Statistical shape modeling of the talocrural joint using a hybrid multi-articulation joint approach

Abstract

Historically, conventional radiographs have been the primary tool to morphometrically evaluate the talocrural joint, which is comprised of the distal tibia, distal fibula, and proximal talus. More recently, high-resolution volumetric imaging, including computed tomography (CT), has enabled the generation of three-dimensional (3D) reconstructions of the talocrural joint. Weightbearing cone-beam CT (WBCT) technology provides additional benefit to assess 3D spatial relationships and joint congruency while the patient is load bearing. In this study we applied statistical shape modeling, a computational morphometrics technique, to objectively quantify anatomical variation, joint level coverage, joint space distance, and congruency at the talocrural joint. Shape models were developed from segmented WBCT images and included the distal tibia, distal fibula, and full talus. Key anatomical variation across subjects included the fibular notch on the tibia, talar trochlea sagittal plane rate of curvature, tibial plafond curvature with medial malleolus prominence, and changes in the fibular shaft diameter. The shape analysis also revealed a highly congruent talocrural joint with minimal inter-individual morphometric differences at the articular regions. These data are helpful to improve understanding of ankle joint pathologies and to guide refinement of operative treatments.

A feature‐based statistical shape model for geometric analysis of the human talus and development of universal talar prostheses

“…Figure13demonstrates the magnitude fields of shape deviations between our mean shape and the best talar shape found byTrovato et al (2017), and the mean shapes obtained byLiu et al (2020) andLenz et al (2021). The deviation fields indicated that the best talar shape presented by Trovato et al was more deviated from our predicted mean shape than the mean shapes predicted byLiu et al and …”

“…Shape deviations of the best talar shape presented by Trovato et al (2017), and the mean shapes obtained by Liu et al (2020) and Lenz et al (2021) from the mean shape predicted in this study [Colour figure can be viewed at wileyonlinelibrary.com]…”

“…The registration methods used in different studies for establishing the geometric correspondence may also affect the mode shapes and the mean shape as well. The significance of this concern needs further investigations; particularly considering the method proposed in this study and the methods recruited by works of Tümer, Arbabi, et al (2019), Tümer et al (2016), Tümer, Vuurberg, et al (2019) and Lenz et al (2021). Tümer et al and Lenz et al followed probabilistic methods of non‐rigid registration, respectively, proposed by van de Giessen et al (2012) and Cates et al (2007, 2017).…”

“…Therefore, the second concern on generating the geometry of a prosthesis by uniformly scaling the mean shape is maintaining the natural articular curvatures. In this regard, Lenz et al (2021) used a curvature‐based congruency index and demonstrated that inter‐individual talar shape variations (i.e. deviations) with respect to the mean shape had minimal effect on the joint congruency at the articular surfaces.…”

“…Besides few treatment methods being available for total/partial loss of talus (Taniguchi et al, 2012), a more recent and so far promising approach is implantation of talar body or total talar prostheses (Ando et al, 2016; Angthong, 2014; Bowes et al, 2019; Harnroongroj & Harnroongroj, 2014; Harnroongroj & Vanadurongwan, 1997; Islam et al, 2014; Magnan et al, 2004; Regauer et al, 2017; Ruatti et al, 2017; Stevens et al, 2007; Taniguchi et al, 2012; Trovato et al, 2017; Tsukamoto et al, 2010). Designing talar prostheses, particularly non‐custom‐made or universal prostheses for total talar replacement, requires understanding of anatomic variations of the talus (Bowes et al, 2019; Islam et al, 2014; Lenz et al, 2021; Liu et al, 2020; Trovato et al, 2017; Tümer, Arbabi, et al, 2019).…”