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Yamamoto T, Paulus P, Setliff JC, Hogan MV, Anderst WJ. Influence of Talar and Calcaneal Morphology on Subtalar Kinematics During Walking. Foot Ankle Int 2024; 45:632-640. [PMID: 38491768 PMCID: PMC11164638 DOI: 10.1177/10711007241231981] [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] [Indexed: 03/18/2024]
Abstract
BACKGROUND Cadaver biomechanical testing suggests that the morphology of articulating bones contributes to the stability of the joints and determines their kinematics; however, there are no studies examining the correlation between bone morphology and kinematics of the subtalar joint. The purpose of this study was to investigate the influence of talar and calcaneal morphology on subtalar kinematics during walking in healthy individuals. METHODS Forty ankles (20 healthy subjects, 10 women/10 men) were included. Participants walked at a self-selected pace while synchronized biplane radiographs of the hindfoot were acquired at 100 images per second during stance. Motion of the talus and calcaneus was tracked using a validated volumetric model-based tracking process, and subtalar kinematics were calculated. Talar and calcaneal morphology were evaluated using statistical shape modeling. Pearson correlation coefficients were used to assess the relationship between subtalar kinematics and the morphology features of the talus and calcaneus. RESULTS This study found that a shallower posterior facet of the talus was correlated with the subtalar joint being in more dorsiflexion, more inversion, and more internal rotation, and higher curvature in the posterior facet was correlated with more inversion and eversion range of motion during stance. In the calcaneus, a gentler slope of the middle facet was correlated with greater subtalar inversion. CONCLUSION The morphology of the posterior facet of the talus was found to a primary factor driving multiplanar subtalar joint kinematics during the stance phase of gait. CLINICAL RELEVANCE This new knowledge relating form and function in the hindfoot may assist in identifying individuals susceptible to subtalar instability and in improving implant design to achieve desired kinematics after surgery.
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Affiliation(s)
- Tetsuya Yamamoto
- Biodynamics Lab, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Paige Paulus
- Biodynamics Lab, University of Pittsburgh, Pittsburgh, PA, USA
| | | | - MaCalus V. Hogan
- Department of Orthopaedic Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - William J. Anderst
- Biodynamics Lab, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Orthopaedic Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
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2
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Behling AV, Welte L, Kelly L, Rainbow MJ. Human in vivo midtarsal and subtalar joint kinematics during walking, running and hopping. J R Soc Interface 2024; 21:20240074. [PMID: 38807524 DOI: 10.1098/rsif.2024.0074] [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: 09/15/2023] [Accepted: 04/08/2024] [Indexed: 05/30/2024] Open
Abstract
The interaction among joints of the midtarsal complex and subtalar joint is important for locomotor function; however, its complexity poses substantial challenges in quantifying the joints' motions. We determine the mobility of these joints across locomotion tasks and investigate the influence of individual talus morphology on their motion. Using highly accurate biplanar videoradiography, three-dimensional bone kinematics were captured during walking, running and hopping. We calculated the axis of rotation of the midtarsal complex and subtalar joint for the landing and push-off phases. A comparison was made between these rotation axes and the morphological subtalar axis. Measurement included total rotation about and the orientation of the rotation axes in the direction of the subtalar joint and its deviation via spatial angles for both phases. The rotation axes of all three bones relative to the talus closely align with the morphological subtalar axis. This suggests that the midtarsal and subtalar joints' motions might be described by one commonly oriented axis. Despite having such an axis, the location of the axes and ranges of motion differed among the bones. Our results provide a novel perspective of healthy foot function across different sagittal plane-dominant locomotion tasks underscoring the importance of quantifying midtarsal complex and subtalar motion while accounting for an individual's talus morphology.
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Affiliation(s)
- Anja-Verena Behling
- School of Human Movement and Nutrition Science, The University of Queensland , Brisbane, Queensland, Australia
- Department of Mechanical and Materials Engineering, Queen's University , Kingston, Ontario, Canada
| | - Lauren Welte
- Mechanical Engineering, University of Alberta , Edmonton, Alberta, Canada
- Biomedical Engineering, University of Alberta , Edmonton, Alberta, Canada
| | - Luke Kelly
- School of Human Movement and Nutrition Science, The University of Queensland , Brisbane, Queensland, Australia
- Griffith Centre of Biomedical & Rehabilitation Engineering, Griffith University , Gold Coast, Queensland, Australia
- School of Health Sciences & Social Work, Griffith University , Gold Coast, Queensland, Australia
| | - Michael J Rainbow
- Department of Mechanical and Materials Engineering, Queen's University , Kingston, Ontario, Canada
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3
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Sakthivel S, Maria Francis Y, G SN, K V SD, Dhakshnamoorthy N. Anthropometric Analysis of Cuboid Bones in a South Indian Population. Cureus 2024; 16:e51622. [PMID: 38313952 PMCID: PMC10837486 DOI: 10.7759/cureus.51622] [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] [Accepted: 01/03/2024] [Indexed: 02/06/2024] Open
Abstract
Purpose Cuboid bone and its fibromuscular supports maintain the lateral longitudinal arch in weight transmission during different gait cycle phases. Morphometry of the cuboid bone is essential for designing a cuboid prosthesis for foot reconstruction and establishing an individual's biological profile. The present study aims to assess the morphology and morphometry of the cuboid bone. Materials and methods The study used 103 cuboid bones (right 50, left 53) of unknown sex. Different shapes of cuboid articular facets were observed, and the morphometric parameters such as length, breadth, and height of cuboid, and the dimensions of articular facets in cuboid (calcaneal facet, fourth and fifth metatarsal facets, ecto-cuneiform facet, navicular facet, and facet for os peroneum) were analyzed. Results The mean length, breadth, and height of the cuboid bone were 33.69 ± 2.61 mm, 25.43 ± 2.87 mm, and 23.03 ± 2.43 mm, respectively. The mean transverse and vertical diameters were 23.22 ± 2.4 mm and 15.97 ± 1.85 mm, respectively. Facet for os peroneum was observed in 74.76% and for navicular bone in 26.2%. The mean transverse and vertical diameters were 7.16 ± 2.08 and 6.78 ± 1.78 mm, respectively. The depth of the peroneal groove was 4.30 ± 1.11 mm. Conclusion The morphometric data from the present study could assist in preoperative planning and designing of prostheses for foot reconstruction, and in establishing the biological profile of an individual, which can help the anthropologists in identifying the unknown remains.
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Affiliation(s)
- Sulochana Sakthivel
- Anatomy, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, IND
| | | | - Sankara N G
- Anatomy, Saveetha Medical College and Hospital, Chennai, IND
| | - Sarala D K V
- Anatomy, Employees' State Insurance Company Medical College and Hospital, Chennai, IND
| | - Nithya Dhakshnamoorthy
- Anatomy, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, IND
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4
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Abstract
Advancements in volumetric imaging makes it possible to generate high-resolution three-dimensional reconstructions of bones in throughout the foot and ankle. The use of weightbearing computed tomography allows for the analysis of joint relationships in a consistent natural position that can be used for statistical shape modeling. Using statistical shape modeling, a population-based statistical model is created that can be used to compare mean bone shape morphology and identify anatomical modes of variation. A review is presented to highlight the current work using statistical shape modeling in the foot and ankle with a future view of the impact on clinical care.
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5
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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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6
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Harper CM, Goldstein DM, Sylvester AD. Comparing and combining sliding semilandmarks and weighted spherical harmonics for shape analysis. J Anat 2022; 240:678-687. [PMID: 34747020 PMCID: PMC8930823 DOI: 10.1111/joa.13589] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Revised: 10/27/2021] [Accepted: 10/29/2021] [Indexed: 11/28/2022] Open
Abstract
Quantifying morphological variation is critical for conducting anatomical research. Three-dimensional geometric morphometric (3D GM) landmark analyses quantify shape using homologous Cartesian coordinates (landmarks). Setting up a high-density landmark set and placing it on all specimens, however, can be a time-consuming task. Weighted spherical harmonics (SPHARM) provides an alternative method for analyzing the shape of such objects. Here we compare sliding semilandmark and SPHARM analyses of the calcaneus of Gorilla gorilla gorilla (n = 20), Pan troglodytes troglodytes (n = 20), and Homo sapiens (n = 20) to determine whether the SPHARM and sliding semilandmark analyses capture comparable levels of shape variation. We also compare both the sliding semilandmark and SPHARM analyses to a novel combination of the two methods, here termed SPHARM-sliding. In SPHARM-sliding, the vertices of the surface models produced from the SPHARM analysis (that are the same in number and relative location) are used as the starting landmark positions for a sliding semilandmark analysis. Calcaneal shape variation quantified by all three analyses was summarized using separate principal components analyses. Results were compared using the root mean square (RMS) and maximum distance between surface models of species averages scaled (up) to centroid size created from each analysis. The average RMS was 0.23 mm between sliding semilandmark and SPHARM average surface models, 0.19 mm between SPHARM and SPHARM sliding average surface models, and 0.22 mm between sliding semilandmark and SPHARM sliding average surface models. Although results indicate that all three analyses are comparable methods for 3D shape analysis, there are advantages and disadvantages to each. While the SPHARM analysis is less time-intensive, it is unable to capture the same level of detail around the sharp edges of articular facets on average surface models as the sliding semilandmark analysis. The SPHARM analysis also does not allow for individual articular facets to be analyzed in isolation. SPHARM-sliding, however, captures the same level of detail as the sliding semilandmark analysis, and (as in the sliding semilandmark analysis) allows for the evaluation of individual portions of bone. SPHARM is a comparable method to a 3D GM analysis for small, irregularly shaped bones, such as the calcaneus, and SPHARM-sliding allows for an expedited set up process for a sliding semilandmark analysis.
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Affiliation(s)
- Christine M. Harper
- Department of Biomedical SciencesCooper Medical School of Rowan UniversityCamdenNew JerseyUSA
- Center for Functional Anatomy and EvolutionThe Johns Hopkins University School of MedicineBaltimoreMarylandUSA
| | - Deanna M. Goldstein
- Center for Functional Anatomy and EvolutionThe Johns Hopkins University School of MedicineBaltimoreMarylandUSA
| | - Adam D. Sylvester
- Center for Functional Anatomy and EvolutionThe Johns Hopkins University School of MedicineBaltimoreMarylandUSA
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7
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Llera Martín CJ, Rose KD, Sylvester AD. A morphometric analysis of early Eocene Euprimate tarsals from Gujarat, India. J Hum Evol 2022; 164:103141. [DOI: 10.1016/j.jhevol.2022.103141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 01/03/2022] [Accepted: 01/03/2022] [Indexed: 11/16/2022]
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8
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Peterson AC, Lisonbee RJ, Krähenbühl N, Saltzman CL, Barg A, Khan N, Elhabian SY, Lenz AL. Multi-level multi-domain statistical shape model of the subtalar, talonavicular, and calcaneocuboid joints. Front Bioeng Biotechnol 2022; 10:1056536. [PMID: 36545681 PMCID: PMC9760736 DOI: 10.3389/fbioe.2022.1056536] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Accepted: 11/03/2022] [Indexed: 12/12/2022] Open
Abstract
Traditionally, two-dimensional conventional radiographs have been the primary tool to measure the complex morphology of the foot and ankle. However, the subtalar, talonavicular, and calcaneocuboid joints are challenging to assess due to their bone morphology and locations within the ankle. Weightbearing computed tomography is a novel high-resolution volumetric imaging mechanism that allows detailed generation of 3D bone reconstructions. This study aimed to develop a multi-domain statistical shape model to assess morphologic and alignment variation of the subtalar, talonavicular, and calcaneocuboid joints across an asymptomatic population and calculate 3D joint measurements in a consistent weightbearing position. Specific joint measurements included joint space distance, congruence, and coverage. Noteworthy anatomical variation predominantly included the talus and calcaneus, specifically an inverse relationship regarding talar dome heightening and calcaneal shortening. While there was minimal navicular and cuboid shape variation, there were alignment variations within these joints; the most notable is the rotational aspect about the anterior-posterior axis. This study also found that multi-domain modeling may be able to predict joint space distance measurements within a population. Additionally, variation across a population of these four bones may be driven far more by morphology than by alignment variation based on all three joint measurements. These data are beneficial in furthering our understanding of joint-level morphology and alignment variants to guide advancements in ankle joint pathological care and operative treatments.
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Affiliation(s)
- Andrew C. Peterson
- Department of Orthopaedics, University of Utah, Salt Lake City, UT, United States
| | - Rich J. Lisonbee
- Department of Orthopaedics, University of Utah, Salt Lake City, UT, United States
| | | | - Charles L. Saltzman
- Department of Orthopaedics, University of Utah, Salt Lake City, UT, United States
| | - Alexej Barg
- Department of Orthopaedics, University of Utah, Salt Lake City, UT, United States
- University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Nawazish Khan
- School of Computing, College of Engineering, University of Utah, Salt Lake City, UT, United States
- Scientific Computing and Imaging Institute, College of Engineering, University of Utah, Salt Lake City, UT, United States
| | - Shireen Y. Elhabian
- School of Computing, College of Engineering, University of Utah, Salt Lake City, UT, United States
- Scientific Computing and Imaging Institute, College of Engineering, University of Utah, Salt Lake City, UT, United States
| | - Amy L. Lenz
- Department of Orthopaedics, University of Utah, Salt Lake City, UT, United States
- Department of Biomedical Engineering, College of Engineering, University of Utah, Salt Lake City, UT, United States
- Department of Mechanical Engineering, College of Engineering, University of Utah, Salt Lake City, UT, United States
- *Correspondence: Amy L. Lenz,
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9
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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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10
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Yang S, Canton SP, Hogan MV, Anderst W. Healthy ankle and hindfoot kinematics during gait: Sex differences, asymmetry and coupled motion revealed through dynamic biplane radiography. J Biomech 2021; 116:110220. [PMID: 33422727 PMCID: PMC7878402 DOI: 10.1016/j.jbiomech.2020.110220] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Revised: 11/02/2020] [Accepted: 12/25/2020] [Indexed: 12/25/2022]
Abstract
The aims of this study were to compare male versus female and dominant versus non-dominant kinematics in the ankle and hindfoot, and to characterize coupled motion between the subtalar and tibiotalar joints during the support phase of gait. Twenty healthy adults walked on a laboratory walkway while synchronized biplane radiographs of the ankle and hindfoot were collected at 100 frames/s. A validated tracking technique was used to measure tibiotalar and subtalar kinematics. Differences between male and female range of motion (ROM) were observed only in tibiotalar (AP and ML) and subtalar (ML) translation (all differences<1 mm and all p < 0.04). Statistical parametric mapping identified differences between kinematics waveforms of males and females in tibiotalar translation (AP and ML) and eversion, and subtalar ML translation. No differences between dominant and non-dominant sides were observed in ROM or kinematics waveforms. The average absolute side-to-side difference in the kinematics waveforms was 4.1° and 1.5 mm or less for all rotations and translations, respectively. Tibiotalar plantarflexion was coupled to subtalar inversion and eversion during the impact and push-off phases of stance (r = 0.90 and r = 0.87, respectively). This data may serve as a guide for evaluating ankle kinematics waveforms, ROM, symmetry, and restoration of healthy coupled motion after surgical intervention or rehabilitation. The observed kinematics differences between males and females may predispose females to higher rates of ankle and knee injury and suggest sex-dependent ankle reconstruction techniques may be beneficial.
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Affiliation(s)
- Shumeng Yang
- Department of Bioengineering, University of Pittsburgh, United States
| | | | - MaCalus V Hogan
- Department of Bioengineering, University of Pittsburgh, United States; University of Pittsburgh School of Medicine, United States; Department of Orthopaedic Surgery, University of Pittsburgh, United States; Foot and Ankle Injury Research [F.A.I.R] Group, United States
| | - William Anderst
- University of Pittsburgh School of Medicine, United States; Department of Orthopaedic Surgery, University of Pittsburgh, United States
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11
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Krahenbuhl N, Lenz AL, Lisonbee R, Peterson AC, Atkins PR, Hintermann B, Saltzman CL, Anderson AE, Barg A. Morphologic analysis of the subtalar joint using statistical shape modeling. J Orthop Res 2020; 38:2625-2633. [PMID: 32816337 PMCID: PMC8713294 DOI: 10.1002/jor.24831] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Revised: 07/30/2020] [Accepted: 08/18/2020] [Indexed: 02/04/2023]
Abstract
Weightbearing computed tomography (WBCT) enables visualization of the foot and ankle as patients stand under load. Clinical measurements of WBCT images are generally limited to two-dimensions, which reduces the ability to quantify complex morphology of individual osseous structures as well as the alignment between two or more bones. The shape and orientation of the healthy/normal subtalar joint, in particular, is not well-understood, which makes it very difficult to diagnose subtalar pathoanatomy. Herein, we employed statistical shape modeling to evaluate three-dimensional (3D) shape variation, coverage, space, and congruency of the subtalar joint using WBCT data of 27 asymptomatic healthy individuals. The four most relevant findings were: (A) talar and calcaneal anatomical differences were found regarding the presence of (a) the talar posterior process, (b) calcaneal pitch, and (c) curvature of the calcaneal posterior facet; (B) the talar posterior facet articular surface area was significantly greater than the calcaneal posterior facet articular surface area; (C) the posterior facet varied in joint space distance, whereas the anteromedial facet was even; and (D) the posterior and anteromedial facet of the subtalar joint was consistently congruent. Despite considerable shape variation across the population, the posterior and anteromedial articular facets of the subtalar joint were consistently congruent. Results provide a detailed 3D analysis of the subtalar joint under a weightbearing condition in a healthy population which can be used for comparisons to pathological patient populations. The described SSM approach also shows promise for clinical evaluation of the subtalar joint from 3D surface reconstructions of WBCT images.
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Affiliation(s)
| | | | - Rich Lisonbee
- Department of Orthopaedics, University of Utah, 590 Wakara Way, Salt Lake City, UT 84108, USA
| | - Andrew C. Peterson
- Department of Orthopaedics, University of Utah, 590 Wakara Way, Salt Lake City, UT 84108, USA
| | - Penny R. Atkins
- Institute for Biomechanics, ETH Zurich, Leopold-Ruzicka-Weg 4, 8093 Zürich, Switzerland
| | - Beat Hintermann
- Department of Orthopaedics, Kantonsspital Baselland, Rheinstrasse 26, 4410 Liestal, Switzerland
| | - Charles L. Saltzman
- Department of Orthopaedics, University of Utah, 590 Wakara Way, Salt Lake City, UT 84108, USA
| | - Andrew E. Anderson
- Department of Orthopaedics, University of Utah, 590 Wakara Way, Salt Lake City, UT 84108, USA
| | - Alexej Barg
- Department of Orthopaedics, University of Utah, 590 Wakara Way, Salt Lake City, UT 84108, USA
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12
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Schuster RW, Cresswell A, Kelly L. Reliability and quality of statistical shape and deformation models constructed from optical foot scans. J Biomech 2020; 115:110137. [PMID: 33267964 DOI: 10.1016/j.jbiomech.2020.110137] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Revised: 10/29/2020] [Accepted: 11/12/2020] [Indexed: 10/22/2022]
Abstract
The unique shape of modern human feet, and how they change shape when loaded are thought to be integral to effective upright gait. This unique shape, and the natural variations therein, have previously been analysed using a range of methods; from visual assessments, anthropometric measurements, and footprints, to x-ray, ultrasound and magnetic resonance images. However, these methods are often limited by their use of linear two-dimensional measures. Only recently have advances in three-dimensional (3D) scanning technology and statistical shape analysis been applied to studying 3D foot shape variations. Given their novelty, information regarding the reliability and repeatability of 3D foot scanning and shape modelling is lacking. To investigate whether repeated foot scans captured by two examiners give the same 3D shape and produce consistent statistical shape models, 17 healthy adults' left feet were scanned while bearing half and full bodyweight, as well as minimal weight. Surface to surface distances between corresponding foot meshes and differences between shape model quality criteria were both found to be small and insignificant. The only exception being the specificity criterion for minimally loaded foot scans. Furthermore, Euclidean vectors were used to model the magnitude and direction of deformation that feet undergo as a consequence of increased loading. The deformation models showed that loading a minimally loaded foot results in greater, but less consistent, shape changes than when increasing the load on an already loaded foot. These results show that the utilized methods offer a valuable, reliable and repeatable approach to analysing foot shape and deformation.
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Affiliation(s)
| | - Andrew Cresswell
- School of Human Movement & Nutrition Sciences, The University of Queensland, Australia
| | - Luke Kelly
- School of Human Movement & Nutrition Sciences, The University of Queensland, Australia
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13
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Liu T, Jomha NM, Adeeb S, El-Rich M, Westover L. Investigation of the Average Shape and Principal Variations of the Human Talus Bone Using Statistic Shape Model. Front Bioeng Biotechnol 2020; 8:656. [PMID: 32714904 PMCID: PMC7351508 DOI: 10.3389/fbioe.2020.00656] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2020] [Accepted: 05/27/2020] [Indexed: 12/24/2022] Open
Abstract
Due to the complexity of articular interconnections and tenuous blood supply to the talus, talus fractures are often associated with complications (e.g., avascular necrosis). Currently, surgically fusing the talus to adjacent bones is widely used as treatment to talus fractures, but this procedure can greatly reduce mobility in the ankle and hindfoot. Alternatively, customized talus implants have shown an overall satisfactory patient feedback but with the limitation of high expenses and time-consuming manufacturing process. In order to circumvent these disadvantages, universal talus implants have been proposed as a potential solution. In our study, we aimed to develop a methodology using Statistical Shape Model (SSM) to simulate the talus, and then evaluate the feasibility of the model to obtain the mean shape needed for universal implant design. In order to achieve this, we registered 98 tali (41 females and 57 males) and used the registered dataset to train our SSM. We used the mean shape derived from the SSM as the basis for our talus implant template, and compared our template with that of previous works. We found that our SSM mean shape talus implant was geometrically similar to implants from other works, which used a different method for the mean shape. This suggests the feasibility of SSM as a method of finding mean shape information for the development of universal implants. A second aim of our study was to investigate if one scalable talus implant can accommodate all patients. In our study, we focused on addressing this from a geometric perspective as there are multiple factors impacting this (e.g., articular surface contact characteristics, implant material properties). Our initial findings are that the first two principal components should be afforded consideration for the geometrical accuracy of talus implant design. Additional factors would need to be further evaluated for their role in informing universal talus implant design.
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Affiliation(s)
- Tao Liu
- Department of Mechanical Engineering, University of Alberta, Edmonton, AB, Canada.,Department of Mechanical Engineering, Khalifa University, Abu Dhabi, United Arab Emirates
| | - Nadr M Jomha
- Department of Surgery, University of Alberta, Edmonton, AB, Canada
| | - Samer Adeeb
- Department of Civil and Environmental Engineering, University of Alberta, Edmonton, AB, Canada
| | - Marwan El-Rich
- Department of Mechanical Engineering, Khalifa University, Abu Dhabi, United Arab Emirates
| | - Lindsey Westover
- Department of Mechanical Engineering, University of Alberta, Edmonton, AB, Canada
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14
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Prediction and diagnosis of vertebral tumors on the Internet of Medical Things Platform using geometric rough propagation neural network. Neural Comput Appl 2020. [DOI: 10.1007/s00521-020-04935-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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15
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Grant TM, Diamond LE, Pizzolato C, Killen BA, Devaprakash D, Kelly L, Maharaj JN, Saxby DJ. Development and validation of statistical shape models of the primary functional bone segments of the foot. PeerJ 2020; 8:e8397. [PMID: 32117607 PMCID: PMC7006516 DOI: 10.7717/peerj.8397] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Accepted: 12/16/2019] [Indexed: 12/15/2022] Open
Abstract
Introduction Musculoskeletal models are important tools for studying movement patterns, tissue loading, and neuromechanics. Personalising bone anatomy within models improves analysis accuracy. Few studies have focused on personalising foot bone anatomy, potentially incorrectly estimating the foot’s contribution to locomotion. Statistical shape models have been created for a subset of foot-ankle bones, but have not been validated. This study aimed to develop and validate statistical shape models of the functional segments in the foot: first metatarsal, midfoot (second-to-fifth metatarsals, cuneiforms, cuboid, and navicular), calcaneus, and talus; then, to assess reconstruction accuracy of these shape models using sparse anatomical data. Methods Magnetic resonance images of 24 individuals feet (age = 28 ± 6 years, 52% female, height = 1.73 ± 0.8 m, mass = 66.6 ± 13.8 kg) were manually segmented to generate three-dimensional point clouds. Point clouds were registered and analysed using principal component analysis. For each bone segment, a statistical shape model and principal components were created, describing population shape variation. Statistical shape models were validated by assessing reconstruction accuracy in a leave-one-out cross validation. Statistical shape models were created by excluding a participant’s bone segment and used to reconstruct that same excluded bone using full segmentations and sparse anatomical data (i.e. three discrete points on each segment), for all combinations in the dataset. Tali were not reconstructed using sparse anatomical data due to a lack of externally accessible landmarks. Reconstruction accuracy was assessed using Jaccard index, root mean square error (mm), and Hausdorff distance (mm). Results Reconstructions generated using full segmentations had mean Jaccard indices between 0.77 ± 0.04 and 0.89 ± 0.02, mean root mean square errors between 0.88 ± 0.19 and 1.17 ± 0.18 mm, and mean Hausdorff distances between 2.99 ± 0.98 mm and 6.63 ± 3.68 mm. Reconstructions generated using sparse anatomical data had mean Jaccard indices between 0.67 ± 0.06 and 0.83 ± 0.05, mean root mean square error between 1.21 ± 0.54 mm and 1.66 ± 0.41 mm, and mean Hausdorff distances between 3.21 ± 0.94 mm and 7.19 ± 3.54 mm. Jaccard index was higher (P < 0.01) and root mean square error was lower (P < 0.01) in reconstructions from full segmentations compared to sparse anatomical data. Hausdorff distance was lower (P < 0.01) for midfoot and calcaneus reconstructions using full segmentations compared to sparse anatomical data. Conclusion For the first time, statistical shape models of the primary functional segments of the foot were developed and validated. Foot segments can be reconstructed with minimal error using full segmentations and sparse anatomical landmarks. In future, larger training datasets could increase statistical shape model robustness, extending use to paediatric or pathological populations.
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Affiliation(s)
- Tamara M Grant
- School of Allied Health Sciences, Griffith University, Gold Coast, QLD, Australia.,Griffith Centre for Biomedical and Rehabilitation Engineering, Menzies Health Institute Queensland, Griffith University, Gold Coast, QLD, Australia
| | - Laura E Diamond
- School of Allied Health Sciences, Griffith University, Gold Coast, QLD, Australia.,Griffith Centre for Biomedical and Rehabilitation Engineering, Menzies Health Institute Queensland, Griffith University, Gold Coast, QLD, Australia
| | - Claudio Pizzolato
- School of Allied Health Sciences, Griffith University, Gold Coast, QLD, Australia.,Griffith Centre for Biomedical and Rehabilitation Engineering, Menzies Health Institute Queensland, Griffith University, Gold Coast, QLD, Australia
| | - Bryce A Killen
- Human Movement Biomechanics Research Group, Katholieke Universiteit Leuven, Leuven, Belgium
| | - Daniel Devaprakash
- School of Allied Health Sciences, Griffith University, Gold Coast, QLD, Australia.,Griffith Centre for Biomedical and Rehabilitation Engineering, Menzies Health Institute Queensland, Griffith University, Gold Coast, QLD, Australia
| | - Luke Kelly
- School of Human Movement and Nutritional Sciences, University of Queensland, Brisbane, QLD, Australia
| | - Jayishni N Maharaj
- School of Human Movement and Nutritional Sciences, University of Queensland, Brisbane, QLD, Australia
| | - David J Saxby
- School of Allied Health Sciences, Griffith University, Gold Coast, QLD, Australia.,Griffith Centre for Biomedical and Rehabilitation Engineering, Menzies Health Institute Queensland, Griffith University, Gold Coast, QLD, Australia
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16
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Gabrielli AS, Gale T, Hogan M, Anderst W. Bilateral Symmetry, Sex Differences, and Primary Shape Factors in Ankle and Hindfoot Bone Morphology. FOOT & ANKLE ORTHOPAEDICS 2020; 5:2473011420908796. [PMID: 35097367 PMCID: PMC8697112 DOI: 10.1177/2473011420908796] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Background: Ankle injuries and joint degeneration may be related to ankle bone morphology. Little data exist to characterize healthy hindfoot bone morphology. The purpose of this study was to characterize side-to-side symmetry and sex differences in ankle and hindfoot bone morphology, and to identify the primary shape factors that differentiate ankle and hindfoot bone morphology among individuals. Methods: Computed tomography was used to create 3D surface models of the distal tibia, talus, and calcaneus for 40 ankle and hindfoot bones from 20 healthy individuals. Morphologic differences between left and right bones of the same individual and between males and females were determined. Statistical shape modeling was performed to identify primary shape variations among individuals. Results: Side-to-side differences in bone morphology averaged 0.79 mm or less. The average distal tibia in males was larger overall than in females. No significant sex difference was noted in the tali. The average female calcaneus was longer and thinner than the average male calcaneus. Variability in ankle and hindfoot bone morphology is primarily associated with articulating surface shape, overall length and width, and tendon/ligament attachment points. Conclusion: In general, the contralateral ankle can serve as an accurate guide for operative restoration of native ankle morphology; however, specific regions demonstrate higher asymmetry. Clinical Relevance: Knowledge of regions of high and low bilateral symmetry can improve hindfoot and ankle reconstruction. Design of ankle prostheses can be improved by accounting for differences in bone morphology associated with sex and shape differences among individuals.
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Affiliation(s)
- Alexandra S. Gabrielli
- Department of Orthopaedic Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Tom Gale
- Biodynamics Lab, University of Pittsburgh, Pittsburgh, PA, USA
| | - MaCalus Hogan
- Department of Orthopaedic Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
- The Foot and Ankle Injury Group, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - William Anderst
- Biodynamics Lab, University of Pittsburgh, Pittsburgh, PA, USA
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Schmutz B, Rathnayaka K, Albrecht T. Anatomical fitting of a plate shape directly derived from a 3D statistical bone model of the tibia. J Clin Orthop Trauma 2019; 10:S236-S241. [PMID: 31700213 PMCID: PMC6823809 DOI: 10.1016/j.jcot.2019.04.019] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2019] [Revised: 04/23/2019] [Accepted: 04/24/2019] [Indexed: 11/26/2022] Open
Abstract
INTRODUCTION Intra- and inter-population variations of bone morphology have made the process of designing an anatomically well-fitting fracture fixation plate challenging. Although statistical bone models have recently been used for analysing morphological variabilities, it is not known to what extent they would also provide the basis for the design of a new plate shape. This would be particularly valuable in the case where no existing plate shape is available to start the process of fit optimisation. Therefore, this study investigated the anatomical fitting of a plate shape (statistical plate) derived from the mean shape of a statistical 3D tibia bone model in comparison to results available from two other plate shapes. METHODS Forty-five 3D bone models of tibiae from Japanese cadaver specimens, as well as 3D models of the plate undersurface of both a commercial and shape optimised Medial Distal Tibia Plate, were utilised from earlier studies. The mean shape of the 3D statistical bone model was generated from the tibia models utilising the Statismo framework. With reverse engineering software, the plate undersurface of the statistical plate shape was derived directly from the mean surface of the statistical 3D bone model. Through an iterative process, the statistical plate model was placed at the correct surgical position on each bone model for fit assessment. RESULTS The statistical plate was fitting for 20% of the tibiae compared to 13% for the commercial and 67% for the optimised plate, respectively. CONCLUSIONS The plate shape derived directly from a statistical bone model was fitting better than the commercial plate, but considerably inferior to that of an optimised plate. However, the results do clearly indicate that this approach provides an appropriate and solid basis for commencing shape optimisation of the statistical plate. Studies of other anatomical regions are required to confirm whether these findings can be generalised.
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Affiliation(s)
- Beat Schmutz
- Institute of Health and Biomedical Innovation Queensland University of Technology 60 Musk Avenue, Kelvin Grove QLD, 4059, Australia,Corresponding author.
| | - Kanchana Rathnayaka
- Accident and Orthopaedic Service The National Hospital of Sri Lanka Colombo 10, Sri Lanka
| | - Thomas Albrecht
- Department of Mathematics and Computer Science University of Basel Spiegelstrasse 1, 4051, Basel, Switzerland
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Van Osch K, Allen D, Gare B, Hudson TJ, Ladak H, Agrawal SK. Morphological analysis of sigmoid sinus anatomy: clinical applications to neurotological surgery. J Otolaryngol Head Neck Surg 2019; 48:2. [PMID: 30635049 PMCID: PMC6329078 DOI: 10.1186/s40463-019-0324-0] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2018] [Accepted: 01/02/2019] [Indexed: 01/18/2023] Open
Abstract
OBJECTIVES The primary objective of this study was to use high-resolution micro-CT images to create accurate three-dimensional (3D) models of several intratemporal structures, and to compare several surgically important dimensions within the temporal bone. The secondary objective was to create a statistical shape model (SSM) of a dominant and non-dominant sigmoid sinus (SS) to provide a template for automated segmentation algorithms. METHODS A free image processing software, 3D Slicer, was utilized to create three-dimensional reconstructions of the SS, jugular bulb (JB), facial nerve (FN), and external auditory canal (EAC) from micro-CT scans. The models were used to compare several clinically important dimensions between the dominant and non-dominant SS. Anatomic variability of the SS was also analyzed using SSMs generated using the Statismo software framework. RESULTS Three-dimensional models from 38 temporal bones were generated and analyzed. Right dominance was observed in 74% of the paired SSs. All distances were significantly shorter on the dominant side (p < 0.05), including: EAC - SS (dominant: 13.7 ± 3.4 mm; non-dominant: 15.3 ± 2.7 mm), FN - SS (dominant: 7.2 ± 1.8 mm; non-dominant: 8.1 ± 2.3 mm), 2nd genu FN - superior tip of JB (dominant: 8.7 ± 2.2 mm; non-dominant: 11.2 ± 2.6 mm), horizontal distance between the superior tip of JB - descending FN (dominant: 9.5 ± 2.3 mm; non-dominant: 13.2 ± 3.5 mm), and horizontal distance between the FN at the stylomastoid foramen - JB (dominant: 5.4 ± 2.2 mm; non-dominant: 7.7 ± 2.1). Analysis of the SSMs indicated that SS morphology is most variable at its junction with the transverse sinus, and least variable at the JB. CONCLUSIONS This is the first known study to investigate the anatomical variation and relationships of the SS using high resolution scans, 3D models and statistical shape analysis. This analysis seeks to guide neurotological surgical approaches and provide a template for automated segmentation and surgical simulation.
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Affiliation(s)
- Kylen Van Osch
- Schulich School of Medicine & Dentistry, Western University, London, Ontario, N6A 5C1, Canada
| | - Daniel Allen
- Department of Electrical and Computer Engineering, Western University, London, Ontario, N6A 5C1, Canada
| | - Bradley Gare
- Department of Electrical and Computer Engineering, Western University, London, Ontario, N6A 5C1, Canada
| | - Thomas J Hudson
- Schulich School of Medicine & Dentistry, Western University, London, Ontario, N6A 5C1, Canada
| | - Hanif Ladak
- Department of Medical Biophysics, Western University, London, Ontario, N6A 5C1, Canada
| | - Sumit K Agrawal
- Department of Otolaryngology - Head and Neck Surgery, Western University, London, Ontario, N6A 5C1, Canada.
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