Analysis of acetabular orientation and femoral anteversion using images of three-dimensional reconstructed bone models

Park, Jaeyeong; Kim, Junyoung; Kim, Hyun Deok; Kim, Young Cheol; Seo, Anna; Je, Minkyu; Mun, Jong Uk; Kim, Bia; Park, Il Hyung; Kim, Shin‐Yoon

doi:10.1007/s11548-016-1514-0

Cited by 7 publications

(8 citation statements)

References 32 publications

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“…This difference had been found previously by Hartel et al [10]. The mean values of FNV in Asians of the present study are close to those found by Zhang and Park who studied a Chinese population (16.4° and 17.3°, respectively) [23,38]. The TT was also significantly lower in Asian subjects with a mean difference of 2.8° [8,12,31,32].…”

Section: Discussionsupporting

confidence: 91%

Healthy middle-aged Asian and Caucasian populations present with large intra- and inter-individual variations of lower limb torsion

Mathon

Micicoi

Seil

et al. 2020

Knee Surg Sports Traumatol Arthrosc

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Purpose There is a lack of standardization in the measurement of lower limb torsional alignment. Normal values published in the literature are inconsistent. A 3D-CT-scan-based method was used in a healthy population to define the femoral neck version (FNV) and the tibial torsion (TT) and their relationship with demographic parameters. The study objectives were (1) to define normal values of lower limb torsional alignment, (2) to estimate inter-and intra-individual variations of torsional deformity of healthy individuals' lower limbs. The hypothesis was that FNV and TT values would be influenced by patient characteristics such as gender, age, and ethnicity, and would have low side-to-side asymmetry. Methods Torsional landmarks of the lower limbs from 191 healthy subjects were automatically calculated with a 3D CTscan-based program. The FNV was defined by the angle between the femoral neck axis and the femoral posterior condylar line. The TT angle was considered between the tibial plateau axis and the axis of the ankle. For the former, two alternatives were considered: the line connecting the more medial and lateral point of the medial and lateral plateau, respectively (method 1; TT1), or the line connecting the two more posterior points of the medial et lateral plateau (method 2; TT2). The ankle axis was defined as the line connecting the medial and lateral malleoli. These reference lines were automatically calculated. Age, gender, ethnic group, and BMI were recorded for every subject. A p value < 0.05 was considered as statistically significant. Results Overall, the mean FNV was 15.3 ± 9.5° and the mean TT was 31.6 ± 6.3°. Female hips were more anteverted than male hips. Caucasians had less anteverted hips than Asians, but more externally rotated tibias. Age and BMI were not correlated with any anatomical parameter. A substantial side-to-side asymmetry was found for FNV [absolute difference (AD) = 6.3°; percentage of asymmetry (%As) = 47%], TT1 (AD = 3°; %As = 12%), and TT2 (AD = 4.9°; %As = 9%) (p = 0.008). ConclusionThe findings showed that lower limb torsional parameters were highly variable from patient to patient and from one leg to the other for the same patient. The understanding of normal values concerning femoral version and external tibial torsion in the present healthy population will help surgeons to define pathological values of FNV and TT, as well as corrections to perform in case of torsional deformities. Level of evidence Level III.

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Section: Discussionsupporting

confidence: 91%

Healthy middle-aged Asian and Caucasian populations present with large intra- and inter-individual variations of lower limb torsion

Mathon

Micicoi

Seil

et al. 2020

Knee Surg Sports Traumatol Arthrosc

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“…Nowadays, the two-dimensional (2D) tomography images could be converted into the three-dimensional (3D) models using specialized imaging programs. 3D modelling, which have an increasing interest in the literature, that could help the surgeons to better understand the lesions by visualizing the real anatomical features compared to plain radiographs and 2D tomography images [7][8][9].…”

Section: Introductionmentioning

confidence: 99%

“…Implant modifications and optimizations, which are made in accordance with genderspecific anatomical differences, could increase the postoperative functional results [7]. The effects of gender, age and race on anatomical features using the tomographic measurements, were largely investigated in the literature [1,3,4,[8][9][10]. In some of these studies, the femoral markings and measurements were performed using 2D methods [3,4], while in a limited number of studies all the femoral markings and measurements 1 were performed on 3D models [1,[8][9][10].…”

Section: Introductionmentioning

confidence: 99%

“…Despite these publications, the complex 3D anatomy of the femur is still not fully defined [11]. 3D anatomical models are not affected by the patient's position in tomography device and the anatomical landmarks could be more easily identified with manual or autonomous methods [2,9]. Therefore, recent studies have emphasized the superiority of 3D evaluation to eliminate the difficulties in understanding the complex femoral anatomy [2,9,11].…”

Section: Introductionmentioning

confidence: 99%

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Determination of the Gender-Related Differences on Native Femoral Anatomy Using Three-Dimensional Computerized Tomography Models in Caucasian Population

Tanoğlu¹

2021

Cureus

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IntroductionThree-dimensional (3D) modelling, which has an increasing interest in the literature, could help surgeons to better understand the lesions by visualizing the real anatomical features compared to plain radiographs and two-dimensional (2D) tomography images. We aimed to evaluate the native femoral anatomical features of Turkish females and males using 3D computed tomography models. MethodsWe evaluated the right femoral anatomical features of 60 females and 60 males between 31 and 65 years of age creating 3D computerized tomography models. The gender-specific differences of femoral neck inclination and anteversion, femoral mechanical-anatomical axis, anatomical and mechanical lateral distal femoral, medial and lateral proximal femoral angles were measured on 3D femoral anatomical models. ResultsThe mean age of our study groups was 50.6 ± 8.5. We determined a statistically significant difference between gender groups in terms of mean femoral neck anteversion angles (p = 0.009). We observed the retroversion of the femoral neck in 12 adults (10%). The mean values of femoral neck inclination, femoral mechanical -anatomical angle, anatomical and mechanical lateral distal femoral angles, medial and lateral proximal femoral angles did not differ any statistical significance between gender groups. ConclusionAlthough the anatomical angle measurements except femoral neck anteversion, did not differ significantly between gender groups of our study, there were differences between mean anatomical angles when compared to other studies in the literature, which investigate the different races or Caucasian population. Through 3D anatomical data, more compatible implants, prosthesis or biomaterials can be produced by determining gender and race-specific anatomical differences.

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“…However, measurements taken in two-dimensional (2D) axial planes have proven less consistent. 21 On the other hand, measurements taken on three-dimensional (3D) CT images could be a gold standard for obtaining reliable measurements of the femoral component regardless of patient positioning. 22 …”

Section: Introductionmentioning

confidence: 99%

CT-based Navigation System Using a Patient-Specific Instrument for Femoral Component Positioning: An Experimental in vitro Study with a Sawbone Model

et al. 2018

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PurposeThe intraoperative version of the femoral component is usually determined by visual appraisal of the stem position relative to the distal femoral condylar axis. However, several studies have suggested that a surgeon's visual assessment of the stem position has a high probability of misinterpretation. We developed a computed tomography (CT)-based navigation system with a patient-specific instrument (PSI) capable of three-dimensional (3D) printing and investigated its accuracy and consistency in comparison to the conventional technique of visual assessment of the stem position.Materials and MethodsA CT scan of a femur sawbone model was performed, and pre-experimental planning was completed. We conducted 30 femoral neck osteotomies using the conventional technique and another 30 femoral neck osteotomies using the proposed technique. The femoral medullary canals were identified in both groups using a box chisel.ResultsFor the absolute deviation between the measured and planned values, the mean two-dimensional anteversions of the proposed and conventional techniques were 1.41° and 4.78°, while their mean 3D anteversions were 1.15° and 3.31°. The mean θ1, θ2, θ3, and d, all of which are parameters for evaluating femoral neck osteotomy, were 2.93°, 1.96°, 5.29°, and 0.48 mm for the proposed technique and 4.26°, 3.17°, 4.43°, and 3.15 mm for the conventional technique, respectively.ConclusionThe CT-based navigation system with PSI was more accurate and consistent than the conventional technique for assessment of stem position. Therefore, it can be used to reduce the frequency of incorrect assessments of the stem position among surgeons and to help with accurate determination of stem anteversion.

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Analysis of acetabular orientation and femoral anteversion using images of three-dimensional reconstructed bone models

Abstract: The differences between the two measurements are explained by the use of different tools. However, more consistent measurements were possible using the images of 3D reconstructed bone models. Therefore, 3D measurement can be a good alternative to measurement using 2D slice images.

Cited by 7 publications

References 32 publications

Healthy middle-aged Asian and Caucasian populations present with large intra- and inter-individual variations of lower limb torsion

Healthy middle-aged Asian and Caucasian populations present with large intra- and inter-individual variations of lower limb torsion

Determination of the Gender-Related Differences on Native Femoral Anatomy Using Three-Dimensional Computerized Tomography Models in Caucasian Population

CT-based Navigation System Using a Patient-Specific Instrument for Femoral Component Positioning: An Experimental in vitro Study with a Sawbone Model

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