scholarly journals Semi-automatic software-based 3D-angular measurement for Weight-Bearing CT (WBCT) in the foot provides different angles than measurement by hand

2022 ◽  
Author(s):  
Martinus Richter ◽  
Fabian Duerr ◽  
Regina Schilke ◽  
Stefan Zech ◽  
Stefan Andreas Meissner ◽  
...  
Keyword(s):  
Weight Bearing ◽  
Angular Measurement ◽  
Automatic Software

scholarly journals Automatic software-based 3D-angular measurement for Weight-Bearing CT (WBCT) provides different angles than measurement by hand

2021 ◽  
Author(s):  
Martinus Richter ◽  
Regina Schilke ◽  
Fabian Duerr ◽  
Stefan Zech ◽  
Stefan Andreas Meissner ◽  
...  
Keyword(s):  
Weight Bearing ◽  
Angular Measurement ◽  
Automatic Software

scholarly journals Semi-automatic Software-based 3D-Angular Measurement For Weight-Bearing CT (WBCT) is 97% Faster than Measurement by Hand and Provides Similar Angles

2020 ◽  
Vol 5 (4) ◽  
pp. 2473011420S0040
Author(s):  
Martinus Richter ◽  
Stefan Zech ◽  
Stefan A. Meissner ◽  
Issam Naef
Keyword(s):  
Weight Bearing ◽  
Position Angle ◽  
3D Models ◽  
Standing Position ◽  
Angle Measurement ◽  
Angular Measurement ◽  
Total Process ◽  
Automatic Software ◽  
Haglund Deformity ◽  
Conventional Ct

Category: Basic Sciences/Biologics Introduction/Purpose: Weight-bearing CT (WBCT) has been proven to allow for more precise and valid measurement of bone position (angles) than conventional weight-bearing radiographs (R) and conventional CT without weight-bearing (CT)1. The measurement by hand (MBH) has demonstrated adequate inter- and intraobserver reliability but high time consumption1. Recently, a semi-automatic software-based angular measurement (SAM) has been developed (Disior Ltd, Helsinki, Finland). The purpose of this study was to compare SAM with MBH regarding angles values and time spent for the investigator. Methods: Fifteen bilateral WBCT scans (PedCAT, Curvebeam, Warrington, PA, USA) were randomly extracted from a local institutional database with more than 13,000 scans. Nineteen angles as shown in table 1 were measured with MBH as previously described and with SAM1. SAM includes software generated 3D models with semi-automatic bone specification of tibia, fibula, talus, calcaneus, navicular, cuboid, cuneiforms and metatarsals. The software automatically defines the longitudinal axes of these bones and automatically measures the angles between these axes. The time spent of the investigator for the measurements was recorded (total process MBH and specification of bones for SAM). The software calculation time for SAM was not measured or considered as investigator time spent. The angles and time spent of MBH and SAM were compared (t-test, homoscedatic). Results: Mean age of the subject was 58 years (range, 7-81), 12 (40%) were male. The pathologies were bilateral in 8 (54%), right in 4 (27%) and left in 3 (20%) subjects (23 feet in total) and were specified as follows, ankle osteoarthritis/instability in 6 (26%), Haglund deformity/Achillodynia in 4 (17%), Forefoot deformity in 7 (30%), Charcot arthropathy in 2 (9%), flatfoot in 4 (17%) feet. The angles did not differ between MBH and SAM (Table 1, each p>.05). The time spent for MBH / SAM was 780+-171s / 20+-8 s on average in total for 19 angles and 41+-9s / 1+-0.4 s per angle (p<.01). Conclusion: This is the first study comparing MBH with SAM. SAM shows similar angles as MBH and can be also considered as reliable measurement option. The investigator time spent is 97% lower for SAM (1 s per angle) than for MBH (41 s per angle). SAM is an important step forward for 3D-angle measurement of WBCT. The next desired is fully automatic software-based measurement. References1. Richter M, Seidl B, Zech S, Hahn S. PedCAT for 3D-Imaging in Standing Position Allows for More Accurate Bone Position (Angle) Measurement than Radiographs or CT. Foot Ankle Surg 2014;20:201-7. [Table: see text]

scholarly journals How Are Coronal Alignments of the Knee and Hindfoot Correlated?

2018 ◽  
Vol 3 (3) ◽  
pp. 2473011418S0032
Author(s):  
Francois Lintz ◽  
Louis Dagneaux ◽  
Maryama Dufrenot ◽  
Arne Burssens ◽  
Martinus Richter ◽  
...  
Keyword(s):  
Weight Bearing ◽  
Valgus Knee ◽  
Compensatory Mechanisms ◽  
Hindfoot Alignment ◽  
Eos Imaging ◽  
Ethical Approval ◽  
History Of ◽  
Level 3 ◽  
Automatic Software ◽  
The Difference

Category: Hindfoot Introduction/Purpose: Hindfoot and knee coronal alignments have shown to be related in previous literature suggesting that there might be some degree of compensation between the two. However, previous studies have focused on the effects of knee surgery on hindfoot alignment, not on the preoperative relationship. Recent 3D weight bearing imaging technology may help to investigate this. The objective of this study was to analyse the preoperative relationships between knee and hindfoot coronal alignments using bilateral weight bearing CT (WBCT) and biplanar low dose radiography (BLDR). We hypothesized that hindfoot valgus and varus respectively compensates knee varus and valgus. Methods: Relevant ethical approval was obtained for this retrospective comparative level 3 study including 124 limbs in 62 patients (32 female, 30 male), mean age 56 (23-84). Mean BMI was 27 (20-38). Cases included had been referred continuously according to diagnostic protocols in our institution, for a combined WBCT and BLDR investigation. Age, gender and BMI were recorded. Cases with a history of trauma or surgery, which may have caused a change in lower limb alignment, were excluded. Hindfoot alignment was measured using a semi automatic software (TALAS, Curvebeam, Warrington PA, USA) and given as Foot Ankle Offset (FAO). Knee alignment was measured using the EOS platform (EOS Imaging, Paris, France) and given as HKA. Distribution and demographics of hindfoot alignment in the varus and valgus knee groups were studied. Correlations were investigated using linear regression and Bland and Altman plots. Results: Incidence of Varus hindfeet was 15.8% in the Valgus knee group and 25.5% in the Varus knee group but the difference was not significant (p=0.82). Bland and Altman plots did not yield any additional result. No linear correlation was found between hindfoot and knee coronal alignments in the study population. Conclusion: Our results do not confirm prior findings regarding compensatory valgus in varus knees, and do not confirm the hypothesis according to which linear compensatory mechanisms may relate knee and hindfoot alignments. In practice, these results suggest that in cases where knee and hindfoot misalignments are associated, the causes for each should be analyzed independently before any assumption is made as to hypothetical interactions. Furthermore, subsequent studies are warranted to investigate whether other kinds of non-linear correlations way be found in selected populations.

scholarly journals Reliability of Hindfoot Alignment Using Weightbearing CT Semi Automatic Software

2017 ◽  
Vol 2 (3) ◽  
pp. 2473011417S0000
Author(s):  
Francois Lintz ◽  
Matthew Welck ◽  
Alessio Bernasconi ◽  
James Thornton ◽  
Nicholas Cullen ◽  
...  
Keyword(s):  
Gaussian Distribution ◽  
Normal Population ◽  
Interobserver Reliability ◽  
Weight Bearing ◽  
Mean Value ◽  
Measurement Tool ◽  
Hindfoot Alignment ◽  
Clinically Normal ◽  
Automatic Software ◽  
Weightbearing Ct

Category: Ankle, Hindfoot, Imaging Introduction/Purpose: Hindfoot Alignment (HA) on 2D radiographs presents anatomical and operator-related bias. In this study, weightbearing CT (WBCT) was used to measure HA using a semi-automatic software which gives HA as a value of Foot Ankle Offset (FAO) after selecting four landmarks (weight bearing points of first and fifth Metatarsals, Calcaneus and center of the ankle joint). We assessed the intra and interobserver reproducibility and the distribution of FAO values in a series of datasets from clinically normal, varus and valgus cases. We hypothesized that reproducibility would be excellent. Furthermore, FAO in normals should have a Gaussian distribution and be significantly different to the varus and valgus groups. Methods: In this level 3, retrospective comparative study, WBCT (PedCAT ®, CurveBeam LLC, Warrington, PA, USA) datasets were obtained from an existing database. The 135 feet were assessed by a senior foot and ankle surgeon as normal, varus or valgus (57, 38 and 40 respectively). Two surgeon investigators (one senior and one trainee) independently analyzed each case using a semi-automatic HA measurement tool (TALAS ™, CurveBeam LLC, Warrington, PA, USA). A third, independent investigator conducted the statistical analysis using Stata® Software. Results: The overall intraoberver and interobserver reliability were 0.99 ± 0.002 and 0.97 ± 0.02 respectively. In normal cases, mean value for FAO was 2.38% ± 2.96, whereas in varus and valgus cases mean was -11.67% ± 6.90 and 11.47% ± 5.79, respectively (p<0.001). The normal population had a Gaussian distribution with a Kolmogorov-Smirnov test > 0.8 Conclusion: This study reports excellent reliability and discriminative power of a semi-automatic 3D measurement tool for Hindfoot Alignment in WBCT.

Single Hemicerclage for Lateral Type B Malleolar Fracture - A Novel, Minimal and Reliable Osteosynthesis

Swiss Surgery ◽  
2003 ◽  
Vol 9 (6) ◽  
pp. 283-288
Author(s):  
Maurer ◽  
Stamenic ◽  
Stouthandel ◽  
Ackermann ◽  
Gonzenbach
Keyword(s):  
Ankle Joint ◽  
Weight Bearing ◽  
Fracture Type ◽  
Type B ◽  
Malleolar Fracture ◽  
Metallic Wire ◽  
Long Term Outcome ◽  
X Ray ◽  
Upper Ankle Joint ◽  
Upper Ankle

Aim of study: To investigate the short- and long-term outcome of patients with isolated lateral malleolar fracture type B treated with a single hemicerclage out of metallic wire or PDS cord. Methods: Over an 8-year period 97 patients were treated with a single hemicerclage for lateral malleolar fracture type B and 89 were amenable to a follow-up after mean 39 months, including interview, clinical examination and X-ray controls. Results: The median operation time was 35 minutes (range 15-85 min). X-ray controls within the first two postoperative days revealed an anatomical restoration of the upper ankle joint in all but one patient. The complication rate was 8%: hematoma (2 patients), wound infection (2), Sudeck's dystrophy (2) and deep vein thrombosis (1). Full weight-bearing was tolerated at median 6.0 weeks (range 2-26 weeks). No secondary displacement, delayed union or consecutive arthrosis of the upper ankle joint was observed. All but one patient had restored symmetric joint mobility. Ninety-seven percent of patients were satisfied or very satisfied with the outcome. Following bone healing, hemicerclage removal was necessary in 19% of osteosyntheses with metallic wire and in none with PDS cord. Conclusion: The single hemicerclage is a novel, simple and reliable osteosynthesis technique for isolated lateral type B malleolar fractures and may be considered as an alternative to the osteosynthesis procedures currently in use.

Force Plate Analysis of Dogs with Bilateral Hip Dysplasia Treated with a Unilateral Triple Pelvic Osteotomy: A Long-term Review of Cases

1998 ◽  
Vol 11 (02) ◽  
pp. 85-93 ◽  
Author(s):  
Joanne R. Cockshutt ◽  
H. Dobson ◽  
C. W. Miller ◽  
D. L. Holmberg ◽  
Connie L. Taves ◽  
...  
Keyword(s):  
Gait Analysis ◽  
Hip Dysplasia ◽  
Weight Bearing ◽  
Force Plate ◽  
Case Series ◽  
Pelvic Osteotomy ◽  
Vertical Force ◽  
Long Term Outcome ◽  
Case Series Study

SummaryA retrospective case series study was done to determine the long-term outcome of operations upon dogs treated for canine hip dysplasia by means of a triple pelvic osteotomy (TPO). Twentyfour dogs with bilateral hip dysplasia, that received a unilateral TPO between January 1988 and June 1995, were re-examined at the Ontario Veterinary College. The assessment included physical, orthopedic and lameness examinations, standard blood work, pelvic radiographs and force plate gait analysis. They were compared to bilaterally dysplastic dogs that had not been treated, and also to normal dogs. Force plate data analysis demonstrated a significant increase in peak vertical force (PVF) and mean vertical force over stance (MVF) in the limb that underwent surgical correction by means of a TPO, when compared to the unoperated hip. It was determined that performing a unilateral TPO on a young dysplastic dog resulted in greater forces and weight bearing being projected through the TPO corrected limb when compared to the unoperated limb.Dogs with bilateral hip dysplasia treated with a unilateral triple pelvic osteotomy (TPO) were assessed by force plate gait analysis, radiographs and orthopedic examination. There was a significant increase in hip Norberg angles over time, although degenerative changes did progress. Limbs that had been operated upon had significantly greater peak and mean ground reaction forces than limbs that had not received an operation.

PHYSIOTHERAPY AFTER SURGICALLY STABILIZED PROXIMAL TIBIA FRACTURE

2020 ◽  
Vol 18 (2) ◽  
pp. 156-160
Author(s):  
R. Tasheva
Keyword(s):  
Proximal Tibia ◽  
Weight Bearing ◽  
Lateral Compartment ◽  
Recovery Phase ◽  
Knee Extension ◽  
Tibia Fracture ◽  
Extension Deficit ◽  
Proximal Tibia Fracture ◽  
Ao Classification ◽  
Correct Function

THE AIM OF THIS STUDY is to present the physiotherapy for overcoming the substitution movements and to restore the correct function in the phase of relative protection after surgical stabilized proximal tibia fracture. Material and method Seven patients after fracture in the proximal lateral compartment of the tibia (type b1 in AO classification) with an average age of 42, 9 years were treated. After surgery, an average of 30 days of the brace was used for relative protection. The aim of the physiotherapy was to overcome muscle imbalance to achieve proper movement in the respective planes. Emphasis on recovery was the proper weight bearing on the operated lower limb. RESULTS The results of the first recovery phase demonstrated very limited knee flexion in range of 22, 7º, and knee extension deficit in the range of -15º. After two weeks the results progressed to 115, 5º flexion and full restoration of the extension. Control of edema and hypotrophy of the thigh were proven by circumference. CONCLUSION The adequate physiotherapy provides overcoming of the substitution movements and to restore the correct knee function in the phase of relative protection after surgical stabilized fracture in the proximal tibia.

FULL WEIGHT BEARING KINEMATIC MRI STUDY OF TT-TG DISTANCE: COMPARING PATIENTS WITH PATELLOFEMORAL PAIN TO HEALTHY INDIVIDUALS

2015 ◽  
Vol 21 (4.1) ◽  
pp. 638-642
Author(s):  
Andrius Brazaitis ◽  
Algirdas Tamosiunas ◽  
Janina Tutkuviene
Keyword(s):  
Patellar Instability ◽  
Weight Bearing ◽  
Patellofemoral Pain ◽  
Full Weight Bearing ◽  
Trochlear Groove ◽  
Patellar Tilt ◽  
Full Extension ◽  
Low Degrees ◽  
Mri Study ◽  
Kinematic Magnetic Resonance Imaging

Purpose. The aim of the present study was to investigate tibial tuberosity-trochlear groove (TT-TG) distance dynamics in patients with patellofemoral pain (PFP) and pain free individuals by using full weight bearing kinematic magnetic resonance imaging (MRI) And correlation with patellar instability. Materials and methods. 51 female individuals with PFP and 26 pain free female individuals participated in the study. The kinematic MRI was performed with 1,5 T MRI unit and full-weight bearing. TT-TG distance, bissect offset (BSO) and patellar tilt angle (PTA) were measured in steps of 10° between 50° of flexion to full extension. Results. The TT–TG was higher in PFP patients compared to volunteers’ from 40° to full extension. This difference was statistically significant (p<0.01). PFP patients demonstrated statistically significantly greater TT-TG distance increase from 30° to full extension. BSO and PTA were moderately correlated to TT-TG from 20° of flexion to full extension. Conclusion. TT-TG distance is dynamic and increases significantly during extension in patients with PFP and pain free individuals, depending on knee flexion angle. It shows different pattern of dynamics in PFP group. TT-TG distance is associated with patellar instability (BSO and PTA) at low degrees of flexion.

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