3D Assessment in Posttraumatic Ankle Osteoarthritis

Kvarda, Peter; Heisler, Lukas; Krähenbühl, Nicola; Steiner, Caspar Samuel; Ruiz, Roxa; Susdorf, Roman; Sripanich, Yantarat; Barg, Alexej; Hintermann, Beat

doi:10.1177/1071100720961315

Cited by 44 publications

(47 citation statements)

References 40 publications

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“…In many previous similar papers from CBCT scans in fact the angles were taken still in planar views, i.e. in the most appropriate single CT image 10 , 17 , 19 , 37 , 40 , 42 – 44 , 54 , 55 and not exactly from 3D models of the foot bones as in the present work. The entire process here present (Fig.…”

Section: Discussionmentioning

confidence: 99%

“…Thereafter, the software automatically registered a mathematical model of each bone on the original rendered image. The software also computed the location of anatomical landmarks and longitudinal axes of the bones of interest 37 , but this feature was not used in the present work.…”

Section: Methodsmentioning

confidence: 99%

“…two-dimensional, angular measurements from radiographs 8 , 9 , others are possible novel representations of foot bone orientations in 3D. This DIS software was developed for medical doctors to analyze medical images of each single patient in 3D, by avoiding the time-consuming bone segmentations and angle calculations 37 , 38 . It has been recently claimed that these auto-generated 3D measurements of hind- and mid-foot alignments are reliable in both healthy individuals and patients with posttraumatic end-stage ankle osteoarthritis 37 .…”

Section: Introductionmentioning

confidence: 99%

“…This DIS software was developed for medical doctors to analyze medical images of each single patient in 3D, by avoiding the time-consuming bone segmentations and angle calculations 37 , 38 . It has been recently claimed that these auto-generated 3D measurements of hind- and mid-foot alignments are reliable in both healthy individuals and patients with posttraumatic end-stage ankle osteoarthritis 37 . A similar objective calculation of absolute and relative orientation angles of the foot bones in 3D from current CBCT scans has been proposed recently by the present authors 39 , though that was limited to a single normal foot and only two representative bones.…”

Section: Introductionmentioning

confidence: 99%

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Angular and linear measurements of adult flexible flatfoot via weight-bearing CT scans and 3D bone reconstruction tools

Ortolani

Leardini

Pavani

et al. 2021

Sci Rep

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Acquired adult flatfoot is a frequent deformity which implies multiple, complex and combined 3D modifications of the foot skeletal structure. The difficult thorough evaluation of the degree of severity pre-op and the corresponding assessment post-op can now be overcome by cone-beam (CBCT) technology, which can provide access to the 3D skeletal structure in weight-bearing. This study aims to report flatfoot deformities originally in 3D and in weight-bearing, with measurements taken using two different bone segmentation techniques. 21 such patients, with indication for surgical corrections, underwent CBCT (Carestream, US) while standing on one leg. From these scans, 3D models of each bone of the foot were reconstructed by using two different state-of-the-art segmentation tools: a semi-automatic (Mimics Innovation Suite, Materialise, Belgium), and an automatic (Bonelogic Ortho Foot and Ankle, Disior, Finland). From both reconstructed models, Principal Component Analysis was used to define anatomical reference frames, and original foot and ankle angles and other parameters were calculated mostly based on the longitudinal axis of the bones, in anatomical plane projections and in 3D. Both bone model reconstructions revealed a considerable valgus of the calcareous, plantarflexion and internal rotation of the talus, and typical Meary’s angles in the lateral and transverse plane projections. The mean difference from these angles between semi-automatic and automatic segmentations was larger than 3.5 degrees for only 3 of the 32 measurements, and a large number of these differences were not statistically significant. CBCT and the present techniques for bone shape reconstruction finally provide a novel and valuable 3D assessment of complex foot deformities in weight-bearing, eliminating previous limitations associated to unloaded feet and bidimensional measures. Corresponding measurements on the bone models from the two segmentation tools compared well. Other more representative measurements can be defined in the future using CBCT and these techniques.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Angular and linear measurements of adult flexible flatfoot via weight-bearing CT scans and 3D bone reconstruction tools

Ortolani

Leardini

Pavani

et al. 2021

Sci Rep

View full text Add to dashboard Cite

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“…Further, de Cesar et al conducted a similar study of patients with a substantial flatfoot deformity and found that WBCT imaging better demonstrated the severity of deformation in the medial cuneiform-to-floor distance and forefoot arch angle when compared to NWBCT conditions [26]. While other studies do exist that measure foot and ankle alignment using WBCT vs. NWBCT or WBPR [27][28][29][30][31][32], to the authors' knowledge, no studies exist in current literature comparing the sensitivity and specificity of NWBCT and WBCT performance in midfoot OA. Recently, Willey et al used WBCT to demonstrate significant postoperative ankle joint-space narrowing in patients who underwent surgical treatment for a tibial pilon fracture [33].…”

Section: Discussionmentioning

confidence: 99%

Comparative assessment of midfoot osteoarthritis diagnostic sensitivity using weightbearing computed tomography vs weightbearing plain radiography

Steadman

Sripanich

Rungprai

et al. 2021

European Journal of Radiology

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Accuracy in diagnosing osteoarthritis in the midfoot using weightbearing plain radiography (WBPR) remains questionable due to the overlapping osseous architecture present, occluding visualization. Weightbearing computed tomography (WBCT), providing clearer bony landmark identification and joint space visualization, can also be used for evaluation. The aim of this project is to perform a standardized retrospective intrapatient analysis identifying the discrepancy of midfoot osteoarthritis diagnosis and osteoarthritis severity grading between WBPR and WBCT. Methods and materials: A cohort of 302 patient feet was acquired from an internal, consecutive patient database using detailed inclusion criteria. The musculoskeletal radiologist interpretation of the WBCT and WBPR of each specimen was then assessed for any direct diagnosis or mention of osteoarthritic signs in specific articulations of 3 midfoot joint groups (Chopart, "central", and tarsometatarsal). WBPR sensitivity and specificity metrics were calculated with WBCT considered the gold standard for comparison. Results: From the WBPR radiologist interpretation, we found diagnostic sensitivity of 72.5 % and specificity of 87.9 % for Chopart joints; 61.5 % sensitivity, and 96.1 % specificity for central joints; and 68.4 % sensitivity, and 92.9 % specificity for tarsometatarsal joints. The severity of degenerative changes was also consistently underestimated when interpreted from WBPR relative to WBCT. Conclusions: In this series, midfoot osteoarthritis was often undetected on WBPR. WBCT imaging facilitates an earlier, more reliable diagnosis and grading of midfoot osteoarthritis relative to WBPR.

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Unique shape variations of hind and midfoot bones in flatfoot subjects—A statistical shape modeling approach

et al. 2022

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Flatfoot deformity is a prevalent hind‐ and midfoot disorder. Given its complexity, single‐plane radiological measurements omit case‐specific joint interaction and bone shape variations. Three‐dimensional medical imaging assessment using statistical shape models provides a complete approach in characterizing bone shape variations unique to flatfoot condition. This study used statistical shape models to define specific bone shape variations of the subtalar, talonavicular, and calcaneocuboid joints that characterize flatfoot deformity, that differentiate them from healthy controls. Bones of the aforementioned joints were segmented from computed tomography scans of 40 feet. The three‐dimensional hindfoot alignment angle categorized the population into 18 flatfoot subjects (≥7° valgus) and 22 controls. Statistical shape models for each joint were defined using the entire study cohort. For each joint, an average weighted shape parameter was calculated for each mode of variation, and then compared between flatfoot and controls. Significance was set at p < 0.05, with values between 0.05 ≤ p < 0.1 considered trending towards significance. The flatfoot population showed a more adducted talar head, inferiorly inclined talar neck, and posteriorly orientated medial subtalar articulation compare to controls, coupled with more navicular eversion, shallower navicular cup, and more prominent navicular tuberosity. The calcaneocuboid joint presented trends of a more adducted calcaneus, more abducted cuboid, narrower calcaneal roof, and less prominent cuboid beak compared to controls. Statistical shape model analysis identified unique shape variations which may enhance understanding and computer‐aided models of the intricacies of flatfoot, leading to better diagnosis and, ultimately, surgical treatment.

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3D Assessment in Posttraumatic Ankle Osteoarthritis

Cited by 44 publications

References 40 publications

Angular and linear measurements of adult flexible flatfoot via weight-bearing CT scans and 3D bone reconstruction tools

Angular and linear measurements of adult flexible flatfoot via weight-bearing CT scans and 3D bone reconstruction tools

Comparative assessment of midfoot osteoarthritis diagnostic sensitivity using weightbearing computed tomography vs weightbearing plain radiography

Unique shape variations of hind and midfoot bones in flatfoot subjects—A statistical shape modeling approach

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