1
|
Verbakel J, Boot MR, van der Gaast N, Dunning H, Bakker M, Jaarsma RL, Doornberg JN, Edwards MJR, van de Groes SAW, Hermans E. Symmetry of the left and right tibial plafond; a comparison of 75 distal tibia pairs. Eur J Trauma Emerg Surg 2024:10.1007/s00068-024-02568-x. [PMID: 38874625 DOI: 10.1007/s00068-024-02568-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Accepted: 05/30/2024] [Indexed: 06/15/2024]
Abstract
PURPOSE Tibia plafond or pilon fractures present a high level of complexity, making their surgical management challenging. Three-Dimensional Virtual Planning (3DVP) can assist in preoperative planning to achieve optimal fracture reduction. This study aimed to assess the symmetry of the left and right tibial plafond and whether left-right mirroring can reliably be used. METHODS Bilateral CT scans of the lower limbs of 75 patients without ankle problems or prior fractures of the lower limb were included. The CT images were segmented to create 3D surface models of the tibia. Subsequently, the left tibial models were mirrored and superimposed onto the right tibia models using a Coherent Point Drift surface matching algorithm. The tibias were then cut to create bone models of the distal tibia with a height of 30 mm, and correspondence points were established. The Euclidean distance was calculated between correspondence points and visualized in a boxplot and heatmaps. The articulating surface was selected as a region of interest. RESULTS The median left-right difference was 0.57 mm (IQR, 0.38 - 0.85 mm) of the entire tibial plafond and 0.53 mm (IQR, 0.37 - 0.76 mm) of the articulating surface. The area with the greatest left-right differences were the medial malleoli and the anterior tubercle of the tibial plafond. CONCLUSION The tibial plafond exhibits a high degree of bilateral symmetry. Therefore, the mirrored unfractured tibial plafond may be used as a template to optimize preoperative surgical reduction using 3DVP techniques in patients with pilon fractures.
Collapse
Affiliation(s)
- Joy Verbakel
- Department of Trauma Surgery, Radboud University Medical Center, Geert Grooteplein Zuid, 6525 GA, Nijmegen, The Netherlands.
| | - Miriam R Boot
- Orthopaedic Research Laboratory, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Nynke van der Gaast
- Department of Trauma Surgery, Radboud University Medical Center, Geert Grooteplein Zuid, 6525 GA, Nijmegen, The Netherlands
| | - Hans Dunning
- Orthopaedic Research Laboratory, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Max Bakker
- Orthopaedic Research Laboratory, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Ruurd L Jaarsma
- Department of Orthopaedic & Trauma Surgery, Flinders University and Flinders Medical Centre, Adelaide, Australia
| | - Job N Doornberg
- Department of Orthopaedic & Trauma Surgery, Flinders University and Flinders Medical Centre, Adelaide, Australia
- Department of Orthopaedic Surgery, University Medical Center Groningen, Groningen, The Netherlands
| | - Michael J R Edwards
- Department of Trauma Surgery, Radboud University Medical Center, Geert Grooteplein Zuid, 6525 GA, Nijmegen, The Netherlands
| | | | - Erik Hermans
- Department of Trauma Surgery, Radboud University Medical Center, Geert Grooteplein Zuid, 6525 GA, Nijmegen, The Netherlands
| |
Collapse
|
2
|
Narahashi É, Guimarães JB, Filho AGO, Nico MAC, Silva FD. Measurement of tibial slope using biplanar stereoradiography (EOS®). Skeletal Radiol 2024; 53:1091-1101. [PMID: 38051424 DOI: 10.1007/s00256-023-04528-9] [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: 10/02/2023] [Revised: 11/20/2023] [Accepted: 11/21/2023] [Indexed: 12/07/2023]
Abstract
OBJECTIVES Posterior tibial slope (PTS) is an important anatomic parameter of the knee related to anteroposterior instability. Biplanar stereoradiography allows for simultaneous low-dose acquisition of anteroposterior and lateral views with 3D capability, enabling separate lateral and medial plateau analyses. We aimed to evaluate the possibility and compare the reproducibility of measuring medial and lateral PTS on EOS® images with two different patient positionings and compare it with CT of the knees as the gold standard. METHODS This is a retrospective study including volunteers who underwent lower limb stereoradiography and knee CT from 01/08/2016 to 07/31/2019. Sixty legs from 30 patients were studied. PTS were measured using stereoradiography and CT by two radiologists. Intraclass correlation was used to calculate intrarater and interrater reproducibilities. Pearson's correlation coefficients were used to calculate the correlation between stereoradiography and CT. We also compared the reproducibility of the stereoradiography of volunteers with 2 different positionings. RESULTS The mean stereoradiography PTS values for right and left knees were as follows: lateral, 12.2° (SD: 4.1) and 10.1° (SD: 3.5); medial,12.2° (SD: 4.4) and 11.6° (SD: 3.9). CT PTS mean values for right and left knee are as follows: lateral, 10.3° (SD:2.5) and 10.6° (SD: 2.8); medial: 8.7° (SD: 3.7) and 10.4° (SD: 3.5). Agreement between CT and EOS for angles between lateral and medial PTS was good (right, 0.874; left, 0.871). Regarding patient positioning on stereoradiography, interrater and intrarater reproducibilities were greater for patients with nonparallel feet (0.738-0.883 and 0.870-0.975). CONCLUSIONS Stereoradiography allows for appropriate delineation of tibial plateaus, especially in patients with nonparallel feet, for the purpose of measuring PTS. The main advantage is lower radiation doses compared to radiography and CT.
Collapse
Affiliation(s)
- Érica Narahashi
- Department of Musculoskeletal Radiology, Fleury Medicine and Health, Rua Mato Grosso, 306, 1o andar, Higienópolis, São Paulo, São Paulo, 01239-040, Brazil.
| | - Júlio Brandão Guimarães
- Department of Musculoskeletal Radiology, Fleury Medicine and Health, Rua Mato Grosso, 306, 1o andar, Higienópolis, São Paulo, São Paulo, 01239-040, Brazil
| | - Alípio Gomes Ormond Filho
- Department of Musculoskeletal Radiology, Fleury Medicine and Health, Rua Mato Grosso, 306, 1o andar, Higienópolis, São Paulo, São Paulo, 01239-040, Brazil
| | - Marcelo Astolfi Caetano Nico
- Department of Musculoskeletal Radiology, Fleury Medicine and Health, Rua Mato Grosso, 306, 1o andar, Higienópolis, São Paulo, São Paulo, 01239-040, Brazil
| | - Flávio Duarte Silva
- Department of Musculoskeletal Radiology, Fleury Medicine and Health, Rua Mato Grosso, 306, 1o andar, Higienópolis, São Paulo, São Paulo, 01239-040, Brazil
| |
Collapse
|
3
|
Nedopil AJ, Rego E, Hernandez AM, Boone JM, Howell SM, Hull ML. Correcting for asymmetry of the proximal tibial epiphysis is warranted to determine postoperative alignment deviations in kinematic alignment from planned alignment of the tibial component on the native tibia. Clin Biomech (Bristol, Avon) 2024; 113:106215. [PMID: 38428263 DOI: 10.1016/j.clinbiomech.2024.106215] [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: 08/24/2023] [Revised: 02/19/2024] [Accepted: 02/20/2024] [Indexed: 03/03/2024]
Abstract
BACKGROUND In total knee arthroplasty, unrestricted kinematic alignment aims to restore pre-arthritic lower limb alignment and joint lines. Joint line orientations of the contralateral healthy proximal tibia might be used to evaluate accuracy of tibial component alignment post-operatively if asymmetry is minimal. Our objective was to evaluate left-to-right asymmetry of the proximal tibial epiphysis in posterior tibial slope and varus-valgus orientation as related to unrestricted kinematic alignment principles. METHODS High resolution CT images (0.5 mm slice thickness) were acquired from bilateral lower limbs of 11 skeletally mature subjects with no skeletal abnormalities. Images were segmented to generate 3D tibia models. Asymmetry was quantified by differences in orientations required to shape-match the proximal epiphysis of the mirror 3D tibia model to the proximal epiphysis of the contralateral 3D tibia model. FINDINGS Systematic and random differences (i.e. mean ± standard deviation) in tibial slope and varus-valgus orientation were - 0.8° ± 1.2° and - 0.2° ± 0.8°, respectively. Ninety five percent confidence intervals on the means included 0° indicating that systematic differences were minimal. INTERPRETATION Since random differences due to asymmetry are substantial in relation to random surgical deviations from pre-arthritic joint lines previously reported, post-operative computer tomograms of the contralateral healthy tibia should not be used to directly assess accuracy of tibial component alignment on a group level without correcting for differences in tibial slope and varus-valgus orientation due to asymmetry.
Collapse
Affiliation(s)
- Alexander J Nedopil
- Department of Orthopaedic Surgery, König-Ludwig-Haus, University of Würzburg, Brettreichstraße 11, 97074 Würzburg, Germany
| | - Ethan Rego
- Department of Biomedical Engineering, University of California at Davis, One Shields Avenue, Davis, CA 95616, USA.
| | - Andrew M Hernandez
- Department of Radiology, University of California at Davis Medical Center, Sacramento, CA 95817, USA.
| | - John M Boone
- Department of Radiology, University of California at Davis Medical Center, Sacramento, CA 95817, USA.
| | - Stephen M Howell
- Department of Orthopaedic Surgery, University of California at Davis Medical Center, Sacramento, CA 95817, USA
| | - Maury L Hull
- Department of Biomedical Engineering, University of California at Davis, One Shields Avenue, Davis, CA 95616, USA; Department of Mechanical Engineering, University of California at Davis, One Shields Avenue, Davis, CA 95616, USA; Department of Orthopaedic Surgery, University of California at Davis Medical Center, Sacramento, CA 95817, USA.
| |
Collapse
|
4
|
Raes L, Peiffer M, Leenders T, Kvarda P, Ahn J, Audenaert E, Burssens A. Medializing Calcaneal Osteotomy for progressive collapsing foot deformity alters the three-dimensional subtalar joint alignment. Foot Ankle Surg 2024; 30:79-84. [PMID: 37802663 DOI: 10.1016/j.fas.2023.09.009] [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: 06/27/2023] [Revised: 08/16/2023] [Accepted: 09/26/2023] [Indexed: 10/08/2023]
Abstract
BACKGROUND A medializing calcaneal osteotomy (MCO) is considered as one of the key inframalleolar osteotomies to correct progressive collapsing foot deformity (PCFD). While many studies were able to determine the post-operative hind- and midfoot alignment, alternations of the subtalar joint alignment remained obscured by superposition on plain radiography. Therefore, we aimed to assess the hind-, midfoot- and subtalar joint alignment pre- compared to post-operatively using 3D weightbearing CT (WBCT) imaging. METHODS Seventeen patients with a mean age of 42 ± 17 years were retrospectively analyzed. Inclusion criteria consisted of PCFD deformity corrected by a medializing calcaneal osteotomy (MCO) as main procedure and imaged by WBCT before and after surgery. Exclusion criteria were patients who had concomitant calcaneal lengthening osteotomies, mid-/hindfoot fusions, hindfoot coalitions, and supramalleolar procedures. Image data were used to generate 3D models and compute the hindfoot (HA), midfoot (MA) - and subtalar joint (STJ) alignment in the coronal, sagittal and axial plane, as well as distance maps. RESULTS Pre-operative measurements of the HA and MA improved significantly relative to their post-operative equivalents p < 0.05). The post-operative STJ alignment showed significant inversion (2.8° ± 1.7), abduction (1.5° ± 1.8), and dorsiflexion (2.3° ± 1.7) of the talus relative to the calcaneus (p < 0.05) compared to the pre-operative alignment. The displacement between the talus and calcaneus relative to the sinus tarsi increased significantly (0.6 mm±0.5; p < 0.05). CONCLUSION This study detected significant changes in the sagittal, coronal, and axial plane alignment of the subtalar joint, which corresponded to a decompression of the sinus tarsi. These findings contribute to our clinical practice by demonstrating the magnitude of alteration in the subtalar joint alignment that can be expected after PCFD correction with MCO as main procedure.
Collapse
Affiliation(s)
- Loïc Raes
- Department of Orthopaedics, Ghent University Hospital, Corneel Heymanslaan 10, 9000 Gent, OVL, Belgium
| | - Matthias Peiffer
- Department of Orthopaedics, Ghent University Hospital, Corneel Heymanslaan 10, 9000 Gent, OVL, Belgium; Foot and Ankle Research and Innovation Lab (FARIL), Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, USA
| | - Tim Leenders
- Department of Orthopaedics, AZ Monica Hospital, Florent Pauwelslei 21, 2100 Deurne, Antwerp, Belgium
| | - Peter Kvarda
- Department of Orthopaedics, Kantonsspital Baselland, Liestal, Switzerland
| | - Jiyong Ahn
- Foot and Ankle Research and Innovation Lab (FARIL), Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, USA; Department of Orthopedic Surgery, Uijeongbu St. Mary's Hospital College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Emmanuel Audenaert
- Department of Orthopaedics, Ghent University Hospital, Corneel Heymanslaan 10, 9000 Gent, OVL, Belgium
| | - Arne Burssens
- Department of Orthopaedics, Ghent University Hospital, Corneel Heymanslaan 10, 9000 Gent, OVL, Belgium.
| |
Collapse
|
5
|
The symmetry of the left and right tibial plateau: a comparison of 200 tibial plateaus. Eur J Trauma Emerg Surg 2023; 49:69-74. [PMID: 35829733 PMCID: PMC9925587 DOI: 10.1007/s00068-022-02043-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Accepted: 06/30/2022] [Indexed: 11/03/2022]
Abstract
PURPOSE This study aims to investigate the symmetry of the left and right tibial plateau in young healthy individuals to determine whether left-right mirroring can be reliably used to optimize preoperative 3D virtual planning for patients with tibial plateau fractures. METHODS One hundred healthy subjects, without previous knee surgery, severe knee trauma, or signs of osteoarthritis were included for a previous dynamic imaging study of the knee. The subjects underwent a CT scan, scanning the left and right knee with a slice thickness of 0.8 mm. 3D surface models of the femur, patella, and tibia were created using a convolutional neural network. The 3D models of the left and right tibias were exported to MATLAB © and the tibias were mirrored. The mirrored tibias were superimposed on the contralateral tibia using a coherent point drift surface matching algorithm. Correspondence points on both surfaces were established, the mean root squared distance was calculated and visualized in a boxplot and heatmaps. RESULTS The overall mean difference between correspondence points on the left and right tibial plateau is 0.6276 ± 0.0343 mm. The greatest differences between correspondence points were seen around two specific surfaces on the outside of the tibial plateau; where the distal tibia was cut 15 mm below the tibial plateau and around the tibiofibular joint. CONCLUSIONS The differences between the left and right tibial plateau are small and therefore, we can be confident that the mirrored contralateral, unfractured, tibial plateau can be used as a template for 3D virtual preoperative planning for young patients without previous damage to the knee.
Collapse
|
6
|
Tomczyk J, Taczała Warga J, Lesman J, Sawicki J, Domżalski M. Assessment of the deformation model of the proximal tibia in the course of degenerative disease: analysis of the 3-dimensional mathematical model. Quant Imaging Med Surg 2022; 12:4202-4212. [PMID: 35919068 PMCID: PMC9338376 DOI: 10.21037/qims-21-1210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Accepted: 05/27/2022] [Indexed: 11/10/2022]
Abstract
Background The high tibial osteotomy (HTO) is an effective knee-saving procedure, which relieves arthritis symptoms and prolongs the life of the knee joint. This procedure requires detailed preoperative planning. Usually, the contralateral side is used as a template for this purpose. Some intra-operative complications made us thinking how exactly the degenerative disease alter the epiphysis if the tibia. Our study aimed to assess morphological differences between healthy knees and degenerative knees using a three-dimensional mathematical model. Methods Twenty-three computed tomography (CT) examinations were collected out of 237 individuals screened for inclusion/exclusion. The inclusion criteria were: age between 40 and 69 years, degenerative knees with visible varus deformation, and signs of radiological osteoarthritis (OA) in the knee joint (such as joint space narrowing, subchondral sclerosis, subchondral cyst formation, and osteophytes. The average age of the included patients was 56.2 years. Nine men’s and 14 women’s knee joints were used for the calculation and comparisons. Results Female varus knees showed much more significant variability in tibial plateau dimensions according to sides of the body than male ones. These differences were statistically significant (P=0.03). In comparison between the basal bone and bones with OA, variability in 3D dimensions was statistically significant only for lateral condyles in males’ right knees (P=0.025). Compared to the degenerative knees to the most average, healthy knees, there were significant differences in the measured surface area of males’ right knees for both condyles: for the medial P=0.0046, for lateral P=0.005. Male varus knees had a statistically more considerable (P=0.028) surface area for all measured condyles. Angles of inclination differ significantly between knees with OA and healthy knees in the male population for the medial condyle plateau in the left knees. The female population for the lateral condyle in left knees and the medial condyle in right knees. Conclusions The proximal tibial plateau deformation showed high variability in the two-dimensional and three-dimensional analysis in the designed mathematical models. This finding must be considered during preoperative planning.
Collapse
Affiliation(s)
- Jolanta Tomczyk
- Department of Radiology, Isotopic Diagnostic and Therapy, Veteran's Memorial Hospital Medical University of Lodz, Lodz, Poland
| | - Joanna Taczała Warga
- Institute of Materials Science and Engineering, Lodz University of Technology, Lodz, Poland
| | - Jędrzej Lesman
- Department of Orthopedics and Traumatology, Veteran's Memorial Hospital Medical University of Lodz, Lodz, Poland
| | - Jacek Sawicki
- Institute of Materials Science and Engineering, Lodz University of Technology, Lodz, Poland
| | - Marcin Domżalski
- Department of Orthopedics and Traumatology, Veteran's Memorial Hospital Medical University of Lodz, Lodz, Poland
| |
Collapse
|
7
|
Vuurberg G, Dahmen J, Dobbe IGG, Kleipool RP, Hayat B, Sierevelt IN, Streekstra G, Kerkhoffs GMMJ, Stufkens SAS. Lower leg symmetry: a Q3D-CT analysis. Surg Radiol Anat 2022; 44:851-860. [PMID: 35534775 PMCID: PMC9246803 DOI: 10.1007/s00276-022-02940-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Accepted: 04/07/2022] [Indexed: 10/29/2022]
Abstract
PURPOSE In fracture and realignment surgery, the contralateral unaffected side is often used as a model or template for the injured bone even though clinically valuable quantitative data of bilateral symmetry are often unavailable. Therefore, the objective of the present study was to quantify and present the bilateral symmetry of the tibia and fibula. METHODS Twenty bilateral lower-leg CT scans were acquired in healthy volunteers. The left and right tibia and fibula were segmented resulting in three-dimensional polygons for geometrical analyses (volume, surface and length). The distal and proximal segment of the right tibia of each individual was subsequently matched to the left tibia to quantify alignment differences (translation and rotation). Bone symmetry on group level was assessed using the Student's t test and intra-individual differences were assessed using mixed-models analyses. RESULTS Intra-individuals differences were found for tibia volume (5.2 ± 3.3 cm3), tibia surface (5.2 ± 3.3 cm2), translations in the lateral (X-axis; 9.3 ± 8.9 mm) and anterior direction (Y-axis; 7.1 ± 7.0 mm), for tibia length (translation along Z-axis: 3.1 ± 2.4 mm), varus/valgus (φz: 1.7o ± 1.4°), and endotorsion/exotorsion (φz: 4.0o ± 2.7°). CONCLUSION This study shows intra-individual tibia asymmetry in both geometric and alignment parameters of which the surgeon needs to be aware in pre-operative planning. The high correlation between tibia and fibula length allows the ipsilateral fibula to aid in estimating the original tibia length post-injury. Future studies need to establish whether the found asymmetry is clinically relevant when the contralateral side is used as reference in corrective surgery. LEVEL OF EVIDENCE III cohort study.
Collapse
Affiliation(s)
- Gwendolyn Vuurberg
- Amsterdam UMC, Department of Orthopedic Surgery, Amsterdam Movement Sciences, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands. .,Academic Center for Evidence-Based Sports Medicine (ACES), Amsterdam, The Netherlands. .,AMC/VUmc IOC Research Center, Amsterdam Collaboration on Health and Safety in Sports (ACHSS), Amsterdam, The Netherlands. .,Amsterdam UMC, Department of Radiology and Nuclear Medicine, Amsterdam Movement Sciences, University of Amsterdam, Amsterdam, The Netherlands. .,Department of Radiology and Nuclear Medicine, Rijnstate Hospital, Arnhem, The Netherlands.
| | - Jari Dahmen
- Amsterdam UMC, Department of Orthopedic Surgery, Amsterdam Movement Sciences, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.,Academic Center for Evidence-Based Sports Medicine (ACES), Amsterdam, The Netherlands.,AMC/VUmc IOC Research Center, Amsterdam Collaboration on Health and Safety in Sports (ACHSS), Amsterdam, The Netherlands
| | - Iwan G G Dobbe
- Amsterdam UMC, Department of Biomedical Engineering and Physics, Amsterdam Movement Sciences, University of Amsterdam, Amsterdam, The Netherlands
| | - Roeland P Kleipool
- Academic Center for Evidence-Based Sports Medicine (ACES), Amsterdam, The Netherlands.,Amsterdam UMC, Department of Medical Biology, Amsterdam Movement Sciences, University of Amsterdam, Amsterdam, The Netherlands
| | - Batur Hayat
- Amsterdam UMC, Department of Orthopedic Surgery, Amsterdam Movement Sciences, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands
| | - Inger N Sierevelt
- Specialized Centre for Orthopedic Research and Education (SCORE), Xpert Orthopedics, Amsterdam, The Netherlands
| | - Geert Streekstra
- Amsterdam UMC, Department of Radiology and Nuclear Medicine, Amsterdam Movement Sciences, University of Amsterdam, Amsterdam, The Netherlands.,Amsterdam UMC, Department of Biomedical Engineering and Physics, Amsterdam Movement Sciences, University of Amsterdam, Amsterdam, The Netherlands
| | - Gino M M J Kerkhoffs
- Amsterdam UMC, Department of Orthopedic Surgery, Amsterdam Movement Sciences, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.,Academic Center for Evidence-Based Sports Medicine (ACES), Amsterdam, The Netherlands.,AMC/VUmc IOC Research Center, Amsterdam Collaboration on Health and Safety in Sports (ACHSS), Amsterdam, The Netherlands
| | - Sjoerd A S Stufkens
- Amsterdam UMC, Department of Orthopedic Surgery, Amsterdam Movement Sciences, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.,Academic Center for Evidence-Based Sports Medicine (ACES), Amsterdam, The Netherlands.,AMC/VUmc IOC Research Center, Amsterdam Collaboration on Health and Safety in Sports (ACHSS), Amsterdam, The Netherlands
| |
Collapse
|
8
|
Tomczyk J, Taczała J, Sawicki J, Domżalski M. Assessment of morphological differences of the proximal tibia in healthy knees: analysis of the 3-dimensional mathematical model. Quant Imaging Med Surg 2021; 11:4354-4364. [PMID: 34603990 DOI: 10.21037/qims-20-1094] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Accepted: 03/26/2021] [Indexed: 11/06/2022]
Abstract
Background High tibial osteotomy and many orthopedic surgical procedures around the knee joint requires precise preoperative planning. In-depth knowledge of the tibial plateau morphology is necessary to limit intraoperative complications like lateral hinge fracture. No studies were exploring the differences in proximal tibia surface geometry, in regards to gender and laterality, using a mathematical model. The aim of our study was to assess morphological differences in healthy knees using a three-dimensional mathematical model. Methods Eighty-seven computed tomography examinations collected from 52 patients were selected for the study. The inclusion criteria were: age between 20 and 40 years, knee joint without visible deformities, no history of significant trauma to index knee, no history of systemic and chronic disorders. The average age of the included patients was 32.5±8.9 years old. For the calculation and comparisons, 45 right knee joints (18 females and 27 males) and 42 left knee joints (17 females and 25 males) were used. Results The male tibial plateau was much larger than the female one, for the right (P=0.001) and left knees (P=0.001). Male knees showed much bigger variability in two-dimensional tibial plateau dimensions especially for the left knees (P=0.001), and there was also a marked difference in variability between sides in males. Three-dimensional variability was significant for medial condyles for both genders. Male knees had a statistically bigger (P=0.04) tibial plateau surface area for all measured condyles. Conclusions The proximal tibial plateau showed in the designed mathematical models high variability in the two-dimensional and three-dimensional analysis. The males' knees presented great variability between sides and condyles. This finding must be considered during preoperative planning.
Collapse
Affiliation(s)
- Jolanta Tomczyk
- Department of Radiology, Isotopic Diagnostic and Therapy, Veteran's Memorial Hospital Medical University of Lodz, Lodz, Poland
| | - Joanna Taczała
- Institute of Materials Science and Engineering, Lodz University of Technology, Lodz, Poland
| | - Jacek Sawicki
- Institute of Materials Science and Engineering, Lodz University of Technology, Lodz, Poland
| | - Marcin Domżalski
- Department of Orthopedics and Traumatology. Veteran's Memorial Hospital Medical University of Lodz, Lodz, Poland
| |
Collapse
|
9
|
Burssens A, Krähenbühl N, Weinberg MM, Lenz AL, Saltzman CL, Barg A. Comparison of External Torque to Axial Loading in Detecting 3-Dimensional Displacement of Syndesmotic Ankle Injuries. Foot Ankle Int 2020; 41:1256-1268. [PMID: 32672067 DOI: 10.1177/1071100720936596] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND Current imaging techniques try to quantify 3-dimensional displacement of syndesmotic ankle injuries using 2-dimensional measurements, which may obscure an exact diagnosis. Therefore, our aim was to determine 3-dimensional displacement of syndesmotic ankle injuries under load and torque using a weightbearing computed tomography (WBCT) and to assess the relation with previously established 2-dimensional measurements. METHODS Seven paired cadaver specimens were mounted into a radiolucent frame. WBCT scans were obtained to generate 3-dimensional models after different patterns of axial load (0 kg, 85 kg) combined with external torque (0, 10 Nm). Sequential imaging was repeated in ankles containing intact syndesmotic ligaments, sectioning of the anterior inferior tibiofibular ligament (AITFL; condition 1A), deltoid ligament (DL; condition 1B), combined AITFL+DL (condition 2), and AITFl+DL+interosseous membrane (condition 3). Reference anatomical landmarks were established relative to the intact position of the fibula to quantify displacement. A subsequent correlation analysis was performed between the obtained 2- and 3-dimensional measurements. RESULTS Axial load increased lateral translation (mean = -0.9 mm, 95% confidence interval [CI]: 1.3, -0.1) significantly in condition 2 relative to the intact ankle (P < .05) but did not demonstrate other significant displacements. External torque increased displacement significantly in all directions (P < .05), except for dorsal translation of the fibula (P > .05). The highest displacement could be detected when external torque was applied in condition 3 and consisted of posterior translation (mean = -3.1 mm; 95% CI: -4.8, -2.7) and external rotation (mean = -4.7 degrees; 95% CI: -5.6, -2.9). Pearson correlation coefficients between the 2-dimensional and 3-dimensional measurements were moderate and ranged from 0.31 to 0.56 (P < .05). CONCLUSION External torque demonstrated superiority over axial load in detecting syndesmotic ankle instability. Axial load increased lateral translation; however, differences were submillimeter in magnitude until torque was applied. A moderate correlation was found with previously established 2-dimensional measurements. CLINICAL RELEVANCE In clinical practice these findings substantiate application of external torque in current imaging modalities to improve detection of syndesmotic ankle injuries.
Collapse
Affiliation(s)
- Arne Burssens
- Department of Orthopaedics, University of Utah, Salt Lake City, UT, USA
| | - Nicola Krähenbühl
- Department of Orthopaedics, University of Utah, Salt Lake City, UT, USA
| | | | - Amy L Lenz
- Department of Orthopaedics, University of Utah, Salt Lake City, UT, USA
| | | | - Alexej Barg
- Department of Orthopaedics, University of Utah, Salt Lake City, UT, USA.,Deartment of Orthopaedics, Trauma and Reconstructive Surgery, University of Hamburg, Hamburg, Germany
| |
Collapse
|
10
|
Quintens L, Herteleer M, Vancleef S, Carette Y, Duflou J, Nijs S, Sloten JV, Hoekstra H. Anatomical Variation of the Tibia - a Principal Component Analysis. Sci Rep 2019; 9:7649. [PMID: 31114000 PMCID: PMC6529455 DOI: 10.1038/s41598-019-44092-8] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Accepted: 05/07/2019] [Indexed: 12/17/2022] Open
Abstract
Conventional anatomically contoured plates do not adequately fit most tibiae. This emphasizes the need for a more thorough morphological study. Statistical shape models are promising tools to display anatomical variations within a population. Herein, we aim to provide a better insight into the anatomical variations of the tibia and tibia plateau. Seventy-nine CT scans of tibiae were segmented, and a principal component analysis was performed. Five morphologically important parameters were measured on the 3D models of the mean tibial shapes as well as the −3SD and +3 SD tibial shapes of the first five components. Longer, wider tibiae are related to a more rounded course of the posterior column, a less prominent tip of the medial malleolus, and a more posteriorly directed fibular notch. Varus/valgus deformations and the angulation of the posterior tibia plateau represent only a small percentage of the total variation. Right and left tibiae are not always perfectly symmetrical, especially not at the level of the tibia plateau. The largest degree of anatomical variation of the tibia is found in its length and around the tibia plateau. Because of the large variation in the anatomy, a more patient-specific approach could improve implant fit, anatomical reduction, biomechanical stability and hardware-related complications.
Collapse
Affiliation(s)
- Liselore Quintens
- KU Leuven - University of Leuven, Faculty of Medicine, Leuven, Belgium
| | - Michiel Herteleer
- Department of Trauma Surgery, University Hospitals Leuven, Leuven, Belgium.,Biomedical Science Group, Organ Systems, KU Leuven - University of Leuven, Leuven, Belgium
| | - Sanne Vancleef
- Department of Mechanical Engineering, KU Leuven - University of Leuven, Leuven, Belgium
| | - Yannick Carette
- Department of Mechanical Engineering, KU Leuven - University of Leuven, Leuven, Belgium
| | - Joost Duflou
- Department of Mechanical Engineering, KU Leuven - University of Leuven, Leuven, Belgium
| | - Stefaan Nijs
- Department of Trauma Surgery, University Hospitals Leuven, Leuven, Belgium.,Department of Development and Regeneration, KU Leuven - University of Leuven, Leuven, Belgium
| | - Jos Vander Sloten
- Department of Mechanical Engineering, KU Leuven - University of Leuven, Leuven, Belgium
| | - Harm Hoekstra
- Department of Trauma Surgery, University Hospitals Leuven, Leuven, Belgium. .,Department of Development and Regeneration, KU Leuven - University of Leuven, Leuven, Belgium.
| |
Collapse
|
11
|
Burssens A, Vermue H, Barg A, Krähenbühl N, Victor J, Buedts K. Templating of Syndesmotic Ankle Lesions by Use of 3D Analysis in Weightbearing and Nonweightbearing CT. Foot Ankle Int 2018; 39:1487-1496. [PMID: 30122077 DOI: 10.1177/1071100718791834] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND: Diagnosis and operative treatment of syndesmotic ankle injuries remain challenging due to the limitations of 2-dimensional imaging. The aim of this study was therefore to develop a reproducible method to quantify the displacement of a syndesmotic lesion based on 3-dimensional computed imaging techniques. METHODS: Eighteen patients with a unilateral syndesmotic lesion were included. Bilateral imaging was performed with weightbearing cone-beam computed tomography (CT) in case of a high ankle sprain (n = 12) and by nonweightbearing CT in case of a fracture-associated syndesmotic lesion (n = 6). The healthy ankle was used as a template after being mirrored and superimposed on the contralateral ankle. The following anatomical landmarks of the distal fibula were computed: the most lateral aspect of the lateral malleolus and the anterior and posterior tubercle. The change in position of these landmarks relative to the stationary, healthy fibula was used to quantify the syndesmotic lesion. A control group of 7 studies was used. RESULTS: The main clinical relevant findings demonstrated a statistically significant difference between the mean mediolateral diastasis of both the sprained (mean [SD], 1.6 [1.0] mm) and the fracture group (mean [SD], 1.7 [0.6] mm) compared to the control group ( P < .001). The mean external rotation was statistically different when comparing the sprained (mean [SD], 4.7 [2.7] degrees) and the fracture group (mean [SD], 7.0 [7.1] degrees) to the control group ( P < .05). CONCLUSION: This study evaluated an effective method for quantifying a unilateral syndesmotic lesion of the ankle. Applications in clinical practice could improve diagnostic accuracy and potentially aid in preoperative planning by determining which correction needs to be achieved to have the fibula correctly reduced in the syndesmosis. LEVEL OF EVIDENCE: Level III, retrospective comparative study.
Collapse
Affiliation(s)
- Arne Burssens
- 1 Department of Orthopaedic Surgery, Ghent University Hospital, Gent, Belgium
| | - Hannes Vermue
- 1 Department of Orthopaedic Surgery, Ghent University Hospital, Gent, Belgium
| | - Alexej Barg
- 2 Department of Orthopaedics, University of Utah, Salt Lake City, UT, USA
| | - Nicola Krähenbühl
- 2 Department of Orthopaedics, University of Utah, Salt Lake City, UT, USA
| | - Jan Victor
- 1 Department of Orthopaedic Surgery, Ghent University Hospital, Gent, Belgium
| | | |
Collapse
|
12
|
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.
Collapse
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
| |
Collapse
|
13
|
Mustafy T, Londono I, Villemure I. Can the contralateral limb be used as a control during the growing period in a rodent model? Med Eng Phys 2018; 58:S1350-4533(18)30073-0. [PMID: 29764734 DOI: 10.1016/j.medengphy.2018.04.013] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2018] [Revised: 04/16/2018] [Accepted: 04/30/2018] [Indexed: 11/23/2022]
Abstract
The contralateral limb is often used as a control in various clinical, forensic and anthropological studies. However, no studies have been performed to determine if the contra-lateral limb is a suitable control during the bone development period. The aim of this study was to determine the bilateral symmetry of growing rat tibiae in terms of geometric shape, mechanical strength and bone morphological parameters with developmental stages. Left and right tibias of 18 male Sprague-Dawley rats at 4, 8 and 12 weeks of age were scanned with micro-CT for bone-morphometric evaluation and for 3D deviation analysis to quantify the geometric shape variations between left and right tibiae. Overall tibial lengths and curvatures were also measured, and bone mechanical strength was investigated using three-point bending tests. Deviation distributions between bilateral tibiae remained below 0.5 mm for more than 80% of the geometry for all groups. Tibial lengths, longitudinal tibial curvatures, bone-morphometric parameters and mechanical strengths changed significantly during the growing period but kept a strong degree of symmetry between bilateral tibiae. These results suggest that bilateral tibiae can be considered symmetrical in nature and that contralateral limb can be used as a control during the growing period in different experimental scenarios.
Collapse
Affiliation(s)
- Tanvir Mustafy
- Department of Mechanical Engineering, École Polytechnique of Montréal, P.O. Box 6079, Station Centre-Ville, Montréal, Québec H3C 3A7, Canada; Sainte-Justine University Hospital Center, 3175 Côte-Sainte-Catherine Rd., Montréal, Québec H3T 1C5, Canada
| | - Irène Londono
- Sainte-Justine University Hospital Center, 3175 Côte-Sainte-Catherine Rd., Montréal, Québec H3T 1C5, Canada
| | - Isabelle Villemure
- Department of Mechanical Engineering, École Polytechnique of Montréal, P.O. Box 6079, Station Centre-Ville, Montréal, Québec H3C 3A7, Canada; Sainte-Justine University Hospital Center, 3175 Côte-Sainte-Catherine Rd., Montréal, Québec H3T 1C5, Canada.
| |
Collapse
|
14
|
Radzi S, Dlaska CE, Cowin G, Robinson M, Pratap J, Schuetz MA, Mishra S, Schmutz B. Can MRI accurately detect pilon articular malreduction? A quantitative comparison between CT and 3T MRI bone models. Quant Imaging Med Surg 2017; 6:634-647. [PMID: 28090442 DOI: 10.21037/qims.2016.07.01] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND Pilon fracture reduction is a challenging surgery. Radiographs are commonly used to assess the quality of reduction, but are limited in revealing the remaining bone incongruities. The study aimed to develop a method in quantifying articular malreductions using 3D computed tomography (CT) and magnetic resonance imaging (MRI) models. METHODS CT and MRI data were acquired using three pairs of human cadaveric ankle specimens. Common tibial pilon fractures were simulated by performing osteotomies to the ankle specimens. Five of the created fractures [three AO type-B (43-B1), and two AO type-C (43-C1) fractures] were then reduced and stabilised using titanium implants, then rescanned. All datasets were reconstructed into CT and MRI models, and were analysed in regards to intra-articular steps and gaps, surface deviations, malrotations and maltranslations of the bone fragments. RESULTS Initial results reveal that type B fracture CT and MRI models differed by ~0.2 (step), ~0.18 (surface deviations), ~0.56° (rotation) and ~0.4 mm (translation). Type C fracture MRI models showed metal artefacts extending to the articular surface, thus unsuitable for analysis. Type C fracture CT models differed from their CT and MRI contralateral models by ~0.15 (surface deviation), ~1.63° (rotation) and ~0.4 mm (translation). CONCLUSIONS Type B fracture MRI models were comparable to CT and may potentially be used for the postoperative assessment of articular reduction on a case-to-case basis.
Collapse
Affiliation(s)
- Shairah Radzi
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia
| | - Constantin Edmond Dlaska
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia;; Trauma Services, Princess Alexandra Hospital, Brisbane, Australia
| | - Gary Cowin
- Centre of Advanced Imaging, University of Queensland, Brisbane, Australia
| | - Mark Robinson
- Orthopaedics Department, Royal Brisbane and Women's Hospital, Brisbane, Australia
| | - Jit Pratap
- Radiology Department, Princess Alexandra Hospital, Brisbane, Australia
| | - Michael Andreas Schuetz
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia;; Trauma Services, Princess Alexandra Hospital, Brisbane, Australia
| | - Sanjay Mishra
- Department of Science & Technology, Government of India, New Delhi, India
| | - Beat Schmutz
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia
| |
Collapse
|
15
|
Tümer N, Blankevoort L, van de Giessen M, Terra MP, de Jong PA, Weinans H, Tuijthof GJM, Zadpoor AA. Bone shape difference between control and osteochondral defect groups of the ankle joint. Osteoarthritis Cartilage 2016; 24:2108-2115. [PMID: 27495945 DOI: 10.1016/j.joca.2016.07.015] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2016] [Revised: 07/06/2016] [Accepted: 07/27/2016] [Indexed: 02/02/2023]
Abstract
OBJECTIVE The etiology of osteochondral defects (OCDs), for which the ankle (talocrural) joint is one of the common sites, is not yet fully understood. In this study, we hypothesized that bone shape plays a role in development of OCDs. Therefore, we quantitatively compared the morphology of the talus and the distal tibia between an OCD group and a control group. METHODS The shape variations of the talus and distal tibia were described separately by constructing two statistical shape models (SSMs) based on the segmentation of the bones from ankle computed tomography (CT) scans obtained from control (i.e., 35 CT scans) and OCD (i.e., 37 CT scans) groups. The first five modes of shape variation for the SSM corresponding to each bone were statistically compared between control and OCD groups using an analysis of variance (ANOVA) corrected with the Bonferroni for multiple comparisons. RESULTS The first five modes of variation in the SSMs respectively represented 49% and 40% of the total variance of talus and tibia. Less than 5% of the variance per mode was described by the higher modes. Mode 5 of the talus (P = 0.004) primarily describing changes in the vertical neck angle and Mode 1 of the tibia (P < 0.0001) representing variations at the medial malleolus, showed statistically significant difference between the control and OCD groups. CONCLUSION Shape differences exist between control and OCD groups. This indicates that a geometry modulated biomechanical behavior of the talocrural joint may be a risk factor for OCD.
Collapse
Affiliation(s)
- N Tümer
- Department of Biomechanical Engineering, Delft University of Technology (TU Delft), Mekelweg 2, Delft, 2628 CD, The Netherlands.
| | - L Blankevoort
- Orthopaedic Research Center Amsterdam, Academic Medical Centre (AMC), Meibergdreef 9, Amsterdam, 1105 AZ, The Netherlands.
| | - M van de Giessen
- Division of Image Processing, Leiden University Medical Center (LUMC), Albinusdreef 2, 2333 ZA, Leiden, The Netherlands.
| | - M P Terra
- Department of Radiology, Academic Medical Centre (AMC), Meibergdreef 9, Amsterdam, 1105 AZ, The Netherlands.
| | - P A de Jong
- Department of Radiology, UMC Utrecht, Heidelberglaan 100, Utrecht, 3584 CX, The Netherlands.
| | - H Weinans
- Department of Biomechanical Engineering, Delft University of Technology (TU Delft), Mekelweg 2, Delft, 2628 CD, The Netherlands; Department of Orthopedics, University Medical Centre Utrecht, Heidelberglaan 100, Utrecht, 3584 CX, The Netherlands; Department of Rheumatology, University Medical Centre Utrecht, Heidelberglaan 100, Utrecht, 3584 CX, The Netherlands.
| | - G J M Tuijthof
- Department of Biomechanical Engineering, Delft University of Technology (TU Delft), Mekelweg 2, Delft, 2628 CD, The Netherlands; Orthopaedic Research Center Amsterdam, Academic Medical Centre (AMC), Meibergdreef 9, Amsterdam, 1105 AZ, The Netherlands.
| | - A A Zadpoor
- Department of Biomechanical Engineering, Delft University of Technology (TU Delft), Mekelweg 2, Delft, 2628 CD, The Netherlands.
| |
Collapse
|
16
|
Brzobohatá H, Krajíček V, Horák Z, Velemínská J. Sexual Dimorphism of the Human Tibia through Time: Insights into Shape Variation Using a Surface-Based Approach. PLoS One 2016; 11:e0166461. [PMID: 27846265 PMCID: PMC5112946 DOI: 10.1371/journal.pone.0166461] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2016] [Accepted: 10/28/2016] [Indexed: 01/08/2023] Open
Abstract
In this paper we present a three-dimensional (3D) morphometrical assessment of human tibia sexual dimorphism based on whole bone digital representation. To detect shape-size and shape differences between sexes, we used geometric morphometric tools and colour-coded surface deviation maps. The surface-based methodology enabled analysis of sexually dimorphic features throughout the shaft and articular ends of the tibia. The overall study dataset consisted of 183 3D models of adult tibiae from three Czech population subsets, dating to the early medieval (9-10th century) (N = 65), early 20th century (N = 61) and 21st-century (N = 57). The time gap between the chronologically most distant and contemporary datasets was more than 1200 years. The results showed that, in all three datasets, sexual dimorphism was pronounced. There were some sex-dimorphic characteristics common to all three samples, such as tuberosity protrusion, anteriorly bowed shaft and relatively larger articular ends in males. Diachronic comparisons also revealed substantial shape variation related to the most dimorphic area. Male/female distinctions showed a consistent temporal trend regarding the location of dimorphic areas (shifting distally with time), while the maximal deviation between male and female digitized surfaces fluctuated and reached the lowest level in the 21st-century sample. Sex determination on a whole-surface basis yielded the lowest return of correct sex assignment in the 20th-century group, which represented the lowest socioeconomic status. The temporal variation could be attributed to changes in living conditions, the decreasing lower limb loading/labour division in the last 12 centuries having the greatest effect. Overall, the results showed that a surface-based approach is successful for analysing complex long bone geometry.
Collapse
Affiliation(s)
- Hana Brzobohatá
- Department of Prehistorical Archaeology, Institute of Archaeology of the Academy of Sciences, Prague, Czech Republic
| | - Václav Krajíček
- Department of Software and Computer Science Education, Faculty of Mathematics and Physics, Charles University in Prague, Prague, Czech Republic
- Department of Anthropology and Human Genetics, Faculty of Science, Charles University in Prague, Prague, Czech Republic
| | - Zdeněk Horák
- Laboratory of Biomechanics, Faculty of Mechanical Engineering, Czech Technical University, Prague, Czech Republic
| | - Jana Velemínská
- Department of Anthropology and Human Genetics, Faculty of Science, Charles University in Prague, Prague, Czech Republic
| |
Collapse
|