scholarly journals Three-Dimensional Weightbearing Assessment of the First Ray in Hallux Valgus: A Case-Control Study

2019 ◽  
Vol 4 (4) ◽  
pp. 2473011419S0005
Author(s):  
Francois Lintz ◽  
Alessio Bernasconi ◽  
Celine Fernando ◽  
Matthew Welck ◽  
Cesar de Cesar Netto
Keyword(s):  
Hallux Valgus ◽  
Case Control Study ◽  
Weight Bearing ◽  
Three Dimensional ◽  
Case Control ◽  
Rotational Deformity ◽  
Intermetatarsal Angle ◽  
First Ray ◽  
3D Architecture ◽  
Control Study

Category: Bunion Introduction/Purpose: Coronal plane rotational deformity of the first ray has been implicated with the developmental pathologic process of hallux valgus (HV). Weight Bearing CT (WBCT) is an imaging technology that can support the assessment of this complex three-dimensional (3D) deformity. The objective of the study was to analyze the 3D architecture of the first ray in patients with HV when compared to controls using WBCT images and a 3D biometric algorithm analyzing the deformity in all three planes. We hypothesized that WBCT would confirm the rotational deformity in HV patients, and that the 3D algorithm would demonstrate increased specificity and sensitivity for the pathology when compared to traditional two-dimensional (2D) HV measurements such as the 1-2 intermetatarsal angle. Methods: Retrospective case-control study, ethics committee approved. Twenty-one feet of patients with clinically symptomatic HV and 20 feet of asymptomatic controls were included. Exclusion criteria applied were previous trauma or surgery affecting first ray or forefoot morphology. All patients were assessed using WBCT. First ray 3D coordinates (x, y, z) were harvested including: center-points of the heads and bases of the first and second metatarsals, center-point of the medial and lateral sesamoids, distal condyles of the proximal phalanx (PP) of the first toe, as well as the medial and lateral borders of the first metatarsal head and diaphysis. The 2D measurements (dorsoplantar 1-2 intermetatarsal (IMA) and metatarsophalangeal (MPA) angles) were obtained using digitally reconstructed radiographs (DRR). The Sesamoid Rotation Angle (SRA) was measured in the coronal plane. Using these coordinates, all 2D, 3D axes, distances, angulations and 3D biometric for HV (HV-3DB) could be calculated. Results: Mean ages were respectively 62.2y in the HV group and 48.8y in the control group (p<0.05). In 2D, the mean IMA and MPA for HV/controls were respectively 14.9/9.3 (p<0.001) and 30.1/13.1 (p<0.001). The SRA were respectively 29.1/7.1 (p<0.001). We found an almost perfect positive correlation between P1 rotation and sesamoid rotation, good correlation between IMA, MPA and SRA angles. There was poor correlation between pronation angles of the 1st phalanx and the 1st metatarsal. The 3D biometric algorithm combining IMA, MPA and SRA had a sensitivity of 95% and a specificity of 95.2% for the diagnosis of HV, compared to 90%/85.6% for the IMA and 90%/90.5% for the SRA. Conclusion: This original study confirmed our hypotheses. Weight Bearing CT efficiently analyzed the 3D architecture of the 1st ray in HV patients compared to asymptomatic controls. We concur with previous findings described in the literature concerning increased pronation of the 1st ray in HV. A novel biometric for HV using a specific multidimensional algorithm which combined IMA, HVA and SRA in a single 3D measurement, demonstrated increased sensitivity and specificity compared to the conventional 2D 1-2 intermetatarsal angle for the diagnosis of HV.

scholarly journals Hallux valgus measurements using weight-bearing computed tomography: what changes?

2021 ◽  
Vol 15 (3) ◽  
pp. 259-264
Author(s):  
Samuel Braza ◽  
Nacime Salomão Barbachan Mansur ◽  
Vineel Mallavarapu ◽  
Kepler Alencar Mendes de Carvalho ◽  
Kevin Dibbern ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Hallux Valgus ◽  
Case Control Study ◽  
Weight Bearing ◽  
Metatarsal Head ◽  
Case Control ◽  
Retrospective Case ◽  
Level Of Evidence ◽  
Mean Values ◽  
Control Study

Objective: To assess whether traditional hallux valgus (HV) measurements obtained with conventional radiography (CR) correspond to those obtained with weight-bearing computed tomography (WBCT). Methods: In this retrospective case-control study, 26 HV feet and 20 control feet were analyzed with CR and WBCT. Hallux valgus angle (HVA), intermetatarsal angle (IMA), interphalangeal angle (IPA), distal metatarsal articular angle (DMAA), sesamoid station (SS), and first metatarsal head shape were measured. Chi-square tests were used to compare hallux valgus and control patients. T-tests were used to compare CR and WBCT. P-values less than 0.05 were considered significant. Results: WBCT was capable of discriminating patients with HV from controls, showing higher mean values for HV patients than controls in HVA (35.29 and 9.02, p < 0.001), IMA (16.01 and 10.01, p < 0.001), and DMAA (18.90 and 4.10, p < 0.001). When comparing the two methods, differences were not significant between CR and WBCT measurements in HVA (-0.84, p = 0.79), IMA (-0.93, p = 0.39), IPA (1.53, p = 0.09), or SS (p = 0.40), but were significant for DMAA (13.43, p < .0001). CR analysis yielded varied metatarsal head shapes, while all WBCT shape classifications were round.  Conclusion: Unidimensional HV measurements were similar between WBCT and CR, while more three-dimensional findings were not. CR may be used to assess the axial aspects of HV, but multidimensional aspects of the deformity may not be accurately assessed with plain radiographs. Level of Evidence III; Therapeutic Studies; Retrospective Case-Control Study.

scholarly journals Evaluation of a Weightbearing CT Artificial Intelligence-based Automatic Measurement for Hallux Valgus: A Case-Control Study

2020 ◽  
Vol 5 (4) ◽  
pp. 2473011420S0003
Author(s):  
Jonathan Day ◽  
Francois Lintz ◽  
Martinus Richter ◽  
Céline Fernando ◽  
Scott J. Ellis ◽  
...  
Keyword(s):  
Artificial Intelligence ◽  
Hallux Valgus ◽  
Case Control Study ◽  
Weight Bearing ◽  
Intraclass Correlation ◽  
Automatic Measurement ◽  
Case Control ◽  
Foot And Ankle ◽  
Beta Version ◽  
Control Study

Category: Bunion; Other Introduction/Purpose: Cone Beam Weight Bearing CT (WBCT) is gaining traction, particularly in the foot and ankle, due to the ability to perform natural stance weight bearing 3D scans. However, the resulting wealth of 3D data renders daily clinical use time consuming. Therefore, reliable automatic measurements are indispensable in order to make best use of the technology. The aim of this study was to evaluate a beta-version WBCT artificial intelligence (AI) automatic measurement system for the M1-M2 intermetatarsal angle (IMA), which is applicable in the absence of metallic hardware in the foot and ankle. We hypothesized that automatic measurements would correlate well with human measurements, and that software reproducibility would be better and close to perfect compared to manual measurements. Methods: In this retrospective case-control study, 90 feet were included from patients who underwent WBCT scans during routine follow up: 44 feet (90.9% female, mean age 54 years) with symptomatic hallux valgus (HV), 46 controls (76.1% female, mean age 49 years). Patients were excluded if they had history of surgery or trauma involving the first or second metatarsals, hallux rigidus, or presence of metal in their foot/ankle. IMA was measured manually on Digitally Reconstructed Radiographs (DRR IMA) and automatically with AI software producing auto 2D (ground plane projection) and 3D (multiplanar) measurements. Each IMA DRR was measured by two independent raters twice to calculate intraclass correlation coefficients (ICCs). To assess intra- software reliability, AI software measurements were made twice on each dataset. Manual and automatic measurements were compared between HV and control groups. Failures of the AI software to produce a measurement were recorded. Results: Mean values for controls were 8.6° +-1.8° (range, 5°-14°) for the manually measured DRR IMA, 9.3° +-2.8° (range, 3°- 17°) for auto 2D, and 9.2° +-2.6° (range, 3°-16°) for auto 3D IMA measurements. Compared to controls, HV patients demonstrated significantly increased IMA (p<0.0001): 14.2° +-2.7° (range, 8°-21°) for the manually measured DRR IMA, 15.4°+- 4.4° (range, 8°-26°) for auto 2D, and 15.1° +-4.1° (range 8°-28°) for auto 3D IMA measurements. There were strong correlations (r=0.75 and r=0.80) between manual and auto 2D and 3D measurements. Intraobserver and interobserver ICCs for DRR IMA were 0.96 and 0.90, respectively, and the intra-software ICCs for the AI were near 1.0 for both auto 2D and auto 3D IMA. The AI software failed in 32.3% cases. Conclusion: Our results demonstrated strong correlation between a WBCT Artificial Intelligence based automatic measurement for IMA with human measurements, with the ability to distinguish HV from control with close to 100% repeatability. However, the number of failures was still high due to the early stage beta-version of the algorithm tested. While these early results are promising, further developments are warranted in order to improve usability of this tool in daily practice, especially in the presence of metal hardware. [Figure: see text]

Three-dimensional (3D) system versus two-dimensional (2D) system for laparoscopic resection of adrenal tumors: a case-control study

2020 ◽  
Vol 405 (8) ◽  
pp. 1163-1173 ◽  
Author(s):  
José Ignacio Rodríguez-Hermosa ◽  
Alejandro Ranea ◽  
Olga Delisau ◽  
Pere Planellas-Giné ◽  
Lídia Cornejo ◽  
...  
Keyword(s):  
Case Control Study ◽  
Laparoscopic Resection ◽  
Three Dimensional ◽  
Case Control ◽  
Adrenal Tumors ◽  
Two Dimensional ◽  
System Versus ◽  
2D System ◽  
Control Study

Magnetic resonance-guided re-ablation for atrial fibrillation is associated with a lower recurrence rate: a case–control study

EP Europace ◽  
2020 ◽  
Vol 22 (12) ◽  
pp. 1805-1811
Author(s):  
Levio Quinto ◽  
Jenniffer Cozzari ◽  
Eva Benito ◽  
Francisco Alarcón ◽  
Felipe Bisbal ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Magnetic Resonance ◽  
Case Control Study ◽  
Cox Regression ◽  
Three Dimensional ◽  
Case Control ◽  
Conventional Group ◽  
3D Navigation ◽  
Control Study

Abstract Aims Our aim was to analyse whether using delayed enhancement cardiac magnetic resonance imaging (DE-CMR) to localize veno-atrial gaps in atrial fibrillation (AF) redo ablation procedures improves outcomes during follow-up. Methods and results We conducted a case–control study with 35 consecutive patients undergoing a DE-CMR-guided Repeat-pulmonary vein isolation (Re-PVI) procedure. Those with more extensive ablations (e.g. roof lines, box) were excluded. Patients were matched for age, sex, AF pattern, and left atrial dimension with 35 patients who had undergone a conventional Re-PVI procedure guided with a three dimensional (3D)-navigation system. Procedural characteristics were recorded, and patients were followed for 24 months in a specialized outpatient clinic. The primary endpoint was freedom from recurrent AF, atrial tachycardia, or flutter. The duration of CMR-guided procedures was shorter compared to the conventional group (161 ± 52 vs. 195 ± 72 min, respectively, P = 0.049), with no significant differences in fluoroscopy or total radiofrequency time. At the 2-year follow-up, more patients in the DE-CMR-guided group remained free from recurrences compared with the conventional group (70% vs. 39%, respectively, P = 0.007). In univariate Cox-regression analyses, AF pattern [persistent AF, hazard ratio (HR) 2.66 (1.27–5.46), P = 0.006] and the use of DE-CMR [HR 0.36 (0.17–0.79), P = 0.009] predicted recurrences during follow-up; both factors remained independent predictors in multivariate analyses. Conclusion The substrate characterization provided by DE-CMR facilitates the identification of anatomical veno-atrial gaps and associates with shorter procedures and better clinical outcomes in repeated AF ablation procedures.

scholarly journals Three-Dimensional Outcome Assessments of Surgical Correction in Cleft and Noncleft Patients with Class III Skeletal Relation: A Case-Control Study

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Te-Ju Wu ◽  
Cheng-Chun Wu ◽  
Chi-Yu Tsai ◽  
Yi-Hao Lee ◽  
Yu-Jen Chang ◽  
...  
Keyword(s):  
Cleft Lip ◽  
Case Control Study ◽  
Cleft Lip And Palate ◽  
Three Dimensional ◽  
Vertical Movement ◽  
Case Control ◽  
Class Iii ◽  
Vertical Movements ◽  
Receiver Operating Characteristic Curves ◽  
Control Study

Background. The orthognathic strategies to treat patients with a concave profile but different tissue conditions remain controversial. The aim of this case-control study was to investigate the outcome predictability of orthognathic surgery in cleft lip and palate (CLP) patients and matched controls. Methods. Fifty consecutive CLP and 45 matched non-CLP patients who received whole-piece Le Fort I and bilateral sagittal split osteotomy to correct class III skeletal relations were enrolled. The outcome discrepancies (ODs) from simulations among all groups were evaluated with consideration of the possible influences from planned surgical movements (PSM). Receiver operating characteristic curves were used to determine threshold values of PSMs that yielded clinically relevant OD. Results. Unilateral CLP (UCLP) patients had comparable postsurgical OD to non-CLP patients in both jaws, whereas bilateral CLP (BCLP) patients had greater deviations from predicted results. Vertical movement of the A − point > 1.33   mm and yaw   correction > 1.65 ° in the BCLP patients was associated with clinically relevant maxillary OD. Conclusions. The OGS outcomes of BCLP patients were less predictable than those of the UCLP and noncleft patients. Vertical movements of the A − point > 1.33   mm and yaw   correction > 1.65 ° in BCLP patients increased OD to a clinically relevant extent.

Three-dimensional scapular kinematics, shoulder outcome measures and quality of life following treatment for breast cancer – A case control study

2019 ◽  
Vol 40 ◽  
pp. 72-79 ◽  
Author(s):  
Ivana Leão Ribeiro ◽  
Paula Rezende Camargo ◽  
Francisco Alburquerque-Sendín ◽  
Angélica Viana Ferrari ◽  
Cristina Lima Arrais ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Quality Of Life ◽  
Outcome Measures ◽  
Case Control Study ◽  
Three Dimensional ◽  
Case Control ◽  
Scapular Kinematics ◽  
Control Study
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