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The hind- and midfoot alignment computed after a medializing calcaneal osteotomy using a 3D weightbearing CT.
Int J Comput Assist Radiol Surg. 2019 Aug; 14(8):1439-1447.IJ

Abstract

PURPOSE

A medializing calcaneal osteotomy (MCO) is a surgical procedure frequently performed to correct an adult acquired flatfoot (AAFD) deformity. However, most studies are limited to a 2D analysis of 3D deformity. Therefore, the aim is to perform a 3D assessment of the hind- and midfoot alignment using a weightbearing CT (WBCT) preoperatively as well as postoperatively.

METHODS

Eighteen patients with a mean age of 49.4 years (range 18-67) were prospectively included in a pre-post-study design. A MCO was performed and a WBCT was obtained pre- and postoperative. Images were converted into 3D models to compute linear and angular measurements, respectively, in millimeters (mm) and degrees (°), based on previously reported landmarks of the hind- and midfoot alignment. A regression analysis was performed between the displacement of a MCO and the obtained postoperative correction.

RESULTS

The mean 3D hindfoot angle improved significantly preoperative compared to postoperative (p < 0.001). This appeared according to a linear relation with the amount of medial translation in a MCO (R2 = 0.84, p < 0.001). The axes of the tibia showed significant coronal as well as axial changes (p < 0.05). Analysis of the midfoot showed significant changes in the navicular height and rotation as well as the Méary angle (p < 0.05). Additionally, a linear trend between the midfoot measurements and amount of medial translation in a MCO was observed, but not significant (p > 0.05).

CONCLUSION

This study demonstrates an effective 3D correction of an AAFD by a MCO according to a linear relationship. The concomitant formula can be used to perform a preoperative planning. The novelty is the comparative 3D weightbearing CT assessment of both the computed hind- and midfoot alignment after a medializing calcaneus osteotomy. This could improve accuracy of the currently performed preoperative planning in clinical practice.

Authors+Show Affiliations

Department of Orthopaedics and Traumatology, University Hospital of Utah, University of Utah, 590 Wakara Way, Salt Lake City, UT, 84108, USA. arne.burssens@hsc.utah.edu. Department of Orthopaedics, Ghent University Hospital, Corneel Heymanslaan 10, 9000, Ghent, OVL, Belgium. arne.burssens@hsc.utah.edu.Department of Orthopaedics, AZ Monica Hospital, Florent Pauwelslei 21, 2100, Deurne, Antwerpen, Belgium.Department of Orthopaedics, Ghent University Hospital, Corneel Heymanslaan 10, 9000, Ghent, OVL, Belgium.Department of Orthopaedics, Ghent University Hospital, Corneel Heymanslaan 10, 9000, Ghent, OVL, Belgium.Department of Orthopaedics, AZ Monica Hospital, Florent Pauwelslei 21, 2100, Deurne, Antwerpen, Belgium.Department of Orthopaedics, Ghent University Hospital, Corneel Heymanslaan 10, 9000, Ghent, OVL, Belgium.Department of Orthopaedics, Ghent University Hospital, Corneel Heymanslaan 10, 9000, Ghent, OVL, Belgium.No affiliation info availableDepartment of Orthopaedics, Ghent University Hospital, Corneel Heymanslaan 10, 9000, Ghent, OVL, Belgium.Department of Orthopaedics, Ghent University Hospital, Corneel Heymanslaan 10, 9000, Ghent, OVL, Belgium.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

30915668

Citation

Burssens, Arne, et al. "The Hind- and Midfoot Alignment Computed After a Medializing Calcaneal Osteotomy Using a 3D Weightbearing CT." International Journal of Computer Assisted Radiology and Surgery, vol. 14, no. 8, 2019, pp. 1439-1447.
Burssens A, Barg A, van Ovost E, et al. The hind- and midfoot alignment computed after a medializing calcaneal osteotomy using a 3D weightbearing CT. Int J Comput Assist Radiol Surg. 2019;14(8):1439-1447.
Burssens, A., Barg, A., van Ovost, E., Van Oevelen, A., Leenders, T., Peiffer, M., Bodere, I., Audenaert, E., & Victor, J. (2019). The hind- and midfoot alignment computed after a medializing calcaneal osteotomy using a 3D weightbearing CT. International Journal of Computer Assisted Radiology and Surgery, 14(8), 1439-1447. https://doi.org/10.1007/s11548-019-01949-7
Burssens A, et al. The Hind- and Midfoot Alignment Computed After a Medializing Calcaneal Osteotomy Using a 3D Weightbearing CT. Int J Comput Assist Radiol Surg. 2019;14(8):1439-1447. PubMed PMID: 30915668.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The hind- and midfoot alignment computed after a medializing calcaneal osteotomy using a 3D weightbearing CT. AU - Burssens,Arne, AU - Barg,Alexej, AU - van Ovost,Esther, AU - Van Oevelen,Aline, AU - Leenders,Tim, AU - Peiffer,Matthias, AU - Bodere,Irina, AU - ,, AU - Audenaert,Emmanuel, AU - Victor,Jan, Y1 - 2019/03/26/ PY - 2018/11/27/received PY - 2019/03/13/accepted PY - 2019/3/28/pubmed PY - 2019/11/28/medline PY - 2019/3/28/entrez KW - Adult acquired flatfoot deformity KW - Computed pre- and postoperative assessment KW - Medializing calcaneal osteotomy KW - Weightbearing CT SP - 1439 EP - 1447 JF - International journal of computer assisted radiology and surgery JO - Int J Comput Assist Radiol Surg VL - 14 IS - 8 N2 - PURPOSE: A medializing calcaneal osteotomy (MCO) is a surgical procedure frequently performed to correct an adult acquired flatfoot (AAFD) deformity. However, most studies are limited to a 2D analysis of 3D deformity. Therefore, the aim is to perform a 3D assessment of the hind- and midfoot alignment using a weightbearing CT (WBCT) preoperatively as well as postoperatively. METHODS: Eighteen patients with a mean age of 49.4 years (range 18-67) were prospectively included in a pre-post-study design. A MCO was performed and a WBCT was obtained pre- and postoperative. Images were converted into 3D models to compute linear and angular measurements, respectively, in millimeters (mm) and degrees (°), based on previously reported landmarks of the hind- and midfoot alignment. A regression analysis was performed between the displacement of a MCO and the obtained postoperative correction. RESULTS: The mean 3D hindfoot angle improved significantly preoperative compared to postoperative (p < 0.001). This appeared according to a linear relation with the amount of medial translation in a MCO (R2 = 0.84, p < 0.001). The axes of the tibia showed significant coronal as well as axial changes (p < 0.05). Analysis of the midfoot showed significant changes in the navicular height and rotation as well as the Méary angle (p < 0.05). Additionally, a linear trend between the midfoot measurements and amount of medial translation in a MCO was observed, but not significant (p > 0.05). CONCLUSION: This study demonstrates an effective 3D correction of an AAFD by a MCO according to a linear relationship. The concomitant formula can be used to perform a preoperative planning. The novelty is the comparative 3D weightbearing CT assessment of both the computed hind- and midfoot alignment after a medializing calcaneus osteotomy. This could improve accuracy of the currently performed preoperative planning in clinical practice. SN - 1861-6429 UR - https://www.unboundmedicine.com/medline/citation/30915668/The_hind__and_midfoot_alignment_computed_after_a_medializing_calcaneal_osteotomy_using_a_3D_weightbearing_CT_ L2 - https://dx.doi.org/10.1007/s11548-019-01949-7 DB - PRIME DP - Unbound Medicine ER -