in complex regional pain syndrome type 1: diagnostic value and involvement of the central sympathetic system. Biomed Eng Online, 5pp.30.
  • Pawl RP. (1991). Thermography in the diagnosis of low back pain. Neurosurg Clin N Am, 2(4), pp.839-850. Planck M. (1901). Ueber das Gesetz der Energieverteilung im Normalspektrum. Annalen der Physik, 309, pp.553-563.
  • Pochaczevsky R. (1987). Thermography in posttraumatic pain. Am J Sports Med, 15(3), pp.243- 250.
  • Poljak-Blazi M, Kolaric D, Jaganjac M, Zarkovic K, Skala K, and Zarkovic N. (2009). Specific thermographic changes during Walker 256 carcinoma development: differential infrared imaging of tumour, inflammation and haematoma. Cancer Detect Prev, 32(5-6), pp.431-436.
  • Popovic N, and Lemaire R. (2003). Anterior knee pain with a posterior-stabilized mobile-bearing knee prosthesis: the effect of femoral component design. J Arthroplasty, 18(4), pp.396-400.
  • Ring EF. (2004). The historical development of thermal imaging in medicine. Rheumatology (Oxford), 43(6), pp.800-802.
  • Ring EF. (2006). The historical development of thermometry and thermal imaging in medicine. J Med Eng Technol, 30(4), pp.192-198.
  • Rusch D, Follmann M, Boss B, and Neeck G. (2000). Dynamic thermography of the knee joints in rheumatoid arthritis (RA) in the course of the first therapy of the patient with methylprednisolone. Z Rheumatol, 59 Suppl 2,pp.131-135.
  • Salisbury RS, Parr G, De Silva M, Hazleman BL, and Page-Thomas DP. (1983). Heat distribution over normal and abnormal joints: thermal pattern and quantification. Ann Rheum Dis, 42(5), pp.494-499.
  • 78 / Vol. 14 (No. 2) Int. Centre for Applied Thermodynamics (ICAT) Schlager O, Gschwandtner ME, Herberg K, Frohner T, Schillinger M, Koppensteiner R, and Mlekusch W. (2010). Correlation of infrared thermography and skin perfusion in Raynaud patients and in healthy controls. Microvasc Res,80, pp.54-57.
  • Seeley TT, Abramson PR, Perry LB, Rothblatt AB, and Seeley DM. (1980). Thermographic measurement of sexual arousal: a methodological note. Arch Sex Behav, 9(2), pp.77-85.
  • Selfe J, Hardaker N, Thewlis D, and Karki A. (2006). An accurate and reliable method of thermal data analysis in thermal imaging of the anterior knee for use in cryotherapy research. Arch Phys Med Rehabil, 87(12), pp.1630-1635.
  • Siegel MG, Siqueland KA, and Noyes FR. (1987). The use of computerized thermography in the evaluation of non-traumatic anterior knee pain. Orthopedics, 10(5), pp.825-830.
  • Skwara A, Tibesku CO, Ostermeier S, StukenborgColsman C, and Fuchs-Winkelmann S. (2008). Differences in patellofemoral contact stresses between mobile-bearing and fixed-bearing total knee arthroplasties: a dynamic in vitro measurement. Arch Orthop Trauma Surg, 129(7),pp.901-907.
  • Smith MJ, Gill PG, Wetzig N, Sourjina T, Gebski V, Ung O, Campbell I, Kollias J, Coskinas X, Macphee A et al. . (2009). Comparing patients' and clinicians' assessment of outcomes in a randomised trial of sentinel node biopsy for breast cancer (the RACS SNAC trial). Breast Cancer Res Treat, 117(1), pp.99- 109.
  • Spalding SJ, Kwoh CK, Boudreau R, Enama J, Lunich J, Huber D, Denes L, and Hirsch R. (2008). Threedimensional and thermal surface imaging produces reliable measures of joint shape and temperature: a potential tool for quantifying arthritis. Arthritis Res Ther, 10(1), pp.R10.
  • Steketee J. (1973). Spectral emissivity of skin and pericardium. Phys Med Biol, 18(5), pp.686-694.
  • Stubsjoen SM, Flo AS, Moe RO, Janczak AM, Skjerve E, Valle PS, and Zanella AJ. (2009). Exploring noninvasive methods to assess pain in sheep. Physiol Behav, 98(5), pp.640-648.
  • Torga-Spak R, Parikh SN, and Stuchin SA. (2004). Anterior knee pain due to biplanar rotatory malalignment of the femoral component in total knee arthroplasty. Case report. J Knee Surg, 17(2), pp.113-116.
  • Varju G, Pieper CF, Renner JB, and Kraus VB. (2004). Assessment of hand osteoarthritis: correlation between thermographic and radiographic methods. Rheumatology (Oxford), 43(7), pp.915-919.
  • Vecchio PC, Adebajo AO, Chard MD, Thomas PP, and Hazleman BL. (1992). Thermography of frozen shoulder and rotator cuff tendinitis. Clin Rheumatol, 11(3), pp.382-384.
  • Verlinden C, Uvin P, Labey L, Luyckx JP, Bellemans J, and Vandenneucker H. (2010). The influence of malrotation of the femoral component in total knee replacement on the mechanics of patellofemoral contact during gait: an in vitro biomechanical study. J Bone Joint Surg Br, 92(5), pp.737-742.
  • Wien W. (1896). Ueber die Energievertheilung im Emissionsspectrum eines schwarzen Körpers. Annalen der Physik und Chemie, 294,pp.662-669. Witonski D. (1999). Anterior knee pain syndrome. Int Orthop, 23(6), pp.341-344.
  • Zaproudina N, Ming Z, and Hanninen OO. (2006). Plantar infrared thermography measurements and low back pain intensity. J Manipulative Physiol Ther, 29(3), pp.219-223.
Birincil Dil en
Konular
Dergi Bölümü Regular Original Research Article
Yazarlar

Yazar: Mathias Glehr
E-posta: mathias.glehr@gmail.com

Yazar: Alexander Stibor
E-posta: stibor@pit.physik.uni-tuebingen.de

Yazar: Patrick Sadoghi
E-posta: patrick.sadoghi@klinikum-graz.at

Yazar: Christian Schuster
E-posta: christian.schuster@meduni-graz.at

Yazar: Franz Quehenberger
E-posta: franz.quehenberger@meduni-graz.at

Yazar: Gerald Gruber
E-posta: gerald.gruber@klinikum-graz.at

Yazar: Andreas Leithner
E-posta: andreas.leithner@meduni-graz.at

Yazar: Reinhard Windhager
E-posta: reinhard.windhager@meduniwien.ac.at

Bibtex @ { eoguijt76862, journal = {International Journal of Thermodynamics}, issn = {1301-9724}, address = {Yaşar DEMİREL}, year = {2010}, volume = {14}, pages = {71 - 78}, doi = {}, title = {Thermal Imaging as a Noninvasive Diagnostic Tool for Anterior Knee Pain Following Implantation of Artificial Knee Joints}, language = {en}, key = {cite}, author = {Windhager, Reinhard and Sadoghi, Patrick and Glehr, Mathias and Gruber, Gerald and Quehenberger, Franz and Schuster, Christian and Leithner, Andreas and Stibor, Alexander} }
APA Glehr, M , Stibor, A , Sadoghi, P , Schuster, C , Quehenberger, F , Gruber, G , Leithner, A , Windhager, R . (2010). Thermal Imaging as a Noninvasive Diagnostic Tool for Anterior Knee Pain Following Implantation of Artificial Knee Joints. International Journal of Thermodynamics, 14 (2), 71-78. Retrieved from http://dergipark.gov.tr/eoguijt/issue/5780/76862
MLA Glehr, M , Stibor, A , Sadoghi, P , Schuster, C , Quehenberger, F , Gruber, G , Leithner, A , Windhager, R . "Thermal Imaging as a Noninvasive Diagnostic Tool for Anterior Knee Pain Following Implantation of Artificial Knee Joints". International Journal of Thermodynamics 14 (2010): 71-78 <http://dergipark.gov.tr/eoguijt/issue/5780/76862>
Chicago Glehr, M , Stibor, A , Sadoghi, P , Schuster, C , Quehenberger, F , Gruber, G , Leithner, A , Windhager, R . "Thermal Imaging as a Noninvasive Diagnostic Tool for Anterior Knee Pain Following Implantation of Artificial Knee Joints". International Journal of Thermodynamics 14 (2010): 71-78
RIS TY - JOUR T1 - Thermal Imaging as a Noninvasive Diagnostic Tool for Anterior Knee Pain Following Implantation of Artificial Knee Joints AU - Mathias Glehr , Alexander Stibor , Patrick Sadoghi , Christian Schuster , Franz Quehenberger , Gerald Gruber , Andreas Leithner , Reinhard Windhager Y1 - 2010 PY - 2010 N1 - DO - T2 - International Journal of Thermodynamics JF - Journal JO - JOR SP - 71 EP - 78 VL - 14 IS - 2 SN - 1301-9724-2146-1511 M3 - UR - Y2 - 2017 ER -
EndNote %0 International Journal of Thermodynamics Thermal Imaging as a Noninvasive Diagnostic Tool for Anterior Knee Pain Following Implantation of Artificial Knee Joints %A Mathias Glehr , Alexander Stibor , Patrick Sadoghi , Christian Schuster , Franz Quehenberger , Gerald Gruber , Andreas Leithner , Reinhard Windhager %T Thermal Imaging as a Noninvasive Diagnostic Tool for Anterior Knee Pain Following Implantation of Artificial Knee Joints %D 2010 %J International Journal of Thermodynamics %P 1301-9724-2146-1511 %V 14 %N 2 %R %U