1
|
Haug LP, Sill AP, Shrestha R, Patel KA, Kile TA, Fox MG. Osteochondral Lesions of the Ankle and Foot. Semin Musculoskelet Radiol 2023; 27:269-282. [PMID: 37230127 DOI: 10.1055/s-0043-1766110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Osteochondral lesions (OCLs) in the ankle are more common than OCLs of the foot, but both share a similar imaging appearance. Knowledge of the various imaging modalities, as well as available surgical techniques, is important for radiologists. We discuss radiographs, ultrasonography, computed tomography, single-photon emission computed tomography/computed tomography, and magnetic resonance imaging to evaluate OCLs. In addition, various surgical techniques used to treat OCLs-debridement, retrograde drilling, microfracture, micronized cartilage-augmented microfracture, autografts, and allografts-are described with an emphasis on postoperative appearance following these techniques.
Collapse
Affiliation(s)
- Logan P Haug
- Department of Radiology, Mayo Clinic, Phoenix, Arizona
| | - Andrew P Sill
- Department of Radiology, Mayo Clinic, Phoenix, Arizona
| | | | - Karan A Patel
- Department of Orthopedics, Mayo Clinic, Phoenix, Arizona
| | - Todd A Kile
- Department of Orthopedics, Mayo Clinic, Phoenix, Arizona
| | - Michael G Fox
- Department of Radiology, Mayo Clinic, Phoenix, Arizona
| |
Collapse
|
2
|
Hegazy MA, Khairy HM, Hegazy AA, Sebaei MAEF, Sadek SI. Talus bone: normal anatomy, anatomical variations and clinical correlations. Anat Sci Int 2023:10.1007/s12565-023-00712-y. [PMID: 37017903 DOI: 10.1007/s12565-023-00712-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Accepted: 02/28/2023] [Indexed: 04/06/2023]
Abstract
Talus is a pivotal bone that assists in easy and correct locomotion and transfers body weight from the shin to the foot. Despite its small size, it is implicated in many clinical disorders. Familiarity with the anatomy of the talus and its anatomical variations is essential for the diagnosis of any disorder related to these variations. Furthermore, orthopedic surgeons must be fully aware by this anatomy during podiatry procedures. In this review, we attempt to present its anatomy in a simple, updated and comprehensive manner. We have also added the anatomical variations and some clinical points relevant to the unique and complex anatomy of talus. The talus has no muscle attachment. However, it does have many ligaments attached to it and others around it to keep it in place. Moreover, the bone plays a pig role in movements due to its involvement in many joints. Most of its surface is covered with articular cartilage. Therefore, its blood supply is relatively poor. This puts the talus at greater risk for poor healing as well as more complications in the event of injury than any other bone. We hope this review will make it easier for clinicians to pursue and understand the updated essential knowledge of one of the most complex bone anatomies that they need in their clinical practice.
Collapse
Affiliation(s)
| | - Hossam Mohammed Khairy
- Orthopedic Surgery Department, Faculty of Medicine, Zagazig University, Zagazig City, 44519, Egypt
| | - Abdelmonem Awad Hegazy
- Basic Medical Science Department, Faculty of Dentistry, Zarqa University, Zarqa City, 13110, Jordan.
- Human Anatomy and Embryology Department, Faculty of Medicine, Zagazig University, Zagazig City, 44519, Egypt.
| | | | - Sami Ibrahim Sadek
- Orthopedic Surgery Department, Faculty of Medicine, Zagazig University, Zagazig City, 44519, Egypt
| |
Collapse
|
3
|
Nevalainen MT, Pitkänen MM, Saarakkala S. Diagnostic Performance of Ultrasonography for Evaluation of Osteoarthritis of Ankle Joint: Comparison With Radiography, Cone-Beam CT, and Symptoms. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2022; 41:1139-1146. [PMID: 34378811 DOI: 10.1002/jum.15803] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 06/09/2021] [Accepted: 07/11/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVES To determine the diagnostic performance of ultrasonography (US) for evaluation of the ankle joint osteoarthritic (OA) changes. Cone-beam computed tomography (CT) was used as the gold standard and US performance was compared with conventional radiography (CR). As a secondary aim, associations between the imaging findings and ankle symptoms were assessed. METHODS US was performed to 51 patients with ankle OA. Every patient had prior ankle CR and underwent cone-beam CT during the same day as US examination. On US, effusion/synovitis, osteophytes, talar cartilage damage, and tenosynovitis were evaluated. Comparison to respective imaging findings on CR and cone-beam CT was then performed. Single radiologist blinded to other modalities assessed all the imaging studies. Symptoms questionnaire, the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), was available for 48 patients. RESULTS US detected effusion/synovitis of the talocrural joint with 45% sensitivity and 90% specificity. For the detection of anterior talocrural osteophytes, US sensitivity was 78% and specificity 79%. For the medial talocrural osteophytes, they were 39 and 83%, and for the lateral talocrural osteophytes 54 and 100%, respectively. Considering cartilage damage of the talus, US yielded a low sensitivity of 18% and high specificity of 97%. Overall, the performance of US was only moderate and comparable to CR. The imaging findings showed only weak associations with ankle symptoms. CONCLUSIONS The ability of US to detect ankle OA is only moderate. Interestingly, performance of CR also remained moderate. The associations between imaging findings and WOMAC score seem to be weak in ankle OA.
Collapse
Affiliation(s)
- Mika T Nevalainen
- Department of Diagnostic Radiology, Oulu University Hospital, Oulu
- Medical Research Center Oulu, University of Oulu, Oulu
- Research Unit of Medical Imaging, Physics and Technology, Faculty of Medicine, University of Oulu, Oulu
| | | | - Simo Saarakkala
- Department of Diagnostic Radiology, Oulu University Hospital, Oulu
- Medical Research Center Oulu, University of Oulu, Oulu
- Research Unit of Medical Imaging, Physics and Technology, Faculty of Medicine, University of Oulu, Oulu
| |
Collapse
|
4
|
Smith SE, Chang EY, Ha AS, Bartolotta RJ, Bucknor M, Chandra T, Chen KC, Gorbachova T, Khurana B, Klitzke AK, Lee KS, Mooar PA, Ross AB, Shih RD, Singer AD, Taljanovic MS, Thomas JM, Tynus KM, Kransdorf MJ. ACR Appropriateness Criteria® Acute Trauma to the Ankle. J Am Coll Radiol 2020; 17:S355-S366. [PMID: 33153549 DOI: 10.1016/j.jacr.2020.09.014] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Accepted: 09/01/2020] [Indexed: 02/07/2023]
Abstract
Acute injuries to the ankle are frequently encountered in the setting of the emergency room, sport, and general practice. This ACR Appropriateness Criteria defines best practices for imaging evaluation for several variants of patients presenting with acute ankle trauma. The variants include scenarios when Ottawa Rules can be evaluated, when there are exclusionary criteria, when Ottawa Rules cannot be evaluated, as well as specific injuries. Clinical scenarios are followed by the imaging choices and their appropriateness with an accompanying narrative explanation to help physicians to order the most appropriate imaging test. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment.
Collapse
Affiliation(s)
- Stacy E Smith
- Brigham & Women's Hospital & Harvard Medical School, Boston, Massachusetts.
| | - Eric Y Chang
- Panel Chair, VA San Diego Healthcare System, San Diego, California
| | - Alice S Ha
- Panel Vice-Chair, University of Washington, Seattle, Washington
| | | | - Matthew Bucknor
- University of California San Francisco, San Francisco, California
| | | | - Karen C Chen
- VA San Diego Healthcare System, San Diego, California
| | | | | | - Alan K Klitzke
- Roswell Park Comprehensive Cancer Center, Buffalo, New York
| | - Kenneth S Lee
- University of Wisconsin Hospital & Clinics, Madison, Wisconsin
| | - Pekka A Mooar
- Temple University Hospital, Philadelphia, Pennsylvania; American Academy of Orthopaedic Surgeons
| | - Andrew B Ross
- University of Wisconsin School of Medicine & Public Health, Madison, Wisconsin
| | - Richard D Shih
- Schmidt College of Medicine, Florida Atlantic University, Boca Raton, Florida, American College of Emergency Physicians
| | - Adam D Singer
- Emory University School of Medicine, Atlanta, Georgia
| | | | - Jonelle M Thomas
- Penn State Milton S. Hershey Medical Center, Hershey, Pennsylvania
| | - Katherine M Tynus
- Northwestern Memorial Hospital, Chicago, Illinois; American College of Physicians
| | | |
Collapse
|
5
|
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.
Collapse
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.
| |
Collapse
|
6
|
Van Dijk CN, Vuurberg G, Batista J, d’Hooghe P. Posterior ankle arthroscopy: current state of the art. J ISAKOS 2017. [DOI: 10.1136/jisakos-2016-000082] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
|
7
|
Flanigan DC, Carey JL, Brophy RH, Graham WC, DiBartola AC, Hamilton D, Nagaraja HN, Lattermann C. Interrater and Intrarater Reliability of Arthroscopic Measurements of Articular Cartilage Defects in the Knee. J Bone Joint Surg Am 2017. [PMID: 28632586 DOI: 10.2106/jbjs.16.01132] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND Cartilage lesions of the knee are difficult to treat. Lesion size is a critical factor in treatment algorithms, and the accurate, reproducible sizing of lesions is important. In this study, we evaluated the interrater and intrarater reliability of, and correlations in relation to, various arthroscopic sizing techniques. METHODS Five lesions were created in each of 10 cadaveric knees (International Cartilage Repair Society grade 3C). Three orthopaedic surgeons used 4 techniques (visualization and use of a 3-mm probe, a simple metal ruler, and a sliding metallic ruler tool) to estimate lesion size. Repeated-measures data were analyzed using a mixed-effect linear model. The differences between observed and gold-standard (plastic mold) values were used as the response. Intraclass and interclass correlation coefficient (ICC) values for intrarater and interrater reliability were computed, as were overall correlation coefficients between measurements and gold standards. RESULTS The mean lesion size was 2.37 cm (range, 0.36 to 6.02 cm). Rater, lesion location and size, and measurement method all affected the cartilage defect measurements. Surgeons underestimated lesion size, and measurements of larger lesions had a higher percentage of error compared with those of smaller lesions. When compared with plastic molds of lesions, 60.5% of surgeon measurements underestimated lesion size. Overall, the correlation between measurements and gold standards was strongest for the simple metal ruler method and weakest for the visualization method. CONCLUSIONS Several factors may influence arthroscopic estimation of cartilage lesion size: the lesion location, measurement tool, surgeon, and defect size itself. The intrarater and interrater reliability was moderate to good using a 3-mm probe, sliding metallic ruler tool, or simple metal ruler and was fair to moderate using visualization only. CLINICAL RELEVANCE There is a need for more accurate methods of determining the size of articular cartilage lesions.
Collapse
Affiliation(s)
- David C Flanigan
- 1Division of Sports Medicine Cartilage Repair Center, Department of Orthopaedics (D.C.F., W.C.G., and A.C.D.), Division of Biostatistics, College of Public Health (H.N.N.), and Wexner Medical Center (D.C.F. and A.C.D.), The Ohio State University, Columbus, Ohio 2Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania 3Department of Orthopaedic Surgery, Washington University, St. Louis, Missouri 4OrthoCarolina, Pineville, North Carolina 5University of Kentucky, Lexington, Kentucky
| | | | | | | | | | | | | | | |
Collapse
|
8
|
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
|
9
|
|
10
|
Bergen CJAV, Gerards RM, Opdam KTM, Terra MP, Kerkhoffs GMMJ. Diagnosing, planning and evaluating osteochondral ankle defects with imaging modalities. World J Orthop 2015; 6:944-953. [PMID: 26716090 PMCID: PMC4686441 DOI: 10.5312/wjo.v6.i11.944] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2015] [Revised: 09/02/2015] [Accepted: 10/13/2015] [Indexed: 02/06/2023] Open
Abstract
This current concepts review outlines the role of different imaging modalities in the diagnosis, preoperative planning, and follow-up of osteochondral ankle defects. An osteochondral ankle defect involves the articular cartilage and subchondral bone (usually of the talus) and is mostly caused by an ankle supination trauma. Conventional radiographs are useful as an initial imaging tool in the diagnostic process, but have only moderate sensitivity for the detection of osteochondral defects. Computed tomography (CT) and magnetic resonance imaging (MRI) are more accurate imaging modalities. Recently, ultrasonography and single photon emission CT have been described for the evaluation of osteochondral talar defects. CT is the most valuable modality for assessing the exact location and size of bony lesions. Cartilage and subchondral bone damage can be visualized using MRI, but the defect size tends to be overestimated due to bone edema. CT with the ankle in full plantar flexion has been shown a reliable tool for preoperative planning of the surgical approach. Postoperative imaging is useful for objective assessment of repair tissue or degenerative changes of the ankle joint. Plain radiography, CT and MRI have been used in outcome studies, and different scoring systems are available.
Collapse
|
11
|
Sarkalkan N, Loeve AJ, van Dongen KWA, Tuijthof GJM, Zadpoor AA. A novel ultrasound technique for detection of osteochondral defects in the ankle joint: a parametric and feasibility study. SENSORS 2014; 15:148-65. [PMID: 25609040 PMCID: PMC4327012 DOI: 10.3390/s150100148] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/08/2014] [Accepted: 12/13/2014] [Indexed: 01/12/2023]
Abstract
(Osteo)chondral defects (OCDs) in the ankle are currently diagnosed with modalities that are not convenient to use in long-term follow-ups. Ultrasound (US) imaging, which is a cost-effective and non-invasive alternative, has limited ability to discriminate OCDs. We aim to develop a new diagnostic technique based on US wave propagation through the ankle joint. The presence of OCDs is identified when a US signal deviates from a reference signal associated with the healthy joint. The feasibility of the proposed technique is studied using experimentally-validated 2D finite-difference time-domain models of the ankle joint. The normalized maximum cross correlation of experiments and simulation was 0.97. Effects of variables relevant to the ankle joint, US transducers and OCDs were evaluated. Variations in joint space width and transducer orientation made noticeable alterations to the reference signal: normalized root mean square error ranged from 6.29% to 65.25% and from 19.59% to 8064.2%, respectively. The results suggest that the new technique could be used for detection of OCDs, if the effects of other parameters (i.e., parameters related to the ankle joint and US transducers) can be reduced.
Collapse
Affiliation(s)
- Nazli Sarkalkan
- Department of Biomechanical Engineering, Faculty of Mechanical Engineering, Delft University of Technology (TU Delft), Mekelweg 2, Delft 2628 CD, The Netherlands.
| | - Arjo J Loeve
- Department of Biomechanical Engineering, Faculty of Mechanical Engineering, Delft University of Technology (TU Delft), Mekelweg 2, Delft 2628 CD, The Netherlands.
| | - Koen W A van Dongen
- Department of Imaging Physics, Faculty of Applied Sciences, Delft University of Technology (TU Delft), Lorentzweg 1, Delft 2628 CJ, The Netherlands.
| | - Gabrielle J M Tuijthof
- Department of Biomechanical Engineering, Faculty of Mechanical Engineering, Delft University of Technology (TU Delft), Mekelweg 2, Delft 2628 CD, The Netherlands.
| | - Amir A Zadpoor
- Department of Biomechanical Engineering, Faculty of Mechanical Engineering, Delft University of Technology (TU Delft), Mekelweg 2, Delft 2628 CD, The Netherlands.
| |
Collapse
|