Multiplanar Semiautomatic Assessment of Foot and Ankle Offset in Adult Acquired Flatfoot Deformity.

AAFD FAO WBCT adult acquired flatfoot deformity flatfoot foot and ankle offset hindfoot alignment measurements weightbearing CT weightbearing computed tomography

Journal

Foot & ankle international
ISSN: 1944-7876
Titre abrégé: Foot Ankle Int
Pays: United States
ID NLM: 9433869

Informations de publication

Date de publication:
07 2020
Historique:
pubmed: 23 5 2020
medline: 11 8 2021
entrez: 23 5 2020
Statut: ppublish

Résumé

Semiautomatic 3-dimensional (3D) biometric weightbearing computed tomography (WBCT) tools have been shown to adequately demonstrate the relationship between the center of the ankle joint and the tripod of the foot. The measurement of the foot and ankle offset (FAO) represents an optimized biomechanical assessment of foot alignment. The objective of this study was to evaluate the correlation between FAO and traditional adult acquired flatfoot deformity (AAFD) markers, measured in different planes. We hypothesized that the FAO would significantly correlate with other radiographic markers of pronounced AAFD. In this retrospective comparative study, we included 113 patients with stage II AAFD, 43 men and 70 women, mean age of 53.5 (range, 20-86) years. 3D coordinates (x, y, and z planes) of the foot tripod (most plantar voxel of the first and fifth metatarsal heads, and calcaneal tuberosity) and the center of the ankle joint (most proximal and central voxel of the talar dome) were assessed by 2 blinded and independent fellowship-trained orthopedic foot and ankle surgeons. The FAO was automatically calculated using the 3D coordinates by dedicated software. Multiple WBCT parameters related to the severity of the deformity in the coronal, sagittal, and transverse planes were manually measured. We found overall good to excellent intra- (range, 0.75-0.99) and interobserver (range, 0.73-0.99) reliability for manual AAFD measurements. FAO semiautomatic measurements demonstrated excellent intra- (0.99) and interobserver (0.99) reliabilities. Hindfoot moment arm (HMA) ( We found that 3D WBCT semiautomatic measurements of FAO significantly correlated with some traditional markers of pronounced AAFD. Measurements of FAO were also found to be slightly more reliable than the manual measurements. The FAO offers a simple and more complete biomechanical and multiplanar assessment of the AAFD, representing in a single measurement the 3D components of the deformity. Level III, retrospective comparative study.

Sections du résumé

BACKGROUND
Semiautomatic 3-dimensional (3D) biometric weightbearing computed tomography (WBCT) tools have been shown to adequately demonstrate the relationship between the center of the ankle joint and the tripod of the foot. The measurement of the foot and ankle offset (FAO) represents an optimized biomechanical assessment of foot alignment. The objective of this study was to evaluate the correlation between FAO and traditional adult acquired flatfoot deformity (AAFD) markers, measured in different planes. We hypothesized that the FAO would significantly correlate with other radiographic markers of pronounced AAFD.
METHODS
In this retrospective comparative study, we included 113 patients with stage II AAFD, 43 men and 70 women, mean age of 53.5 (range, 20-86) years. 3D coordinates (x, y, and z planes) of the foot tripod (most plantar voxel of the first and fifth metatarsal heads, and calcaneal tuberosity) and the center of the ankle joint (most proximal and central voxel of the talar dome) were assessed by 2 blinded and independent fellowship-trained orthopedic foot and ankle surgeons. The FAO was automatically calculated using the 3D coordinates by dedicated software. Multiple WBCT parameters related to the severity of the deformity in the coronal, sagittal, and transverse planes were manually measured.
RESULTS
We found overall good to excellent intra- (range, 0.75-0.99) and interobserver (range, 0.73-0.99) reliability for manual AAFD measurements. FAO semiautomatic measurements demonstrated excellent intra- (0.99) and interobserver (0.99) reliabilities. Hindfoot moment arm (HMA) (
CONCLUSION
We found that 3D WBCT semiautomatic measurements of FAO significantly correlated with some traditional markers of pronounced AAFD. Measurements of FAO were also found to be slightly more reliable than the manual measurements. The FAO offers a simple and more complete biomechanical and multiplanar assessment of the AAFD, representing in a single measurement the 3D components of the deformity.
LEVEL OF EVIDENCE
Level III, retrospective comparative study.

Identifiants

pubmed: 32441540
doi: 10.1177/1071100720920274
doi:

Types de publication

Comparative Study Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

839-848

Auteurs

Cesar de Cesar Netto (C)

Department of Orthopaedics and Rehabilitation, University of Iowa, Iowa City, IA, USA.
Foot and Ankle Surgery, Hospital for Special Surgery, New York, NY, USA.

Katrina Bang (K)

Department of Orthopaedics and Rehabilitation, University of Iowa, Iowa City, IA, USA.

Nacime Salomao Mansur (NS)

Federal University of Sao Paulo (UNIFESP), São Paulo, Brazil.

Jonathan H Garfinkel (JH)

Foot and Ankle Surgery, Hospital for Special Surgery, New York, NY, USA.

Alessio Bernasconi (A)

Foot and Ankle Unit, Royal National Orthopaedic Hospital, Stanmore, UK.

Francois Lintz (F)

Foot and Ankle Surgery Center, Clinique de l'Union, Saint-Jean, France.

Jonathan T Deland (JT)

Foot and Ankle Surgery, Hospital for Special Surgery, New York, NY, USA.

Scott J Ellis (SJ)

Foot and Ankle Surgery, Hospital for Special Surgery, New York, NY, USA.

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