Three-Dimensional Correction of Complex Ankle Deformities With Computer-Assisted Planning and Patient-Specific Surgical Guides

Weigelt, Lizzy; Fürnstahl, Philipp; Hirsiger, Stefanie; Vlachopoulos, Lazaros; Espinosa, Norman; Wirth, Stephan

doi:10.1053/j.jfas.2017.05.025

Cited by 18 publications

(14 citation statements)

References 23 publications

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“…To date, studies on the application of computer-assisted 3D virtual planning and PSI in treating complex deformities of the foot and ankle have been investigated less, however, the results are promising [ 15 – 17 , 20 ]. Weigelt et al [ 15 ] reported that postoperative CT scans showed accurate reduction with a residual translational and rotational error of < 3 mm and < 6° in 4 cases who underwent computer-assisted corrective osteotomy of ankle deformities. A recent study compared the results of this technique with those of conventional methods in ankle surgery [ 20 ].…”

Section: Discussionmentioning

confidence: 99%

“…Recently, the combination of computer-assisted planning and patient-specific instruments (PSIs) has been reported as a mature technology to achieve accurate correction of complex limb deformities [ 15 – 20 ]. We further extended this technique in the correction of ankle OA deformities, and the purpose of this study was to verify the reliability and accuracy of PSI in corrective osteotomy for intra-articular varus OA with medial distal tibial platform erosion.…”

Section: Introductionmentioning

confidence: 99%

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Intra-articular opening wedge osteotomy for varus ankle arthritis with computer-assisted planning and patient-specific surgical guides: a retrospective case series

Zhao

et al. 2022

BMC Musculoskelet Disord

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Background Computer-assisted preoperative planning, combined with PSI has become an effective technique for treating complex limb deformities. The purpose of this study was to evaluate the efficacy and safety of the novel technique in corrective osteotomy for intra-articular varus ankle deformities associated with osteoarthritis and ankle instability. Methods Nineteen patients with intra-articular varus ankle arthritis were reviewed between April 2017 and June 2019, including ten men and nine women with a mean age of 58.3 ± 9.9 years (range, 38 to 76 years). All patients underwent intra-articular opening wedge osteotomy assisted by 3D virtual planning and PSI. Weight-bearing radiographs were used to assess the radiographic results, including TAS angle, TT angle, TMM angle, TC angle, TLS angle, opening-wedge angle, and wedge height. Functional outcomes were assessed by the AOFAS score, VAS score, and ROM of the ankle. Results The average follow-up time was 32.2 ± 9.0 months (range, 22 to 47 months). The average union time was 4.4 ± 0.9 months (range, 3.0 to 6.5 months). The TAS angle significantly changed from 84.1 ± 4.6° preoperatively to 87.7 ± 3.1° at the 1-year follow-up and 86.2 ± 2.6° at the latest follow-up. Similarly, the TT angle, TMM angle and TC angle changed significantly at the 1-year follow-up compared with the preoperative assessment and remained stable until the last follow-up. However, the TLS was not corrected significantly. The postoperative obtained opening-wedge angle, and wedge height showed no significant change with preoperative planning. The overall complication rate was 15.8%. The mean VAS score improved from 5.3 ± 0.6 to 2.7 ± 0.7. The mean AOFAS score improved from 56.2 ± 7.6 to 80.6 ± 4.6. However, the ROM showed no significant change. Conclusions Accurate correction and satisfactory functional recovery were attained with computer-assisted planning and PSI in the corrective osteotomy of intra-articular varus ankle deformities.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Intra-articular opening wedge osteotomy for varus ankle arthritis with computer-assisted planning and patient-specific surgical guides: a retrospective case series

Zhao

et al. 2022

BMC Musculoskelet Disord

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“…This software was developed in our institution and has already been evaluated and published for 3D planning in orthopedic surgery. [13][14][15][16][17] The surgeon defined the resection planes by specifying consecutive line segments on the bone surface. The line segments were automatically extruded to create the corresponding 3D osteotomy planes of 2 mm thickness (Figure 1C).…”

Section: Preoperative Planningmentioning

confidence: 99%

<p>The Accuracy of Three-Dimensional Planned Bone Tumor Resection Using Patient-Specific Instrument</p>

Müller¹,

Stutz²,

Vlachopoulos³

et al. 2020

CMAR

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Introduction Although treatment of bone tumors is multidisciplinary, the complete surgical resection of bone tumors remains the mainstay of the treatment. Patient-specific instruments (PSI) are personalized tools, which help the surgeon to perform tumor resections accurately. The aim of this study is to evaluate how precise the planned resection can be intraoperatively executed with the use of PSI. Patients and Methods Eleven patients who underwent a resection of bone tumor using PSI were analyzed. A preoperative model of the tumor and the affected bone was created from acquired CT scans and MRI. After defining the resection planes, PSI were produced by a 3D printer. The resected piece of bone was scanned and imported in the original planning model enabling the assessment of the distance between the planned resection plane and the realized osteotomy in every direction. Results In overall, the combined error of an osteotomy ranges from 0.74 ± 0.96 mm to 3.60 ± 2.46 mm. The average errors observed in situations with one resection plane (simple osteotomy) are lower than in complex curved osteotomies with multiple planes, in which we also found a greater variance. Conclusion 3D planned bone tumor resections using PSI show promising results for precise resection at different anatomical regions. Even if the found error range in this series is slightly higher than reported, PSI remain a valuable tool to facilitate complex bone tumor resections.

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“…28,34 A recent study addressed posttraumatic ankle deformities with a similar technique of mirroring the contralateral ankle, but 3D computer calculations of the deformity were not taken into account. 46 Our study has numerous limitations. First, measurements of this 3D method have no clear cutoff values to differentiate between healthy ankles and ankles with a syndesmotic lesion.…”

Section: Discussionmentioning

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Templating of Syndesmotic Ankle Lesions by Use of 3D Analysis in Weightbearing and Nonweightbearing CT

et al. 2018

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Three-Dimensional Correction of Complex Ankle Deformities With Computer-Assisted Planning and Patient-Specific Surgical Guides

Cited by 18 publications

References 23 publications

Intra-articular opening wedge osteotomy for varus ankle arthritis with computer-assisted planning and patient-specific surgical guides: a retrospective case series

Intra-articular opening wedge osteotomy for varus ankle arthritis with computer-assisted planning and patient-specific surgical guides: a retrospective case series

<p>The Accuracy of Three-Dimensional Planned Bone Tumor Resection Using Patient-Specific Instrument</p>

Templating of Syndesmotic Ankle Lesions by Use of 3D Analysis in Weightbearing and Nonweightbearing CT

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