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A model-based radiostereometric analysis (MBRSA) is a method for precise measurement of prosthesis migration, which does not require marking the implant with tantalum beads. Instead, the prosthesis pose is typically recovered using a feature-based 2D-3D registration of its virtual model into a stereo pair of radiographs. In this study, we evaluate a novel intensity-based formulation of previously published nonoverlapping area (NOA) approach. The registration is capable of performing with both binary radiographic segmentations and nonsegmented X-ray images. In contrast with the feature-based version, it is capable of dealing with unreliable parts of prosthesis. As the straightforward formulation allows efficient acceleration using modern graphics adapters, it is possible to involve precise high-poly virtual models. Moreover, in case of binary segmentations, the nonoverlapping area is simply interpretable and useful for indicating the accuracy of the registration outcome. In silico and phantom evaluations were performed using a cementless Zweymüller femoral stem and its reverse engineered (RE) model. For initial pose estimates with difference from the ground-truth limited to ±4 mm and ±4°, respectively, the mean absolute translational error was not higher than 0.042 ± 0.035 mm. The error in rotation around the proximodistal axis was 0.181 ± 0.265°, and the error for the remaining axes was not higher than 0.035 ± 0.037°.

Intensity-Based Nonoverlapping Area Registration Supporting “Drop-Outs” in Terms of Model-Based Radiostereometric Analysis