Correction of ankle varus deformity using patient-specific dome-shaped osteotomy guides designed on weight-bearing CT: a pilot study

Faict, Sebastian; Burssens, Arne; Oevelen, Aline Van; Maeckelbergh, Liselore; Mertens, Peter R.; Buedts, Kristian

doi:10.1007/s00402-021-04164-9

Cited by 15 publications

(8 citation statements)

References 54 publications

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“…Multiplanar weight-bearing CT has already proven its superiority in assessing subtalar joint subluxation [29][30][31][32], and subfibular impingement [16,33]. Adding a weight-bearing CT assessment in our readings may improve the reliability of this class [18,[34][35][36][37][38]. In the original PCFD publication [13], it is also unclear whether the presence of sinus tarsi impingement should be considered as peritalar subluxation (Class D) or midfoot abduction (Class B) sign.…”

Section: Discussionmentioning

confidence: 98%

A comparison between the Bluman et al. and the progressive collapsing foot deformity classifications for flatfeet assessment

Lalevée

Mansur

Lee

et al. 2021

Arch Orthop Trauma Surg

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Introduction Bluman et al., flatfoot classification is based on posterior tibial tendon (PTT) dysfunction leading to a chronological appearance of several foot deformities. An expert consensus recently proposed a new classification named Progressive Collapsing Foot Deformity (PCFD) in which the focus was shifted to five different independent foot and ankle deformities and their flexibility or rigidity. The aim of this study was to compare Bluman and PCFD classifications. We hypothesize that both classifications will be reliable and that the PCFD classification will allow a larger distribution of the different types of foot deformity. Materials and methodsWe performed a retrospective IRB-approved study including 92 flatfeet. Three foot and ankle surgeons reviewed patient files and radiographs to classify each foot using both classifications. Bluman classification was performed one time as initially described and a second time after removing the Angle of Gissane sclerosis sign. Interobserver reliabilities were determined with Fleiss' kappa values. Results Interobserver reliabilities of Bluman and PCFD classifications were, respectively, substantial 0.67 and moderate 0.55. PCFD Class C and D reliabilities were, respectively, slight 0.07 and fair 0.28. The 276 readings were spread into 10 substages in Bluman and 65 subclasses in PCFD. The progressivity of the Bluman classification prevented the combination of flexible hindfoot valgus (II Bluman, 1A PCFD), midfoot abduction (IIB, 1B) and medial column instability (IIC, 1C) which was frequent in our study (112/276 readings, 40.6%). By removing the Angle of Gissane sclerosis sign from the Bluman classification, the prevalence of stage III decreased from 44.2 to 10.1%. Conclusions Bluman and PCFD classifications were reliable. The PCFD classification showed a larger distribution of different types of flatfeet but Classes C and D need better definition. The progressivity of Bluman classification causes inconsistencies and Gissane angle sclerosis sign is inappropriately used and might lead to incorrect surgical indications.

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Section: Discussionmentioning

confidence: 98%

A comparison between the Bluman et al. and the progressive collapsing foot deformity classifications for flatfeet assessment

Lalevée

Mansur

Lee

et al. 2021

Arch Orthop Trauma Surg

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“…Several other radiological methods have been used for the evaluation of the prosthetic joint components, in particular regarding micro-movements at the bone-prosthesis interface and regarding the wear, or other orthopedic surgical procedures. Among the most described, we find CT-based analysis [40][41][42]. Despite the described value of this method, a higher radiant dose was reported in the literature than in RSA [41].…”

Section: Discussionmentioning

confidence: 99%

Mobile-Bearing Total Ankle Replacement In Vivo Kinematic Assessment: A Prospective Study Protocol

Caravelli

Bragonzoni

Vocale

et al. 2022

JCM

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Total ankle prosthesis as a surgical solution in the case of end-stage osteoarthritis has seen a considerable increase in the last two decades. This study protocol arises from the need to understand the in vivo kinematics of mobile-bearing, flat tibial component total ankle replacement, evaluating the real range of motion and the reciprocal relationships between the components during normal motor tasks through the use of model-based radio-stereometric analysis (MB-RSA). In addition, pre- and post-operative evaluation of walking kinematics with inertial motion sensors, proprioception through a dedicated workstation, and clinical outcomes are discussed. We expect that with the results based on our study protocol, we will be able to improve future prosthetic designs and validate the setup of MB-RSA, as well as to understand “how an ankle prosthesis moves” once implanted in the patient.

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“…A previous study had proved the advantages of the 3D-printed guides in correcting ankle varus deformity. [30] the differences were the basic data was acquired from weight bearing computer tomography. Another retrospective study reported the satisfactory clinical and radiographic outcomes of the varus ankle osteoarthritis treated by the computerassisted planning and Patient speci c instrument.…”

Section: Discussionmentioning

confidence: 99%

Open wedge supramalleolar osteotomy versus 3D printing patient-specific guides for varus ankle osteoarthritis: A retrospective case control study

Shi

Chen

Wang

et al. 2023

Preprint

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Purpose Degenerative joint disease (DJD) of the ankle is a chronic disease that can severely limit function and cause debilitating pain, and with the development of digital medicine, 3D printing patient-specific instrumentation has been used in many subjects. The purpose of the study was to compare the clinical and radiographic outcomes of 3D-printed patient-specific guides with the traditional open- wedge supramalleolar osteotomy . Materials and methods We retrospectively analyzed 10 patients with varus ankle osteoarthritis treated by open wedge supramalleolar osteotomy via 3D patient-specific instrument (PSI group) and 14 patients treated via the traditional method (control group). The demographic data and the pre- and post-operative TAS, TT, TLS angle were recorded. The AOFAS and VAS score were acquired pre-operatively and at the last follow-up time. Results All patients were obtained after surgery 49.4 ± 8.3 months (36–62) follow-up. The TAS, TT, TLS angle and VAS, AOFAS score was comparable pre-operatively between two groups(p＞0.05). The VAS and AOFAS score was statistically improved at the last follow-up time in both cohorts. And the TAS angle was significantly increased post-operatively in the overall cohort. The TT,TLS angle was also ameliorated, though insignificantly. The intraoperative fluoroscopy time, estimated blood loss, and operating time was statistically less in the PSI group in the two cohorts. The post-operative TAS, TT, TLS angle and VAS, AOFAS score at the last follow-up time was comparable between the two cohorts. Conclusion 3D-printed patient-specific guides have a short operation time, low intraoperative blood loss and less fluoroscopy frequency. Patient-specific guides can assist in facilitating doctor-patient communication, shortening the learning curve, reducing surgery time, and correcting varus deformity accurately. And the functional outcome was non-inferior to the traditional method.

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Correction of ankle varus deformity using patient-specific dome-shaped osteotomy guides designed on weight-bearing CT: a pilot study

Cited by 15 publications

References 54 publications

A comparison between the Bluman et al. and the progressive collapsing foot deformity classifications for flatfeet assessment

A comparison between the Bluman et al. and the progressive collapsing foot deformity classifications for flatfeet assessment

Mobile-Bearing Total Ankle Replacement In Vivo Kinematic Assessment: A Prospective Study Protocol

Open wedge supramalleolar osteotomy versus 3D printing patient-specific guides for varus ankle osteoarthritis: A retrospective case control study

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