The hind- and midfoot alignment computed after a medializing calcaneal osteotomy using a 3D weightbearing CT

Burssens, Arne; Barg, Alexej; Ovost, Esther van; Oevelen, Aline Van; Leenders, T.; Peiffer, Matthias; Bodere, Irina; Audenaert, Emmanuel; Victor, Jan

doi:10.1007/s11548-019-01949-7

Cited by 21 publications

(6 citation statements)

References 41 publications

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“…Furthermore, other domains, such as performing ostectomies that require precise positional and kinematic control, may also benefit from a similar setup. 21,22 This study has several limitations, but they do not affect the conclusion. First, the number of participants was relatively small (three experts and six novices) due to a pilot study.…”

Section: Discussion Of Resultsmentioning

confidence: 89%

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An objective assessment for bone drilling: A pilot study on vertical drilling

Nigam

Mohanty

Kellam

et al. 2022

Journal Orthopaedic Research

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The purpose of this study is to propose a quantitative assessment scheme to help with surgical bone drilling training. This pilot study gathered and compared motion and force data from expert surgeons (n = 3) and novice residents (n = 6). The experiment used three‐dimensional printed bone simulants of young bone (YB) and osteoporotic bone (OB), and drilling overshoot, time, and force were measured. There was no statistically significant difference in overshoot between the two groups (p = 0.217 for YB and 0.215 for OB). The results, however, show that the experts took less time (mean = 4.01 s) than the novices (mean = 9.98 s), with a statistical difference (p = 0.003 for YB and 0.0001 for OB). In addition, the expert group performed more consistently than the novices. The force analysis further revealed that experts used a higher force to drill the first cortical section and a noticeably lower force in the second cortex to control the overshoot (approximate reduction of 5.5 N). Finally, when drilling time and overshoot distance were combined, the motion data distinguished the skill gap between expert and novice drilling; the force data provided insight into the drilling mechanism and performance outcomes. This study lays the groundwork for a data‐driven training scheme to prepare novice residents for clinical practice.

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Section: Discussion Of Resultsmentioning

confidence: 89%

“…The primary benefit is that quantitative data can be used to evaluate and improve drilling skills. Furthermore, other domains, such as performing ostectomies that require precise positional and kinematic control, may also benefit from a similar setup 21,22 …”

Section: Discussion Of Resultsmentioning

confidence: 99%

An objective assessment for bone drilling: A pilot study on vertical drilling

Nigam

Mohanty

Kellam

et al. 2022

Journal Orthopaedic Research

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“…However, detailed analysis of the cuboid and calcaneus as well as their interaction with the talus should be the focus of future studies. Especially, 3-D weightbearing CT assessment of the hind-and midfoot before and after corrective surgery might be an improved way to assess correlation with the 3-D shape [31]. Furthermore, future work should analyse how these morphological differences are manifest during functional activities.…”

Section: Discussionmentioning

confidence: 99%

Talus morphology differs between flatfeet and controls, but its variety has no influence on extent of surgical deformity correction

Flury

Hasler

Beeler

et al. 2021

Arch Orthop Trauma Surg

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Background Progressive collapsing foot deformity (PCFD) is a complex 3-dimensional (3-D) deformity with varying degrees of hindfoot valgus, forefoot abduction, and midfoot varus. The first aim of this study was to perform a 3-D analysis of the talus morphology between symptomatic PCFD patients that underwent operative flatfoot correction and controls. The second aim was to investigate if there is an impact of individual talus morphology on the success of operative flatfoot correction. Methods We reviewed all patients that underwent lateral calcaneal lengthening for correction of PCFD between 2008 and 2018 at our clinic. Radiographic flatfoot parameters on preoperative and postoperative radiographs were assessed. Additionally, 3-D surface models of the tali were generated using computed tomography (CT) data. The talus morphology of 44 flatfeet was compared to 3-D models of 50 controls without foot or ankle pain of any kind. Results Groups were comparable regarding demographics. Talus morphology differed significantly between PCFD and controls in multiple aspects. There was a 2.6° increased plantar flexion (22.3° versus 26°; p = 0.02) and medial deviation (31.7° and 33.5°; p = 0.04) of the talar head in relation to the body in PCFD patients compared to controls. Moreover, PCFD were characterized by an increased valgus (difference of 4.6°; p = 0.01) alignment of the subtalar joint. Satisfactory correction was achieved in all cases, with an improvement of the talometatarsal-angle and the talonavicular uncoverage angle of 5.6° ± 9.7 (p = 0.02) and 9.9° ± 16.3 (p = 0.001), respectively. No statistically significant correlation was found between talus morphology and the correction achieved or loss of correction one year postoperatively. Conclusion The different morphological features mentioned above might be contributing or risk factors for progression to PCFD. However, despite the variety of talar morphology, which is different compared to controls, the surgical outcome of calcaneal lengthening osteotomy was not affected. Level of evidence III.

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“…Following guidelines set out in the literature (Burssens et al, 2018(Burssens et al, , 2019, subjects were classified as either flatfoot or control based on the hindfoot alignment angle (HAA) measured in 3Matic (Version 10, Materialize, Belgium). The HAA has been suggested as the best measurement in a review of 3D flatfoot measurements (de Cesar Netto et al, 2019), and has been used for 3D assessment of foot pathologies in the literature (Kvarda et al, 2021).…”

Section: Flatfoot Classificationmentioning

confidence: 99%

Unique shape variations of hind and midfoot bones in flatfoot subjects—A statistical shape modeling approach

et al. 2022

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Flatfoot deformity is a prevalent hind‐ and midfoot disorder. Given its complexity, single‐plane radiological measurements omit case‐specific joint interaction and bone shape variations. Three‐dimensional medical imaging assessment using statistical shape models provides a complete approach in characterizing bone shape variations unique to flatfoot condition. This study used statistical shape models to define specific bone shape variations of the subtalar, talonavicular, and calcaneocuboid joints that characterize flatfoot deformity, that differentiate them from healthy controls. Bones of the aforementioned joints were segmented from computed tomography scans of 40 feet. The three‐dimensional hindfoot alignment angle categorized the population into 18 flatfoot subjects (≥7° valgus) and 22 controls. Statistical shape models for each joint were defined using the entire study cohort. For each joint, an average weighted shape parameter was calculated for each mode of variation, and then compared between flatfoot and controls. Significance was set at p < 0.05, with values between 0.05 ≤ p < 0.1 considered trending towards significance. The flatfoot population showed a more adducted talar head, inferiorly inclined talar neck, and posteriorly orientated medial subtalar articulation compare to controls, coupled with more navicular eversion, shallower navicular cup, and more prominent navicular tuberosity. The calcaneocuboid joint presented trends of a more adducted calcaneus, more abducted cuboid, narrower calcaneal roof, and less prominent cuboid beak compared to controls. Statistical shape model analysis identified unique shape variations which may enhance understanding and computer‐aided models of the intricacies of flatfoot, leading to better diagnosis and, ultimately, surgical treatment.

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The hind- and midfoot alignment computed after a medializing calcaneal osteotomy using a 3D weightbearing CT

Cited by 21 publications

References 41 publications

An objective assessment for bone drilling: A pilot study on vertical drilling

An objective assessment for bone drilling: A pilot study on vertical drilling

Talus morphology differs between flatfeet and controls, but its variety has no influence on extent of surgical deformity correction

Unique shape variations of hind and midfoot bones in flatfoot subjects—A statistical shape modeling approach

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