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Huang L, Wu W, Wang N, Zhou X, Peng W, Jiang S, Chen X, Xiong B, Wang J, Wang G, Zhang L. Skeletal Features of Talus in Hepple V Lesion. J Foot Ankle Surg 2024:S1067-2516(24)00086-3. [PMID: 38679411 DOI: 10.1053/j.jfas.2024.04.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Revised: 04/10/2024] [Accepted: 04/21/2024] [Indexed: 05/01/2024]
Abstract
The present study was to determine the characteristics of the ankle skeletal structure in patients with talus Hepple V type. We conducted a retrospective study on the skeletal structure of the talus in 110 patients with Hepple V osteochondral lesions of the talus and in control participants. The radiographic measurements taken include the following: in the coronal plane - depth of talus frontal curvature, length of the lateral and medial malleolus; in the sagittal plane - radius and height of talus, angle of tibial lateral surface, tibiotalar sector, and vertical neck angle. The osteochondral lesion of the talus showed a significantly larger mean radius (mean ± SD, 21.4 ± 2.5 mm; p < .001) and height (mean ± SD, 26.0 ± 2.7 mm; p < .005). It also demonstrated a longer mean medial malleolus length (mean ± SD, 15.7 ± 2.4 mm; p < .005), a larger mean vertical neck angle (mean ± SD, 86.2 ± 5.4°; p < .050), and a greater mean tibial lateral surface angle (mean ± SD, 80.0 ± 4.5°; p < .001). And there was a greater mean frontal curvature depth (mean ± SD, 3.9 ± 0.6 mm; p < .005). Overall, this study found that patients with Hepple V osteochondral lesions of the talus had a larger vertical neck angle and tibial lateral surface angle, a longer talus radius and medial malleolus length, a higher talus height, and a deeper frontal curvature depth. STUDY DESIGNS: Retrospective Case-Control Study.
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Affiliation(s)
- Lei Huang
- School of Physical Education, Southwest Medical University, Luzhou, 646000, China
| | - Wangyu Wu
- School of Traditional Chinese and Western Medicine, Southwest Medical University, Luzhou, 646000, China
| | - Nan Wang
- School of Traditional Chinese and Western Medicine, Southwest Medical University, Luzhou, 646000, China
| | - Xin Zhou
- Department of Orthopedics, The Affiliated Traditional Chinese Medicine Hospital, Southwest Medical University, Luzhou, 646000, China; Center for Orthopedic Diseases Research, The Affiliated Traditional Chinese Medicine Hospital, Southwest Medical University, Luzhou, 646000, China; Luzhou Key Laboratory of Orthopedic Disorders, Luzhou, 646000, China
| | - Wanlin Peng
- Department of Imaging Medicine, Southwest Medical University, Luzhou, 646000, China
| | - Songtao Jiang
- School of Clinical Medicine, Southwest Medical University, Luzhou, 646000, China
| | - Xu Chen
- Department of Pediatrics, Southwest Medical University, Luzhou, 646000, China
| | - Bin Xiong
- School of Clinical Medicine, Southwest Medical University, Luzhou, 646000, China
| | - Jiarui Wang
- School of Clinical Medicine, Southwest Medical University, Luzhou, 646000, China
| | - Guoyou Wang
- Department of Orthopedics, The Affiliated Traditional Chinese Medicine Hospital, Southwest Medical University, Luzhou, 646000, China; Center for Orthopedic Diseases Research, The Affiliated Traditional Chinese Medicine Hospital, Southwest Medical University, Luzhou, 646000, China; Luzhou Key Laboratory of Orthopedic Disorders, Luzhou, 646000, China
| | - Lei Zhang
- Department of Orthopedics, The Affiliated Traditional Chinese Medicine Hospital, Southwest Medical University, Luzhou, 646000, China; Center for Orthopedic Diseases Research, The Affiliated Traditional Chinese Medicine Hospital, Southwest Medical University, Luzhou, 646000, China; Luzhou Key Laboratory of Orthopedic Disorders, Luzhou, 646000, China.
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Florkow MC, Nguyen CH, Sakkers RJB, Weinans H, Jansen MP, Custers RJH, van Stralen M, Seevinck PR. Magnetic resonance imaging-based bone imaging of the lower limb: Strategies for generating high-resolution synthetic computed tomography. J Orthop Res 2024; 42:843-854. [PMID: 37807082 DOI: 10.1002/jor.25707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Revised: 09/13/2023] [Accepted: 10/05/2023] [Indexed: 10/10/2023]
Abstract
This study aims at assessing approaches for generating high-resolution magnetic resonance imaging- (MRI-) based synthetic computed tomography (sCT) images suitable for orthopedic care using a deep learning model trained on low-resolution computed tomography (CT) data. To that end, paired MRI and CT data of three anatomical regions were used: high-resolution knee and ankle data, and low-resolution hip data. Four experiments were conducted to investigate the impact of low-resolution training CT data on sCT generation and to find ways to train models on low-resolution data while providing high-resolution sCT images. Experiments included resampling of the training data or augmentation of the low-resolution data with high-resolution data. Training sCT generation models using low-resolution CT data resulted in blurry sCT images. By resampling the MRI/CT pairs before the training, models generated sharper images, presumably through an increase in the MRI/CT mutual information. Alternatively, augmenting the low-resolution with high-resolution data improved sCT in terms of mean absolute error proportionally to the amount of high-resolution data. Overall, the morphological accuracy was satisfactory as assessed by an average intermodal distance between joint centers ranging from 0.7 to 1.2 mm and by an average intermodal root-mean-squared distances between bone surfaces under 0.7 mm. Average dice scores ranged from 79.8% to 87.3% for bony structures. To conclude, this paper proposed approaches to generate high-resolution sCT suitable for orthopedic care using low-resolution data. This can generalize the use of sCT for imaging the musculoskeletal system, paving the way for an MR-only imaging with simplified logistics and no ionizing radiation.
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Affiliation(s)
- Mateusz C Florkow
- Image Sciences Institute, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Chien H Nguyen
- Department of Orthopaedics, University Medical Centre Utrecht, Utrecht, The Netherlands
- 3D Lab, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Ralph J B Sakkers
- Department of Orthopaedics, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Harrie Weinans
- Department of Orthopaedics, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Mylene P Jansen
- Department of Rheumatology & Clinical Immunology, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Roel J H Custers
- Department of Orthopaedics, University Medical Centre Utrecht, Utrecht, The Netherlands
| | | | - Peter R Seevinck
- Image Sciences Institute, University Medical Centre Utrecht, Utrecht, The Netherlands
- MRIguidance B.V., Utrecht, The Netherlands
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Seki H, Nozaki S, Ogihara N, Kokubo T, Nagura T. Morphological features of the non-affected side of the hindfoot in patients with unilateral varus ankle osteoarthritis. Ann Anat 2024; 252:152198. [PMID: 38101707 DOI: 10.1016/j.aanat.2023.152198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Revised: 11/19/2023] [Accepted: 12/06/2023] [Indexed: 12/17/2023]
Abstract
BACKGROUND The innate shape characteristics of the hindfoot bones alter the loading conditions of the foot and thus may be associated with an increased risk of developing varus ankle osteoarthritis (OA). This study aimed to clarify the innate morphological patterns of the hindfoot bones that may be associated with ankle OA by analyzing the differences between the bone morphology of the non-affected side of patients with unilateral varus ankle OA and that of healthy participants. METHODS In this case-control study, computed tomography images were used to develop three-dimensional models of three hindfoot bones (distal tibia with fibula, talus, and calcaneus) from 23 non-affected sides of patients with radiography-diagnosed unilateral ankle OA and 22 healthy control participants. Anatomical and sliding landmarks were placed on the surface of each bone, and the principal components (PCs) of shape variation among specimens were independently calculated for each bone, preserving homology between individuals. The PC modes representing 5% or more of the overall variation were statistically compared between the ankle OA and control groups. RESULTS Significant differences were identified between the OA and control groups in the fifth PC mode for the tibia with fibula (proportion of variance, 5.1%; p =.025), fifth PC mode for the talus (6.7%, p =.031), and third PC mode for the calcaneus (7.4%, p =.001). The hindfoot bones of the participants who developed ankle OA had the following innate morphological characteristics: the lateral malleolar articular surface of the fibula was shifted superiorly, tibial plafond was enlarged posteroinferiorly, posterior width of the talar trochlea was narrower, talonavicular articular surface of the talus was oriented more frontally, anterior-middle talocalcaneal articular surfaces of the talus were more medially shifted and those of the calcaneus were flatter, calcaneal sustentaculum tali was less protruding, and lateral plantar process of the calcaneus was more superiorly positioned. CONCLUSIONS These distinctive morphological alterations may increase the incidence and progression of varus ankle OA through aberrant anterior translation, internal rotation, and varus tilting of the talus.
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Affiliation(s)
- Hiroyuki Seki
- Department of Orthopaedics Surgery, Tachikawa Hospital, 4-2-22 Nishiki-cho, Tachikawa-shi, Tokyo 190-8531, Japan; Department of Orthopaedics Surgery, School of Medicine, Keio University, 35 Shinano-machi, Shinjuku-ku, Tokyo 160-8582, Japan; Department of Clinical Biomechanics, Keio University, 35 Shinano-machi, Shinjuku-ku, Tokyo 160-8582, Japan.
| | - Shuhei Nozaki
- Laboratory of Human Evolutionary Biomechanics, Department of Biological Sciences, Graduate School of Science, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan
| | - Naomichi Ogihara
- Laboratory of Human Evolutionary Biomechanics, Department of Biological Sciences, Graduate School of Science, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan.
| | - Tetsuro Kokubo
- Department of Orthopaedics Surgery, Tachikawa Hospital, 4-2-22 Nishiki-cho, Tachikawa-shi, Tokyo 190-8531, Japan
| | - Takeo Nagura
- Department of Orthopaedics Surgery, School of Medicine, Keio University, 35 Shinano-machi, Shinjuku-ku, Tokyo 160-8582, Japan; Department of Clinical Biomechanics, Keio University, 35 Shinano-machi, Shinjuku-ku, Tokyo 160-8582, Japan
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Yu P, Cen X, Xiang L, Mei Q, Wang A, Gu Y, Fernandez J. Regional plantar forces and surface geometry variations of a chronic ankle instability population described by statistical shape modelling. Gait Posture 2023; 106:11-17. [PMID: 37611480 DOI: 10.1016/j.gaitpost.2023.08.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 08/03/2023] [Accepted: 08/17/2023] [Indexed: 08/25/2023]
Abstract
BACKGROUND Understanding detailed foot morphology as well as regional plantar forces could provide insight into foot function and provide recommendation for footwear design for chronic ankle instability (CAI) people. RESEARCH QUESTION This study presented 3-dimensional statistical shape models of feet from three different populations including CAI, copers and healthy individuals, with regional plantar forces also acquired. METHODS Sixty-six males (22 participants per group) were included in this study to capture 3-dimensional foot shapes under a standing condition and regional plantar forces during a cutting maneuver. Principal component analysis was performed to generate a mean foot shape of each group as well as modes of variations. A generalized procrustes analysis was used to achieve rapid registration of mean shapes. Besides, regional plantar forces and contact duration among these three populations were compared. RESULTS For 3-dimensional foot shapes, although no significant differences of the average distance between each mode and mean shape were found among three populations, there were subtle variations in mean shapes. The CAI population presented a more bulging of the lateral malleolus; copers were characterized by the flexion of the lesser toes, a more bulging of the medial foot in the sagittal plane; and healthy individuals showed a greater heel width and a more bulging of the heel in the sagittal plane. In terms of plantar forces, healthy individuals had significantly greater summated plantar forces and greater plantar forces in the lateral heel area during the early contact phase compared to copers and CAI participants. SIGNIFICANCE Overall, this study suggested that repetitive ankle sprains may lead to the bulging of the lateral malleolus. Further, CAI and copers seem to stabilize the ankle joint by medially shifting the center of pressure compared to healthy individuals under the static and less challenging dynamic conditions.
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Affiliation(s)
- Peimin Yu
- Faculty of Sports Science, Ningbo University, Ningbo, China; Auckland Bioengineering Institute, The University of Auckland, Auckland, New Zealand
| | - Xuanzhen Cen
- Faculty of Sports Science, Ningbo University, Ningbo, China; Doctoral School on Safety and Security Sciences, Óbuda University, Budapest, Hungary; Faculty of Engineering, University of Szeged, Szeged, Hungary
| | - Liangliang Xiang
- Faculty of Sports Science, Ningbo University, Ningbo, China; Auckland Bioengineering Institute, The University of Auckland, Auckland, New Zealand
| | - Qichang Mei
- Faculty of Sports Science, Ningbo University, Ningbo, China; Auckland Bioengineering Institute, The University of Auckland, Auckland, New Zealand
| | - Alan Wang
- Auckland Bioengineering Institute, The University of Auckland, Auckland, New Zealand
| | - Yaodong Gu
- Faculty of Sports Science, Ningbo University, Ningbo, China; Auckland Bioengineering Institute, The University of Auckland, Auckland, New Zealand.
| | - Justin Fernandez
- Auckland Bioengineering Institute, The University of Auckland, Auckland, New Zealand; Department of Engineering Science, University of Auckland, Auckland, New Zealand
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Fallon Verbruggen F, Killen BA, Burssens A, Boey H, Vander Sloten J, Jonkers I. Unique shape variations of hind and midfoot bones in flatfoot subjects-A statistical shape modeling approach. Clin Anat 2023; 36:848-857. [PMID: 36373980 DOI: 10.1002/ca.23969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 10/06/2022] [Accepted: 10/17/2022] [Indexed: 11/16/2022]
Abstract
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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Affiliation(s)
- Ferdia Fallon Verbruggen
- Human Movement Biomechanics Research Group, Department of Movement Sciences, KU Leuven, Leuven, Belgium
| | - Bryce A Killen
- Human Movement Biomechanics Research Group, Department of Movement Sciences, KU Leuven, Leuven, Belgium
| | - Arne Burssens
- Department of Orthopaedics, UZ Ghent, Ghent, Belgium
| | - Hannelore Boey
- Human Movement Biomechanics Research Group, Department of Movement Sciences, KU Leuven, Leuven, Belgium
| | - Jos Vander Sloten
- Biomechanics Section, Department of Mechanical Engineering, KU Leuven, Leuven, Belgium
| | - Ilse Jonkers
- Human Movement Biomechanics Research Group, Department of Movement Sciences, KU Leuven, Leuven, Belgium
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Eijkenboom JFA, Tümer N, Schiphof D, Oei EH, Zadpoor AA, Bierma-Zeinstra SMA, van Middelkoop M. 3D patellar shape is associated with radiological and clinical signs of patellofemoral osteoarthritis. Osteoarthritis Cartilage 2023; 31:534-542. [PMID: 36623637 DOI: 10.1016/j.joca.2022.12.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 11/25/2022] [Accepted: 12/20/2022] [Indexed: 01/09/2023]
Abstract
OBJECTIVE To examine the association between 3D patellar shape and 1) isolated magnetic resonance imaging (MRI)-based patellofemoral osteoarthritis (PFOA), 2) the morphological features of PFOA, and 3) the clinical symptoms of PFOA. DESIGN MRI data from 66 women with isolated MRI-based PFOA and 66 age- and BMI-matched healthy women were selected from a cohort study. The patellae were manually segmented from MRI scans and used to create a 3D statistical shape model (SSM) of the patella. Structural abnormalities were semi-standardized scored on MRI using MRI osteoarthritis knee score (MOAKS). Regression analyses were applied to determine the associations between the shape parameters retrieved from the SSM, group status, clinical symptoms, and structural abnormalities. RESULTS Four shape variants showed a statistically significant (<0.05) association with the group status. The mode responsible for most of the shape variations showed participants with PFOA possess a relatively thicker dorsal bump on the articular part of the patella, compared to patellae of control participants. Three of these variants showed an association with the presence of osteophytes and cartilage loss on the patella. Multiple associations were found between patellar shape and the clinical symptoms of PFOA. CONCLUSIONS Patellar shape is associated with the prevalence of MRI-based PFOA in women. Some shape variants were also associated with clinical symptoms. Interestingly, one particular shape variant associated with the presence of MRI-based PFOA was earlier shown to be associated with structural abnormalities associated with OA in a population aged under 40. This may suggest that patellar shape may be an early detectable risk factor for PFOA.
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Affiliation(s)
- J F A Eijkenboom
- Department of General Practice, Erasmus MC University Medical Center Rotterdam, the Netherlands.
| | - N Tümer
- Department of Biomechanical Engineering, Delft University of Technology, the Netherlands.
| | - D Schiphof
- Department of General Practice, Erasmus MC University Medical Center Rotterdam, the Netherlands.
| | - E H Oei
- Department of Radiology & Nuclear Medicine, Erasmus MC University Medical Center Rotterdam, the Netherlands.
| | - A A Zadpoor
- Department of Biomechanical Engineering, Delft University of Technology, the Netherlands.
| | - S M A Bierma-Zeinstra
- Department of General Practice, Erasmus MC University Medical Center Rotterdam, the Netherlands; Department of Orthopedics and Sports Medicine, Erasmus MC University Medical Center Rotterdam, the Netherlands.
| | - M van Middelkoop
- Department of General Practice, Erasmus MC University Medical Center Rotterdam, the Netherlands.
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Arbabi S, Seevinck P, Weinans H, de Jong PA, Sturkenboom J, van Hamersvelt RW, Foppen W, Arbabi V. Statistical shape model of the talus bone morphology: A comparison between impinged and nonimpinged ankles. J Orthop Res 2023; 41:183-195. [PMID: 35289957 PMCID: PMC10084311 DOI: 10.1002/jor.25328] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Revised: 02/14/2022] [Accepted: 03/13/2022] [Indexed: 02/04/2023]
Abstract
Diagnosis of ankle impingement is performed primarily by clinical examination, whereas medical imaging is used for severity staging and treatment guidance. The association of impingement symptoms with regional three-dimensional (3D) bone shape variaties visible in medical images has not been systematically explored, nor do we know the type and magnitude of this relation. In this cross-sectional case-control study, we hypothesized that 3D talus bone shape could be used to quantitatively formulate the discriminating shape variations between ankles with impingement from ankles without impingement, and we aimed to characterize and quantify these variations. We used statistical shape modeling (SSM) methods to determine the most prevalent modes of shape variations that discriminate between the impinged and nonimpinged ankles. Results of the compactness and parallel analysis test on the statistical shape model identify 8 prominent shape modes of variations (MoVs) representing approximately 78% of the total 3D variations in the population of shapes, among which two modes captured discriminating features between impinged and nonimpinged ankles (p value of 0.023 and 0.042). Visual inspection confirms that these two shape modes, capturing abnormalities in the anterior and posterior parts of talus, represent the two main bony risk factors in anterior and posterior ankle impingement. In conclusion, in this research using SSM we have identified shape MoVs that were found to correlate significantly with bony ankle impingement. We also illustrated potential guidance from SSMs for surgical planning.
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Affiliation(s)
- Saeed Arbabi
- Image Sciences Institute, University Medical Center Utrecht, Utrecht, The Netherlands.,Department of Orthopedics, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Peter Seevinck
- Image Sciences Institute, University Medical Center Utrecht, Utrecht, The Netherlands.,MRIguidance B.V., Utrecht, The Netherlands
| | - Harrie Weinans
- Department of Orthopedics, University Medical Center Utrecht, Utrecht, The Netherlands.,Department of Biomechanical Engineering, Delft University of Technology (TU Delft), Delft, The Netherlands
| | - Pim A de Jong
- Department of Radiology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Joran Sturkenboom
- Polikliniek Orthopedie, Central Military Hospital, Utrecht, The Netherlands
| | | | - Wouter Foppen
- Department of Radiology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Vahid Arbabi
- Department of Orthopedics, University Medical Center Utrecht, Utrecht, The Netherlands.,Department of Mechanical Engineering, Faculty of Engineering, Orthopaedic-Biomechanics Research Group, Birjand, Iran
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Vuurberg G, Tümer N, Sierevelt I, Dobbe JGG, Hemke R, Wiegerinck JJ, Maas M, Kerkhoffs GMMJ, Tuijthof GJM. Translation of 3D Anatomy to 2D Radiographic Angle Measurements in the Ankle Joint: Validity and Reliability. FOOT & ANKLE ORTHOPAEDICS 2022; 7:24730114221112945. [PMID: 35898795 PMCID: PMC9310239 DOI: 10.1177/24730114221112945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Background: The objective consisted of 2 elements, primarily to define 2 bone geometry variations of the ankle that may be of prognostic value on ankle instability and secondly to translate these bone variations from a 3D model to a simple 2D radiographic measurement for clinical use. Methods: The 3D tibial and talar shape differences derived from earlier studies were translated to two 2D radiographic parameters: the medial malleolar height angle (MMHA) and talar convexity angle (TCA) respectively to ensure clinical use. To assess validity, the MMHA and TCA were measured on 3D polygons derived from lower leg computed tomographic (CT) scans and 2D digitally reconstructed radiographs (DRRs) of these polygons. To assess reliability, the MMHA and TCA were measured on standard radiographs by 2 observers calculating the intraclass correlation coefficient (ICC). Results: The 3D angle measurements on the polygons showed substantial to excellent agreement with the 2D measurements on DRR for both the MMHA (ICC 0.84-0.93) and TCA (ICC 0.88-0.96). The interobserver reliability was moderate with an ICC of 0.58 and an ICC of 0.64 for both the MMHA and TCA, respectively. The intraobserver reliability was excellent with an ICC of 0.96 and 0.97 for the MMHA and the TCA, respectively. Conclusion: Two newly defined radiographic parameters (MMHA and TCA) are valid and can be assessed with excellent intraobserver reliability on standard radiographs. The interobserver reliability was moderate and indicates training is required to ensure uniformity in measurement technique. The current method may be used to translate more variations in bone shape prior to implementation in clinical practice. Level of Evidence: Level III, cohort study.
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Affiliation(s)
- Gwendolyn Vuurberg
- Department of Orthopedic Surgery, Amsterdam Movement Sciences, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
- Academic Center for Evidence-based Sports Medicine (ACES), Amsterdam, the Netherlands
- Amsterdam Collaboration on Health & Safety in Sports (ACHSS), AMC/VUmc IOC Research Center, Amsterdam, the Netherlands
- Radiology and Nuclear Medicine, Amsterdam Movement Sciences, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
- Department of Radiology and Nuclear Medicine, Rijnstate Hospital, Arnhem, the Netherlands
| | - Nazli Tümer
- Department of Biomechanical Engineering, Delft University of Technology (TU Delft), the Netherlands
| | - Inger Sierevelt
- Specialized Centre for Orthopedic Research and Education (SCORE), Xpert Orthopedics, Amsterdam, the Netherlands
- Spaarne Gasthuis Academy, Orthopedic Department, Hoofddorp
| | - Johannes G. G. Dobbe
- Department of Biomedical Engineering and Physics, Amsterdam Movement Sciences, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Robert Hemke
- Academic Center for Evidence-based Sports Medicine (ACES), Amsterdam, the Netherlands
- Amsterdam Collaboration on Health & Safety in Sports (ACHSS), AMC/VUmc IOC Research Center, Amsterdam, the Netherlands
- Radiology and Nuclear Medicine, Amsterdam Movement Sciences, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Jan Joost Wiegerinck
- Department of Orthopedic Surgery, Amsterdam Movement Sciences, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
- Bergman Clinics, Rijswijk, the Netherlands
| | - Mario Maas
- Academic Center for Evidence-based Sports Medicine (ACES), Amsterdam, the Netherlands
- Amsterdam Collaboration on Health & Safety in Sports (ACHSS), AMC/VUmc IOC Research Center, Amsterdam, the Netherlands
- Radiology and Nuclear Medicine, Amsterdam Movement Sciences, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Gino M. M. J. Kerkhoffs
- Department of Orthopedic Surgery, Amsterdam Movement Sciences, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
- Academic Center for Evidence-based Sports Medicine (ACES), Amsterdam, the Netherlands
- Amsterdam Collaboration on Health & Safety in Sports (ACHSS), AMC/VUmc IOC Research Center, Amsterdam, the Netherlands
| | - Gabriëlle J. M. Tuijthof
- Department of Orthopedic Surgery, Amsterdam Movement Sciences, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
- Academic Center for Evidence-based Sports Medicine (ACES), Amsterdam, the Netherlands
- Amsterdam Collaboration on Health & Safety in Sports (ACHSS), AMC/VUmc IOC Research Center, Amsterdam, the Netherlands
- Department of Research Engineering, Faculty Health, Medicine & Life Science, Maastricht University, Maastricht, the Netherlands
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Vafaeian B, Riahi HT, Amoushahi H, Jomha NM, Adeeb S. A feature-based statistical shape model for geometric analysis of the human talus and development of universal talar prostheses. J Anat 2022; 240:305-322. [PMID: 34549428 PMCID: PMC8742977 DOI: 10.1111/joa.13552] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 08/16/2021] [Accepted: 09/07/2021] [Indexed: 12/26/2022] Open
Abstract
Statistical data pertaining to anatomic variations of the human talus contain valuable information for advances in biological anthropology, diagnosis of the talar pathologies, and designing talar prostheses. A statistical shape model (SSM) can be a powerful data analysis tool for the anatomic variations of the talus. The main concern in constructing an SSM for the talus is establishing the true geometric correspondence between the talar geometries. The true correspondence complies with biological and/or mathematical homologies on the talar surfaces. In this study, we proposed a semi-automatic approach to establish a dense correspondence between talar surfaces discretized by triangular meshes. Through our approach, homologous salient surface features in the form of crest lines were detected on 49 talar surfaces. Then, the point-wise correspondence information of the crest lines was recruited to create posterior Gaussian process morphable models that non-rigidly registered the talar meshes and consequently established inter-mesh dense correspondence. The resultant correspondence perceptually represented the true correspondence as per our visual assessments. Having established the correspondence, we computed the mean shape using full generalized Procrustes analysis and constructed an SSM by means of principal component analysis. Anatomical variations and the mean shape of the talus were predicted by the SSM. As a clinically related application, we considered the mean shape and investigated the feasibility of designing universal talar prostheses. Our results suggest that the mean shape of (the shapes of) tali can be used as a scalable shape template for designing universal talar prostheses.
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Affiliation(s)
- Behzad Vafaeian
- Faculty of Civil Engineering and TransportationDepartment of Civil EngineeringUniversity of IsfahanIsfahanIran
| | - Hossein Tajmir Riahi
- Faculty of Civil Engineering and TransportationDepartment of Civil EngineeringUniversity of IsfahanIsfahanIran
| | - Hossein Amoushahi
- Faculty of Civil Engineering and TransportationDepartment of Civil EngineeringUniversity of IsfahanIsfahanIran
| | - Nadr M. Jomha
- Division of Orthopaedic SurgeryDepartment of SurgeryUniversity of AlbertaEdmontonABCanada
| | - Samer Adeeb
- Department of Civil and Environmental EngineeringUniversity of AlbertaEdmontonABCanada
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10
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Tümer N, Hiemstra O, Schreurs Y, Kraan GA, van der Stok J, Zadpoor AA. The three-dimensional shape symmetry of the lunate and its implications. J Hand Surg Eur Vol 2021; 46:587-593. [PMID: 33784838 DOI: 10.1177/17531934211004080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
We studied the three-dimensional (3-D) shape variations and symmetry of the lunate to evaluate whether a contralateral shape-based approach to design patient-specific implants for treatment of Kienböck's disease is accurate. A 3-D statistical shape model of the lunate was built using the computed tomography scans of 54 lunate pairs and shape symmetry was evaluated based on an intraclass correlation analysis. The lunate shape was not bilaterally symmetrical in (1) the angle scaphoid surface - radius-ulna surface, (2) the dorsal side and the length of the side adjacent to the triquetrum, (3) the orientation of the volar surface, (4) the width of the side adjacent to the scaphoid, (5) the skewness in the coronal plane and (6) the curvature of bone articulating with the hamate and capitate. These findings suggest that using the contralateral lunate to design patient-specific lunate implants may not be as accurate as it is intended.
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Affiliation(s)
- Nazlı Tümer
- Department of Biomechanical Engineering, Delft University of Technology (TU Delft), Delft, The Netherlands
| | - Olivier Hiemstra
- Department of Orthopaedic Surgery, Reinier Haga Orthopaedic Centre, Zoetermeer, The Netherlands
| | - Yvonne Schreurs
- Department of Orthopaedic Surgery, Reinier Haga Orthopaedic Centre, Zoetermeer, The Netherlands
| | - Gerald A Kraan
- Department of Orthopaedic Surgery, Reinier Haga Orthopaedic Centre, Zoetermeer, The Netherlands
| | - Johan van der Stok
- Department of Orthopaedic Surgery, Reinier Haga Orthopaedic Centre, Zoetermeer, The Netherlands
| | - Amir A Zadpoor
- Department of Biomechanical Engineering, Delft University of Technology (TU Delft), Delft, The Netherlands
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11
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Lenz AL, Krähenbühl N, Peterson AC, Lisonbee RJ, Hintermann B, Saltzman CL, Barg A, Anderson AE. Statistical shape modeling of the talocrural joint using a hybrid multi-articulation joint approach. Sci Rep 2021; 11:7314. [PMID: 33795729 PMCID: PMC8016855 DOI: 10.1038/s41598-021-86567-7] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Accepted: 03/15/2021] [Indexed: 01/16/2023] Open
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.
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Affiliation(s)
- Amy L Lenz
- Department of Orthopaedics, University of Utah, Salt Lake City, 84108, USA
| | - Nicola Krähenbühl
- Department of Orthopaedics, Kantonsspital Baselland, 4410, Liestal, Switzerland
| | - Andrew C Peterson
- Department of Orthopaedics, University of Utah, Salt Lake City, 84108, USA
| | - Rich J Lisonbee
- Department of Orthopaedics, University of Utah, Salt Lake City, 84108, USA
| | - Beat Hintermann
- Department of Orthopaedics, Kantonsspital Baselland, 4410, Liestal, Switzerland
| | - Charles L Saltzman
- Department of Orthopaedics, University of Utah, Salt Lake City, 84108, USA
| | - Alexej Barg
- Department of Orthopaedics, University of Utah, Salt Lake City, 84108, USA.,Department of Orthopaedics, Trauma and Reconstructive Surgery, University Medical Center Hamburg-Eppendorf, 20251, Hamburg, Germany
| | - Andrew E Anderson
- Department of Orthopaedics, University of Utah, Salt Lake City, 84108, USA.
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12
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Categorizing Three-Dimensional Symmetry Using Reflection, Rotoinversion, and Translation Symmetry. Symmetry (Basel) 2019. [DOI: 10.3390/sym11091132] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Symmetry is a property that has been widely examined clinically as a measurement of health and aesthetic appeal. Many current techniques that assess geometric symmetry rely on interpretation from a trained operator or produce two-dimensional measurements that cannot express the three-dimensional character of an object. In this article, we propose a comprehensive markerless method that describes an object’s symmetry using three types of fundamental symmetry, reflection, rotoinversion a combination of reflection and rotation and translation a process of reflection and rigid movement. This is done by mirroring an object over an arbitrary plane and aligning the mirrored image with the original object in a position that minimizes deviation between both objects. Each object’s symmetry can be displayed in two ways, numerically, with a best plane of symmetry or “Psym”, a fixed point and the mirrored objects rotation and magnitude of translation in relation to the original object, and visually, through a 3D deviation contour map. Three examples were made: Model 1 showed reflection symmetry and resulted in a standard deviation of 0.002 mm, Model 2 expressed rotoinversion symmetry and produced a standard deviation of 0.003 mm and Model 3 expressed translational symmetry which resulted in a translation magnitude difference of 0.015% with respect to model height. This simple procedure accurately recognizes reflection, rotoinversion and translation symmetry, takes minimal time and expertise and has the ability to expand previous case specific methods to a global application of symmetry analysis.
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13
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Tümer N, Vuurberg G, Blankevoort L, Kerkhoffs GMMJ, Tuijthof GJM, Zadpoor AA. Typical Shape Differences in the Subtalar Joint Bones Between Subjects with Chronic Ankle Instability and Controls. J Orthop Res 2019; 37:1892-1902. [PMID: 31042001 PMCID: PMC6772087 DOI: 10.1002/jor.24336] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2018] [Accepted: 04/23/2019] [Indexed: 02/04/2023]
Abstract
Bone shapes, particularly those defining the subtalar joint (STJ), have not received much attention yet as a risk factor for developing chronic ankle instability (CAI) after sustaining a lateral ankle sprain (LAS). This study aimed to compare three-dimensional (3D) shape variations in the STJ bones within individuals with CAI and healthy controls. 3D statistical shape models (SSMs) of the STJ bones were built to describe the bone shape variations observed within a population consisting of 26 individuals with unilateral CAI and 26 healthy controls. Using the SSMs and analysis of covariance test, age- and gender-adjusted shape variations in the bones were compared within individuals with CAI and healthy controls. The mean age of the CAI patients (14 males and 12 females) and healthy controls (12 males and 14 females) was 29 (standard deviation [SD] = 11) and 36 years (SD = 11), respectively. Tali and calcanei did not significantly vary between ipsilateral CAI and their contralateral ankle. Two shape modes, one for the talus (p = 0.015, variations in the curvature of the talar lateral process and the inclination angle of the talar neck relative to the body) and one for the calcaneus (p = 0.003, variations in the medial and lateral tuberosities, and the contour of the anterior articular surface), described significant shape differences between the CAI patients and healthy controls. The CAI patients generally had flatter talar joint surfaces and a flattened calcaneal ground-contact surface. These findings suggest that specific bone shapes may increase the risk of developing CAI after sustaining a LAS. © 2019 The Authors. Journal of Orthopaedic Research® Published by Wiley Periodicals, Inc. on behalf of Orthopaedic Research Society. J Orthop Res 37:1892-1902, 2019.
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Affiliation(s)
- Nazlı Tümer
- Department of Biomechanical EngineeringDelft University of Technology (TU Delft)DelftThe Netherlands
| | - Gwendolyn Vuurberg
- Department of Orthopaedic Surgery, Amsterdam UMC, University of AmsterdamAmsterdam Movement SciencesAmsterdamThe Netherlands,Academic Center for Evidence‐based Sports Medicine (ACES)AmsterdamThe Netherlands,Amsterdam Collaboration on Health & Safety in Sports (ACHSS)AMC/VUmc IOC Research CenterAmsterdamThe Netherlands
| | - Leendert Blankevoort
- Department of Orthopaedic Surgery, Amsterdam UMC, University of AmsterdamAmsterdam Movement SciencesAmsterdamThe Netherlands,Academic Center for Evidence‐based Sports Medicine (ACES)AmsterdamThe Netherlands,Amsterdam Collaboration on Health & Safety in Sports (ACHSS)AMC/VUmc IOC Research CenterAmsterdamThe Netherlands
| | - Gino M M. J. Kerkhoffs
- Department of Orthopaedic Surgery, Amsterdam UMC, University of AmsterdamAmsterdam Movement SciencesAmsterdamThe Netherlands,Academic Center for Evidence‐based Sports Medicine (ACES)AmsterdamThe Netherlands,Amsterdam Collaboration on Health & Safety in Sports (ACHSS)AMC/VUmc IOC Research CenterAmsterdamThe Netherlands
| | - Gabrielle J. M. Tuijthof
- Department of Orthopaedic Surgery, Amsterdam UMC, University of AmsterdamAmsterdam Movement SciencesAmsterdamThe Netherlands,Academic Center for Evidence‐based Sports Medicine (ACES)AmsterdamThe Netherlands,Amsterdam Collaboration on Health & Safety in Sports (ACHSS)AMC/VUmc IOC Research CenterAmsterdamThe Netherlands,Research Centre Smart DevicesZuyd University of Applied SciencesHeerlenThe Netherlands
| | - Amir A. Zadpoor
- Department of Biomechanical EngineeringDelft University of Technology (TU Delft)DelftThe Netherlands
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14
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Tümer N, Arbabi V, Gielis WP, de Jong PA, Weinans H, Tuijthof GJM, Zadpoor AA. Three-dimensional analysis of shape variations and symmetry of the fibula, tibia, calcaneus and talus. J Anat 2018; 234:132-144. [PMID: 30393864 PMCID: PMC6284442 DOI: 10.1111/joa.12900] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/29/2018] [Indexed: 12/01/2022] Open
Abstract
The bones forming the talocrural joint (TCJ) and subtalar joint (STJ) are often assumed to be bilaterally symmetric. Therefore, the contralateral limb (i.e. the fibula, tibia, calcaneus and talus) is used as a template or an intra‐subject control in clinical and research practice. However, the validity of the symmetry assumption is controversial, because insufficient information is available on the shape variations and bilateral (a)symmetry of the fibula, tibia, calcaneus and talus. Using three‐dimensional spatially dense sampled representations of bone shapes extracted from bilateral computed tomography scans of 66 individuals (55 male, mean age: 61 ± 10 years; 11 female, mean age: 53 ± 15 years), we analyzed whether: (i) similar shape patterns exist in the left and right bones of the same type; (ii) gender has an effect on bone shape variations; (iii) intra‐subject shape variation is smaller than that of inter‐subject for a given shape variance direction. For the first set of analyses, all left and right instances of the same type of bone were considered as two separate groups, and statistically compared with each other on multiple aspects including group location (central tendency), variance‐covariance scale (dispersion) and orientation (covariance structure) using distance‐based permutational tests. For the second and third sets of analyses, all left and right bones of the same type were pooled into one group, and shape variations in the TCJ and STJ bones were extracted using principal component analysis. The effects of gender on age‐adjusted bone shape differences were assessed using an analysis of covariance. Moreover, intra‐class correlation was employed to evaluate intra‐ and inter‐subject bone shape variations. For each bone type, both sides had similar shape patterns (Ppermutational‐values > 0.05). After Bonferroni adjustment, gender led to shape differences, which were mainly in the lateral and medial condyles of the tibia (P = 0.003), the length and height of the calcaneus (P < 0.001), the posterior and anterior talar articular surfaces of the calcaneus (P = 0.001), and in the posterior aspect of the talus (P = 0.001). Intra‐subject shape variations in the tibial tuberosity together with the diameter of the tibia, and the curvature of the fibula shaft and the diameter of the fibula were as high as those of inter‐subject. This result suggests that the shape symmetry assumption could be violated for some specific shape variations in the fibula and tibia.
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Affiliation(s)
- Nazlı Tümer
- Department of Biomechanical Engineering, Delft University of Technology (TU Delft), Delft, The Netherlands
| | - Vahid Arbabi
- Department of Biomechanical Engineering, Delft University of Technology (TU Delft), Delft, The Netherlands.,Department of Orthopedics, UMC Utrecht, Utrecht, The Netherlands.,Department of Mechanical Engineering, Faculty of Engineering, University of Birjand, Birjand, Iran
| | | | - Pim A de Jong
- Department of Radiology, UMC Utrecht, Utrecht, The Netherlands
| | - Harrie Weinans
- Department of Biomechanical Engineering, Delft University of Technology (TU Delft), Delft, The Netherlands.,Department of Orthopedics, UMC Utrecht, Utrecht, The Netherlands
| | - Gabrielle J M Tuijthof
- Department of Orthopaedic Surgery, Academic Medical Center, University of Amsterdam, Amsterdam Movement Sciences, Amsterdam, The Netherlands.,Research Centre Smart Devices, Zuyd University of Applied Sciences, Heerlen, The Netherlands
| | - Amir A Zadpoor
- Department of Biomechanical Engineering, Delft University of Technology (TU Delft), Delft, The Netherlands
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15
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Radius of curvature at the talocrural joint surface: inference of subject-specific kinematics. Surg Radiol Anat 2018; 41:53-64. [DOI: 10.1007/s00276-018-2098-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2018] [Accepted: 07/18/2018] [Indexed: 11/25/2022]
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16
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D'Ambrosi R, Maccario C, Serra N, Ursino C, Usuelli FG. Relationship between symptomatic osteochondral lesions of the talus and quality of life, body mass index, age, size and anatomic location. Foot Ankle Surg 2018; 24:365-372. [PMID: 29409207 DOI: 10.1016/j.fas.2017.04.011] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2016] [Revised: 03/03/2017] [Accepted: 04/11/2017] [Indexed: 02/04/2023]
Abstract
INTRODUCTION The aim of the study was to assess the relationship between symptomatic osteochondral lesions of the talus (OLTs) and age, body mass index (BMI), quality of life (QOL), size and anatomic location. METHODS Fifty-two patients with chronic OLTs were analyzed including BMI, Visual Analogue Scale (VAS), American Orthopaedic Foot and Ankle Society (AOFAS), Short-Form Health Survey (SF-12 divided into Mental (MCS) and Physical (PCS) score) and the 12-Item General Health Questionnaire (GHQ-12). Every patient underwent magnetic resonance imaging (MRI) and computed tomography (CT) examinations. We carried out a sub-analysis by dividing the talus into 6 areas, 3 vertical (medial, central and lateral group) and 3 horizontal (anterior, middle and posterior group). RESULTS There were 31 (60%) male and 21 (40%) female patients. Mean MCS and PCS resulted respectively 43.9 and 35.2. OLTs were located as follows: medial 20 (38.50%); central 13 (24.0%); and lateral 19 (36.50%); anterior 24 (46.15%); middle 16 (30.77%); and posterior 12 (23.08%). No significant differences were found among different groups with the exception of the anterior and posterior group for MCS (p=0.021). In the central group we identified a negative correlation (R=-0.672) between aging and AOFAS and a positive correlation between BMI and lesion size. We found a positive correlation between CT and MRI in each group. CONCLUSIONS OLTs impact patients' quality of life particularly in the physical component. Additionally, in patients with central lesions we found a positive linear correlation between lesion size and BMI and a worsening of the ankle with increasing age.
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Affiliation(s)
- Riccardo D'Ambrosi
- Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Milan, Italy; IRCCS Istituto Ortopedico Galeazzi, U.O. CASCO - Piede e Caviglia, Milan, Italy.
| | - Camilla Maccario
- Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Milan, Italy; IRCCS Istituto Ortopedico Galeazzi, U.O. CASCO - Piede e Caviglia, Milan, Italy
| | - Nicola Serra
- Seconda Università di Napoli, Dipartimento di Radiologia, Naples, Italy
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17
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Tümer N, Kok AC, Vos FM, Streekstra GJ, Askeland C, Tuijthof GJM, Zadpoor AA. Three-Dimensional Registration of Freehand-Tracked Ultrasound to CT Images of the Talocrural Joint. SENSORS (BASEL, SWITZERLAND) 2018; 18:E2375. [PMID: 30037099 PMCID: PMC6068753 DOI: 10.3390/s18072375] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/06/2018] [Revised: 07/09/2018] [Accepted: 07/19/2018] [Indexed: 12/11/2022]
Abstract
A rigid surface⁻volume registration scheme is presented in this study to register computed tomography (CT) and free-hand tracked ultrasound (US) images of the talocrural joint. Prior to registration, bone surfaces expected to be visible in US are extracted from the CT volume and bone contours in 2D US data are enhanced based on monogenic signal representation of 2D US images. A 3D monogenic signal data is reconstructed from the 2D data using the position of the US probe recorded with an optical tracking system. When registering the surface extracted from the CT scan to the monogenic signal feature volume, six transformation parameters are estimated so as to optimize the sum of monogenic signal features over the transformed surface. The robustness of the registration algorithm was tested on a dataset collected from 12 cadaveric ankles. The proposed method was used in a clinical case study to investigate the potential of US imaging for pre-operative planning of arthroscopic access to talar (osteo)chondral defects (OCDs). The results suggest that registrations with a registration error of 2 mm and less is achievable, and US has the potential to be used in assessment of an OCD' arthroscopic accessibility, given the fact that 51% of the talar surface could be visualized.
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Affiliation(s)
- Nazlı Tümer
- Department of Biomechanical Engineering, Delft University of Technology (TU Delft), Mekelweg 2, 2628 CD Delft, The Netherlands.
| | - Aimee C Kok
- Orthopaedic Research Center Amsterdam, Academic Medical Centre (AMC), Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands.
| | - Frans M Vos
- Department of Imaging Science and Technology, Quantitative Imaging Group, Delft University of Technology (TU Delft), Lorentzweg 1, 2628 CJ Delft, The Netherlands.
- Department of Radiology, Academic Medical Centre (AMC), Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands.
| | - Geert J Streekstra
- Department of Radiology, Academic Medical Centre (AMC), Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands.
| | | | - Gabrielle J M Tuijthof
- Orthopaedic Research Center Amsterdam, Academic Medical Centre (AMC), Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands.
- Zuyd University of Applied Sciences, Research Centre Smart Devices, Nieuw Eyckholt 300, 6419 DJ Heerlen, The Netherlands.
| | - Amir A Zadpoor
- Department of Biomechanical Engineering, Delft University of Technology (TU Delft), Mekelweg 2, 2628 CD Delft, The Netherlands.
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18
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Vuurberg G, Wink LM, Blankevoort L, Haverkamp D, Hemke R, Jens S, Sierevelt IN, Maas M, Kerkhoffs GMMJ. A risk assessment model for chronic ankle instability: indications for early surgical treatment? An observational prospective cohort - study protocol. BMC Musculoskelet Disord 2018; 19:225. [PMID: 30021553 PMCID: PMC6052530 DOI: 10.1186/s12891-018-2124-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2017] [Accepted: 06/05/2018] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Chronic ankle instability (CAI) is a common result of an ankle sprain. Even though early surgical treatment yields the best results, overall only professional athletes are eligible for acute surgical stabilization. Treating all patients with early surgical stabilization leads to a high amount of unnecessary invasive interventions, as not all patients progress to CAI. If patients at risk of developing CAI can be identified, treatment policies may be applied more effectively and efficiently. The purpose of this study is to develop a risk assessment model to identify patients at risk for CAI that should receive early surgical treatment. METHODS In this observational prospective cohort, all patients aged sixteen years and older, reporting at the emergency department of one of the participating hospitals after sustaining a lateral ankle sprain, and filled out 1 out of 3 follow-up questionnaires and the 1 year follow-up are included. A lateral and anteroposterior radiograph is made. Patients are excluded if a fracture or other pathology is present. The included patients receive four questionnaires, including questions focusing on the sprain, treatment and complaints, the Foot and Ankle Outcome Score and the Cumberland Ankle Instability Tool. A total of eleven radiographic variables are assessed for inter- and intra-observer reliability. Additionally, four factors extracted from the questionnaires, will be evaluated for correlation with CAI. Significantly correlating factors (e.a. risk factors) will be implemented in a risk assessment model. For the final model, based on sixteen variables with a minimum of 20 events per variable and a prevalence of 30-40% after an initial sprain, a sample size of 2370 patients is needed to perform both internal and external model validation. DISCUSSION This study will develop the first large scale model for the risk at CAI after an ankle sprain combining radiographic and patient characteristics. With this risk assessment model, patients at risk for CAI may be identified and properly informed on the treatment options. Patients identified as being at risk, may receive more adequate follow-up and become eligible for early surgical stabilization. This prevents patients from experiencing unnecessary long-lasting complaints, increasing the success rate of conservative and surgical treatment. TRIAL REGISTRATION Retrospectively registered: NCT02955485 [Registration date: 3-11-2016]. NTR6139 [Registration date: 3-1-2017].
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Affiliation(s)
- Gwendolyn Vuurberg
- Orthopaedic Research Center Amsterdam, Department of Orthopedic Surgery, Amsterdam Movement Sciences, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
- Academic Center for Evidence based Sports medicine (ACES), Amsterdam, The Netherlands
- Amsterdam Collaboration for Health and Safety in Sports (ACHSS), Amsterdam, The Netherlands
- Department of Musculoskeletal Radiology, Amsterdam Movement Sciences, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
| | - Lauren M. Wink
- Orthopaedic Research Center Amsterdam, Department of Orthopedic Surgery, Amsterdam Movement Sciences, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
- Amsterdam Movement Sciences, VU Medical Center, Department of Surgery, De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands
| | - Leendert Blankevoort
- Orthopaedic Research Center Amsterdam, Department of Orthopedic Surgery, Amsterdam Movement Sciences, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
- Academic Center for Evidence based Sports medicine (ACES), Amsterdam, The Netherlands
- Amsterdam Collaboration for Health and Safety in Sports (ACHSS), Amsterdam, The Netherlands
| | - Daniel Haverkamp
- Slotervaart Medical Center, Department of Orthopedic Surgery, Louwesweg 6, 1066 EC Amsterdam, The Netherlands
- Slotervaart Center of Orthopedic Research & Education (SCORE), Amsterdam, The Netherlands
| | - Robert Hemke
- Department of Musculoskeletal Radiology, Amsterdam Movement Sciences, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
| | - Sjoerd Jens
- Department of Musculoskeletal Radiology, Amsterdam Movement Sciences, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
| | - Inger N. Sierevelt
- Slotervaart Medical Center, Department of Orthopedic Surgery, Louwesweg 6, 1066 EC Amsterdam, The Netherlands
- Slotervaart Center of Orthopedic Research & Education (SCORE), Amsterdam, The Netherlands
| | - Mario Maas
- Academic Center for Evidence based Sports medicine (ACES), Amsterdam, The Netherlands
- Amsterdam Collaboration for Health and Safety in Sports (ACHSS), Amsterdam, The Netherlands
- Department of Musculoskeletal Radiology, Amsterdam Movement Sciences, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
| | - Gino M. M. J. Kerkhoffs
- Orthopaedic Research Center Amsterdam, Department of Orthopedic Surgery, Amsterdam Movement Sciences, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
- Academic Center for Evidence based Sports medicine (ACES), Amsterdam, The Netherlands
- Amsterdam Collaboration for Health and Safety in Sports (ACHSS), Amsterdam, The Netherlands
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Subject-Specific Axes of Rotation Based on Talar Morphology Do Not Improve Predictions of Tibiotalar and Subtalar Joint Kinematics. Ann Biomed Eng 2017. [PMID: 28639171 DOI: 10.1007/s10439-017-1874-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Use of subject-specific axes of rotation may improve predictions generated by kinematic models, especially for joints with complex anatomy, such as the tibiotalar and subtalar joints of the ankle. The objective of this study was twofold. First, we compared the axes of rotation between generic and subject-specific ankle models for ten control subjects. Second, we quantified the accuracy of generic and subject-specific models for predicting tibiotalar and subtalar joint motion during level walking using inverse kinematics. Here, tibiotalar and subtalar joint kinematics measured in vivo by dual-fluoroscopy served as the reference standard. The generic model was based on a cadaver study, while the subject-specific models were derived from each subject's talus reconstructed from computed tomography images. The subject-specific and generic axes of rotation were significantly different. The average angle between the modeled axes was 12.9° ± 4.3° and 24.4° ± 5.9° at the tibiotalar and subtalar joints, respectively. However, predictions from both models did not agree well with dynamic dual-fluoroscopy data, where errors ranged from 1.0° to 8.9° and 0.6° to 7.6° for the generic and subject-specific models, respectively. Our results suggest that methods that rely on talar morphology to define subject-specific axes may be inadequate for accurately predicting tibiotalar and subtalar joint kinematics.
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20
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Nozaki S, Watanabe K, Katayose M. Three-dimensional analysis of talar trochlea morphology: Implications for subject-specific kinematics of the talocrural joint. Clin Anat 2016; 29:1066-1074. [DOI: 10.1002/ca.22785] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2016] [Revised: 08/27/2016] [Accepted: 08/28/2016] [Indexed: 11/07/2022]
Affiliation(s)
- Shuhei Nozaki
- Department of Rehabilitation; Hokkaido Obihiro Kyokai Hospital; Obihiro Hokkaido Japan
- Second Division of Physical Therapy; School of Health Sciences, Sapporo Medical University; Sapporo Hokkaido Japan
| | - Kota Watanabe
- Second Division of Physical Therapy; School of Health Sciences, Sapporo Medical University; Sapporo Hokkaido Japan
| | - Masaki Katayose
- Second Division of Physical Therapy; School of Health Sciences, Sapporo Medical University; Sapporo Hokkaido Japan
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