Three-dimensional biplanar radiography as a new means of accessing femoral version: a comparitive study of EOS three-dimensional radiography versus computed tomography

Pomerantz, M. Lucius; Glaser, Diana; Doan, Josh; Kumar, Sita; Edmonds, Eric W.

doi:10.1007/s00256-014-2031-2

Cited by 32 publications

(12 citation statements)

References 24 publications

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“…The study by Rosskopf et al [32] also shows results similar to the present trial regarding the comparability of EOS and CT scan. The results can also be confirmed in the study by Pomerantz et al [33]. The determination coefficient of both measurement methods was 0.83-0.84.…”

Section: The Present Findingssupporting

confidence: 80%

Anteversion Angle Measurement in Suspected Torsional Malalignment of the Femur in 3-Dimensional EOS vs Computed Tomography—A Validation Study

Mayr

Schmidt

Haasters

et al. 2021

The Journal of Arthroplasty

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Background: Computed tomography (CT) scan is the standard for assessment of femoral torsion. This observational study was conducted to evaluate the comparability of the EOS radiation dose scanning system (EOS imaging, Paris, France) and the CT scan in patients with suspected torsional malalignment of the femur. Methods: Patients with suspected torsional malalignment of the femur were included in a study for surgical planning. The primary endpoint was to compare the 3-dimensional radiological (EOS) imaging system with the CT scan to determine femoral anteversion (AV) angle. Three independent raters performed measurements. Comparability of CT scan and EOS values was assessed by Pearson correlation, t test, interobserver reliability, and intraobserver reliability (Cronbach alpha). Results: About 34 femora were examined. Interobserver reliability/intraobserver reliability was 0.911 of 0.955 for EOS and 0.934 of 0.934 for CT scan. EOS system revealed an AV angle of 12.2 ± 10.0 (À15.0 to 32.0 ). CT examinations showed an AV angle of 12.6 ± 9.2 (À3.2 to 35.6 ). About 11 hips featured physiological AV, 14 hips showed decreased AV (<10 ) or retroversion (<0 ), and 9 hips showed increased AV (>20 ). Overall, a strong Pearson correlation of t ¼ 0.855 and a highly significant correlation in the t test for both methods was seen. In patients with decreased AV, retroversion, or increased AV, Pearson correlation only resulted in a moderate/low correlation of t ¼ 0.495 and t ¼ 0.292. The t test showed no significant correlation at malrotation. Conclusion: In torsional malalignment, EOS does not have correlation with CT measurements. In contrast to CT scan, EOS allows femoral torsion measurement independent of legs' positioning.

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Section: The Present Findingssupporting

confidence: 80%

Anteversion Angle Measurement in Suspected Torsional Malalignment of the Femur in 3-Dimensional EOS vs Computed Tomography—A Validation Study

Mayr

Schmidt

Haasters

et al. 2021

The Journal of Arthroplasty

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“…The CORA can also be determined and used to determine osteotomy planning in the sagittal plane. For axial plane malalignment, a CT scan can also be used to determine femoral version 12 and should be obtained in cases of concern for axial malalignment.…”

Section: Sagittal and Axial Plane Measurementsmentioning

confidence: 99%

Management of Extra-articular Deformity in the Setting of Total Knee Arthroplasty

Sculco

Kahlenberg

Fragomen

et al. 2019

J Am Acad Orthop Surg

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Extra-articular deformities of the femur and tibia in conjunction with advanced knee osteoarthritis pose unique challenges for the arthroplasty surgeon. Careful preoperative planning is needed to evaluate both the intra-and extra-articular deformities and to determine the best route to total knee arthroplasty. An intra-articular compensatory correction can typically be performed if the extraarticular deformity is distant from the joint or if preoperative templating shows that bony cuts do not interfere with ligamentous attachments. Staged osteotomy followed by arthroplasty is beneficial in severe cases in which bony cuts are excessive or would interfere with softtissue structures and in cases with leg-length discrepancy. Osteotomies can be performed percutaneously and fixed with intramedullary nails, external fixators, or plate and screw constructs. Ligamentous laxity after correction and risk of peroneal nerve injury are increased in extra-articular deformity cases and must be considered during the knee arthroplasty procedure with increased implant constraint and patient counseling, respectively. Computerassisted navigation has an emerging role in total knee arthroplasty in patients with extra-articular deformity. M ore than 700,000 total knee arthroplasties (TKAs) are performed annually in the United States. 1 Although correction of intra-articular pathology is a mainstay of TKA, less has been published on the evaluation and management of extra-articular deformity in the setting of TKA. An extra-articular deformity may be a result of previous trauma or skeletal developmental abnormalities and may increase the risk of knee osteoarthritis. 2 Thus, orthopaedic surgeons should be aware of the diagnosis and treatment algorithms for extraarticular deformity in the setting of TKA. Performing a TKA without addressing underlying extra-articular malalignment may place the patient at risk of ongoing pain and early implant failure. 3 The purpose of this article is to present treatment algorithms for the management of extra-articular deformity in either the femur or tibia and in the coronal, sagittal, or axial plane and to review the radiographic imaging, surgical planning, and multidisciplinary approach necessary to optimize clinical outcomes and minimize arthroplasty failure. Causes of Extra-articular Deformity of the Femur and Tibia and Its Association With Knee Osteoarthritis Causes of extra-articular deformity of the femur and tibia are numerous

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“…A similar study was performed on cadaveric femurs in different axial rotations (−10°, −5°, 0°, 5°, and 10°), and the femoral torsion measurements obtained from EOS ® 3D reconstruction were compared to those gained from CT-scan 3D reconstruction [ 47 ]. The interobserver reproducibility and the intraobserver repeatability were excellent for both CT-scan and EOS ® 3D reconstructions (ICC 0.981–0.998), and there was no statistically significant difference between the values yielded by these two techniques and the reference values of femoral torsion.…”

Section: Lower Limb and Pelvismentioning

confidence: 99%

EOS^® biplanar X-ray imaging: Concept, developments, benefits, and limitations

Melhem

Assi

Rachkidi

et al. 2016

Journal of Children's Orthopaedics

216

136

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PurposeIn 1992, Georges Charpak invented a new type of X-ray detector, which in turn led to the development of the EOS® 2D/3D imaging system. This system takes simultaneous anteroposterior and lateral 2D images of the whole body and can be utilized to perform 3D reconstruction based on statistical models. The purpose of this review is to present the state of the art for this EOS® imaging technique, to report recent developments and advances in the technique, and to stress its benefits while also noting its limitations.MethodsThe review was based on a thorough literature search on the subject as well as personal experience gained from many years of using the EOS® system.ResultsWhile EOS® imaging could be proposed for many applications, it is most useful in relation to scoliosis and sagittal balance, due to its ability to take simultaneous orthogonal images while the patient is standing, to perform 3D reconstruction, and to determine various relationships among adjacent segments (cervical spine, pelvis, and lower limbs). The technique has also been validated for the study of pelvic and lower-limb deformity and pathology in adult and pediatric populations; in such a study it has the advantage of allowing the measurement of torsional deformity, which classically requires a CT scan.ConclusionsThe major advantages of EOS® are the relatively low dose of radiation (50–80 % less than conventional X-rays) that the patient receives and the possibility of obtaining a 3D reconstruction of the bones. However, this 3D reconstruction is not created automatically; a well-trained operator is required to generate it. The EOS® imaging technique has proven itself to be a very useful research and diagnostic tool.

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Three-dimensional biplanar radiography as a new means of accessing femoral version: a comparitive study of EOS three-dimensional radiography versus computed tomography

Abstract: BR 3D reconstructions accurately and reliably provide clinical data on femoral version compared to CT even with rotation of the patient of up to 10° from neutral.

Cited by 32 publications

References 24 publications

Anteversion Angle Measurement in Suspected Torsional Malalignment of the Femur in 3-Dimensional EOS vs Computed Tomography—A Validation Study

Anteversion Angle Measurement in Suspected Torsional Malalignment of the Femur in 3-Dimensional EOS vs Computed Tomography—A Validation Study

Management of Extra-articular Deformity in the Setting of Total Knee Arthroplasty

EOS^® biplanar X-ray imaging: Concept, developments, benefits, and limitations

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Three-dimensional biplanar radiography as a new means of accessing femoral version: a comparitive study of EOS three-dimensional radiography versus computed tomography

Abstract: BR 3D reconstructions accurately and reliably provide clinical data on femoral version compared to CT even with rotation of the patient of up to 10° from neutral.

Cited by 32 publications

References 24 publications

Anteversion Angle Measurement in Suspected Torsional Malalignment of the Femur in 3-Dimensional EOS vs Computed Tomography—A Validation Study

Anteversion Angle Measurement in Suspected Torsional Malalignment of the Femur in 3-Dimensional EOS vs Computed Tomography—A Validation Study

Management of Extra-articular Deformity in the Setting of Total Knee Arthroplasty

EOS® biplanar X-ray imaging: Concept, developments, benefits, and limitations

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Product

Resources

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EOS^® biplanar X-ray imaging: Concept, developments, benefits, and limitations