Semi-automated landmark-based 3D analysis reveals new morphometric characteristics in the trochlear dysplastic femur

Haver, Annemieke Van; Roo, Karel De; Beule, Matthieu De; Cauter, Sofie Van; Audenaert, Emmanuel; Claessens, Tom; Verdonk, Peter

doi:10.1007/s00167-013-2573-1

Cited by 31 publications

(61 citation statements)

References 42 publications

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“…Recently, Van Haver et al. () found not only that the trochlear region is affected in the trochlear dysplastic femur, but that the posterior femur also has a different morphology. In addition, the geometry of the tibial plateau has been linked to the severity of trochlear dysplasia (Balcarek et al.…”

Section: Discussionmentioning

confidence: 99%

“…In addition, a morphometric analysis revealed that the trochlear dysplastic femur is also characterized by 6–8% larger posterior condyles (lateral‐medial) in the anteroposterior direction and a 6% larger medial condyle in the proximodistal direction compared with a normal femur (Van Haver et al. ).…”

Section: Discussionmentioning

confidence: 99%

“…The trochlear dysplastic femur plays a crucial in determining which patellae are likely to dislocate (Dejour et al 1994). However, the geometry of the trochlear dysplastic femur is not only characterized by morphological changes to the trochlea but also to the posterior aspect of the distal femur (Van Haver et al 2013). Recently, an increased femoral antetorsion (angle formed between the axis of the femoral neck and the posterior condylar axis of the distal femur) has been considered a primary risk factor for lateral patellar dislocation (LPD; Diederichs et al 2013).…”

Section: Introductionmentioning

confidence: 99%

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Characteristics of femorotibial joint geometry in the trochlear dysplastic femur

Frosch

Brodkorb²,

Schüttrumpf³

et al. 2014

Journal of Anatomy

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The medial and lateral tibia plateau geometry has been linked with the severity of trochlear dysplasia. The aim of the present study was to evaluate the tibial slope and the femoral posterior condylar offset in a cohort of consecutive subjects with a trochlear dysplastic femur to investigate whether the condylar offset correlates with, and thus potentially compensates for, tibial slope asymmetry. Magnetic resonance imaging was used to assess the severity of trochlear dysplasia as well as the tibial slope and posterior offset of the femoral condyles separately for the medial and lateral compartment of the knee joint in 98 subjects with a trochlear dysplastic femur and 88 control subjects. A significant positive correlation was found for the medial tibial slope and the medial posterior condylar offset in the study group (r 2 = 0.1566; P < 0.001). This relationship was significant for all subtypes of trochlear dysplasia and was most pronounced in the severe trochlear dysplastic femur (Dejour type D) (r 2 = 0.3734; P = 0.04). No correlation was found for the lateral condylar offset and the lateral tibial slope in the study group or for the condylar offset and the tibial slope on both sides in the control group. The positive correlation between the medial femoral condylar offset and the medial tibial slope, that is, a greater degree of the medial tibial slope indicated a larger offset of the medial femoral condyle, appears to represent a general anthropomorphic characteristic of distal femur geometry in patients with a trochlear dysplastic femur.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Characteristics of femorotibial joint geometry in the trochlear dysplastic femur

Frosch

Brodkorb²,

Schüttrumpf³

et al. 2014

Journal of Anatomy

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“…Interestingly, the SSM represented changes of the sulcus angle occurring without modification in the notch width (MoV #3 in aSSM and #8 in cSSM), being this a clinical condition consistent again with dysplasia as reported in the literature . Likewise, MoV #5 in cSSM mapped notch narrowing associated to an overall enlargement of the two condylar surfaces distally, along with an increasing bump in the lateral facet, a morphologic anomaly correlated to dysplasia . Merging healthy and severe dysplastic shapes into dSSM allowed to better elucidate the association between trochlear flatness and notch width (see Figure ).…”

Section: Discussionmentioning

confidence: 55%

“…12,13 In an attempt to accurately describe the morphologic condition of the trochlear region, quantitative methods were proposed to identify morphometric indexes of the femoral geometry, such as trochlear depth, sulcus angle, lateral trochlear inclination, and trochlear facet asymmetry ratio. These indexes are computed by exploiting anatomical landmarks measured on computed tomography (CT)/magnetic resonance imaging (MRI) scans [14][15][16][17] and/or three-dimensional (3D) reconstructed shapes of the femur. [18][19][20][21][22] However, two main aspects make critical the application of such indexes to dysplastic staging.…”

Section: Introductionmentioning

confidence: 99%

Stacked sparse autoencoder networks and statistical shape models for automatic staging of distal femur trochlear dysplasia

Cerveri

Belfatto

Baroni

et al. 2018

Int J Med Robotics Comput Assist Surg

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Statistical shape model‐based tibiofibular assessment of syndesmotic ankle lesions using weight‐bearing CT

Peiffer

Burssens

Mits

et al. 2022

Journal Orthopaedic Research

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Forced external rotation is hypothesized as the key mechanism of syndesmotic ankle injuries, inducing a three‐dimensional deviation from the normal distal tibiofibular joint (DTFJ) alignment. However, current diagnostic imaging modalities are impeded by a two‐dimensional assessment, without considering ligamentous stabilizers. Therefore, our aim is threefold: (1) to construct an articulated statistical shape model of the normal DTFJ with the inclusion of ligamentous morphometry, (2) to investigate the effect of weight‐bearing on the DTFJ alignment, and (3) to detect differences in predicted syndesmotic ligament length of patients with syndesmotic lesions with respect to normative data. Training data comprised non‐weight‐bearing CT scans from asymptomatic controls (N = 76), weight‐bearing CT scans from patients with syndesmotic ankle injury (N = 13), and their weight‐bearing healthy contralateral side (N = 13). Path and length of the syndesmotic ligaments were predicted using a discrete element model, wrapped around bony contours. Statistical shape model evaluation was based on accuracy, generalization, and compactness. The predicted ligament length in patients with syndesmotic lesions was compared with healthy controls. With respect to the first aim, our presented skeletal shape model described the training data with an accuracy of 0.23 ± 0.028 mm. Mean prediction accuracy of ligament insertions was 0.53 ± 0.12 mm. In accordance with the second aim, our results showed an increased tibiofibular diastasis in healthy ankles after weight‐bearing. Concerning our third aim, a statistically significant difference in anterior syndesmotic ligament length was found between ankles with syndesmotic lesions and healthy controls (p = 0.017). There was a significant correlation between the presence of syndesmotic injury and the positional alignment between the distal tibia and fibula (r = 0.873, p < 0,001). Clinical Significance: Statistical shape modeling combined with patient‐specific ligament wrapping techniques can facilitate the diagnostic workup of syndesmosic ankle lesions under weight‐bearing conditions. In doing so, an increased anterior tibiofibular distance was detected, corresponding to an “anterior open‐book injury” of the ankle syndesmosis as a result of anterior inferior tibiofibular ligament elongation/rupture.

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Semi-automated landmark-based 3D analysis reveals new morphometric characteristics in the trochlear dysplastic femur

Abstract: This study shows that knee size is important in the application of absolute metric cut-off values and that the posterior femur also shows a significantly different morphology.

Cited by 31 publications

References 42 publications

Characteristics of femorotibial joint geometry in the trochlear dysplastic femur

Characteristics of femorotibial joint geometry in the trochlear dysplastic femur

Stacked sparse autoencoder networks and statistical shape models for automatic staging of distal femur trochlear dysplasia

Statistical shape model‐based tibiofibular assessment of syndesmotic ankle lesions using weight‐bearing CT

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