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  • 1
    Online Resource
    Online Resource
    Hallux valgus measurements using weight-bearing computed tomography: what changes?
    Associacao Brasileira de Medicina e Cirurgia do Tornozelo e Pe (ABTPe) ; 2021
    In:  Journal of the Foot & Ankle Vol. 15, No. 3 ( 2021-12-20), p. 259-264
    Details
    In: Journal of the Foot & Ankle, Associacao Brasileira de Medicina e Cirurgia do Tornozelo e Pe (ABTPe), Vol. 15, No. 3 ( 2021-12-20), p. 259-264
    Abstract: Objective: To assess whether traditional hallux valgus (HV) measurements obtained with conventional radiography (CR) correspond to those obtained with weight-bearing computed tomography (WBCT). Methods: In this retrospective case-control study, 26 HV feet and 20 control feet were analyzed with CR and WBCT. Hallux valgus angle (HVA), intermetatarsal angle (IMA), interphalangeal angle (IPA), distal metatarsal articular angle (DMAA), sesamoid station (SS), and first metatarsal head shape were measured. Chi-square tests were used to compare hallux valgus and control patients. T-tests were used to compare CR and WBCT. P-values less than 0.05 were considered significant. Results: WBCT was capable of discriminating patients with HV from controls, showing higher mean values for HV patients than controls in HVA (35.29 and 9.02, p 〈 0.001), IMA (16.01 and 10.01, p 〈 0.001), and DMAA (18.90 and 4.10, p 〈 0.001). When comparing the two methods, differences were not significant between CR and WBCT measurements in HVA (-0.84, p = 0.79), IMA (-0.93, p = 0.39), IPA (1.53, p = 0.09), or SS (p = 0.40), but were significant for DMAA (13.43, p 〈 .0001). CR analysis yielded varied metatarsal head shapes, while all WBCT shape classifications were round.  Conclusion: Unidimensional HV measurements were similar between WBCT and CR, while more three-dimensional findings were not. CR may be used to assess the axial aspects of HV, but multidimensional aspects of the deformity may not be accurately assessed with plain radiographs. Level of Evidence III; Therapeutic Studies; Retrospective Case-Control Study.
    Type of Medium: Online Resource
    ISSN: 2675-2980
    URL: Article
    DOI: 10.30795/jfootankle.2021.v15.1600
    Language: Unknown
    Publisher: Associacao Brasileira de Medicina e Cirurgia do Tornozelo e Pe (ABTPe)
    Publication Date: 2021
    detail.hit.zdb_id: 3040308-X
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  • 2
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    Three-dimensional assessment of hallux valgus correction using the Lapicotton technique
    Associacao Brasileira de Medicina e Cirurgia do Tornozelo e Pe (ABTPe) ; 2022
    In:  Journal of the Foot & Ankle Vol. 16, No. 3 ( 2022-12-20), p. 237-241
    Details
    In: Journal of the Foot & Ankle, Associacao Brasileira de Medicina e Cirurgia do Tornozelo e Pe (ABTPe), Vol. 16, No. 3 ( 2022-12-20), p. 237-241
    Abstract: Objective: The objective of the study was to assess the efficacy of the LapiCotton procedure on patients with hallux valgus (HV) combined with medial longitudinal arch collapse. Methods: Preoperative and postoperative weight-bearing computed tomography (WBCT) scans were obtained from patients with HV submitted to the LapiCotton procedure. Semi-automatic measurements were applied to 22 WBCT images across 11 patients enrolled in the study using a software package (Bonelogic, Disior™, Helsinki, Finland). Significance level was set at 0.05. Results: The hallux valgus angle (HVA) was significantly larger (p=0.026) in the preoperative group (Mdn = 27.52) than in the postoperative group (Mdn = 20). In addition, the Meary sagittal measurement was found to be significantly increased (p=0.033) in the preoperative group (Mdn = -14.28) when compared to the postoperative group (Mdn = -11.15). It was also observed that the intermetatarsal angle was significantly larger (p=0.003) in the preoperative group (Mdn = 15.68) compared to the postoperative group (Mdn = 11.26). Conclusion: The LapiCotton procedure effectively corrected radiographic parameters in patients with HV combined with the medial longitudinal arch collapse. Level of Evidence III; Therapeutic Studies; Comparative Retrospective Study.
    Type of Medium: Online Resource
    ISSN: 2675-2980
    URL: Article
    DOI: 10.30795/jfootankle.2022.v16.1674
    Language: Unknown
    Publisher: Associacao Brasileira de Medicina e Cirurgia do Tornozelo e Pe (ABTPe)
    Publication Date: 2022
    detail.hit.zdb_id: 3040308-X
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  • 3
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    Weight-bearing CT Hounsfield unit algorithm assessment of calcaneal osteotomy healing. A prospective study comparing metallic and bio-integrative screws
    Associacao Brasileira de Medicina e Cirurgia do Tornozelo e Pe (ABTPe) ; 2022
    In:  Journal of the Foot & Ankle Vol. 16, No. 1 ( 2022-04-30), p. 52-58
    Details
    In: Journal of the Foot & Ankle, Associacao Brasileira de Medicina e Cirurgia do Tornozelo e Pe (ABTPe), Vol. 16, No. 1 ( 2022-04-30), p. 52-58
    Abstract: Objective: To investigate the capability of biointegrative screws to achieve similar radiographical healing outcomes to metallic screws, measured using Hounsfield Unit (HU) algorithms, in medial displacement calcaneus osteotomies (MDCO). Our main hypothesis is that both implant methods would demonstrate comparable results. Methods: In this prospective comparative study, patients undergoing MDCO were allocated to either a biointegrative or a metallic group. Surgeon, primary diagnosis, technique, and displacement were the same for both groups. Patients were assessed using weight-bearing computed tomography preoperatively and at weeks 2, 6, and 12 postoperatively. A 40x40x40 mm cube was centered on the osteotomy site, defining a volume of interest (VOI). Image intensity (Hounsfield Units) profiles along lines perpendicular to the osteotomy line and crossing it were recorded. Graphical plots of the HU distributions were generated for each line and then used to calculate the HU contrast. Results: Three patients were allocated to the metallic group (age: 50.66; BMI: 27.78) and three to the biointegrative group (age: 47.33; BMI: 39.35). At two weeks, mean HU intensity was lower in the metallic group on the center (403.25 vs. 416.28; p=0.312) and superior lines (438.97 vs. 497.92), but not on the inferior line (513.24 vs. 386.57; p 〈 0.001). At six weeks, the mean HU intensity was higher in the biointegrative group on the center line (p 〈 0.001) and the superior line (p=0.018). At 12 weeks, the metallic group presented lower HU values on the center (p 〈 0.001) and inferior (p 〈 0.001) lines, but higher values on the superior line (p=0.010). Contrast was higher in the metallic group patients in the second (p=0.034) and 12th weeks (p=0.049). Conclusion: Bone healing radiographical status results were similar for metallic and bio-integrative screws. Maximum HU values were equivalent, indicating comparable results at the osteotomy sites. However, the biointegrative group had lower contrast, portraying lower variability of bone density over the area. Level of Evidence II; Prospective Comparative Study.
    Type of Medium: Online Resource
    ISSN: 2675-2980
    URL: Article
    DOI: 10.30795/jfootankle.2022.v16.1630
    Language: Unknown
    Publisher: Associacao Brasileira de Medicina e Cirurgia do Tornozelo e Pe (ABTPe)
    Publication Date: 2022
    detail.hit.zdb_id: 3040308-X
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  • 4
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    Online Resource
    Achilles tendon reconstruction using a biosynthetic graft: a case report
    Associacao Brasileira de Medicina e Cirurgia do Tornozelo e Pe (ABTPe) ; 2022
    In:  Journal of the Foot & Ankle Vol. 16, No. 3 ( 2022-12-20), p. 288-294
    Details
    In: Journal of the Foot & Ankle, Associacao Brasileira de Medicina e Cirurgia do Tornozelo e Pe (ABTPe), Vol. 16, No. 3 ( 2022-12-20), p. 288-294
    Abstract: A 56-year-old male was admitted to an outpatient clinic five months after feeling a snap in his right heel while walking in the yard. Clinical and imaging evaluation demonstrated a discontinuity of Achilles tendon (AT). The measured gap between the insertion and the proximal stump was 13cm. The patient underwent reconstruction using a bio-absorbable synthetic graft associated with a Flexor Hallucis Longus (FHL) transfer. Good functional outcomes were noted. Achilles tendon reconstruction with the biosynthetic flexible band proved feasible for massive tendon defects by inserting a biological scaffold for native tendon healing, improving postoperative recovery and strength. Level of Evidence V; Therapeutic Studies; Expert Opinion.
    Type of Medium: Online Resource
    ISSN: 2675-2980
    URL: Article
    DOI: 10.30795/jfootankle.2022.v16.1655
    Language: Unknown
    Publisher: Associacao Brasileira de Medicina e Cirurgia do Tornozelo e Pe (ABTPe)
    Publication Date: 2022
    detail.hit.zdb_id: 3040308-X
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  • 5
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    Foot and ankle offset in the setting of severe rotational foot and ankle deformities
    Associacao Brasileira de Medicina e Cirurgia do Tornozelo e Pe (ABTPe) ; 2022
    In:  Journal of the Foot & Ankle Vol. 16, No. 3 ( 2022-12-20), p. 215-221
    Details
    In: Journal of the Foot & Ankle, Associacao Brasileira de Medicina e Cirurgia do Tornozelo e Pe (ABTPe), Vol. 16, No. 3 ( 2022-12-20), p. 215-221
    Abstract: Objective: The goal of this paper was to evaluate the validity of foot and ankle offset (FAO) measurements in the setting of severe foot and ankle deformities. Methods: This study included 57 feet (36 patients) that had a history of severe cavovarus deformity. Each participant received a weight-bearing computed tomography (WBCT) scan that was then used to measure FAO. This measurement was performed once using the traditional measurement technique and two additional times using a modified technique that allows for rotational correction of the images to align the talus. Results: Traditional FAO (TFAO) and modified FAO (MFAO) were found to have a significant correlation with one another (r (54)=0.92, p 〈 0.001). There was a high positive correlation between the variables of the two techniques (r=0.92) with the intraobserver reliabilities (ICC=0.95) for FAO measurements. The agreement between TFAO and Modified foot and ankle offset (MFAO) measurements was also considered excellent (ICC=0.99). Conclusion: The MFAO method provides statistically similar FAO measurements compared to the TFAO method in this population. Thus, the TFAO method could potentially expand its patient population to provide surgeons with a reliable tool for assessing more severe deformities. Level of Evidence IV; Retrospective Study.
    Type of Medium: Online Resource
    ISSN: 2675-2980
    URL: Article
    DOI: 10.30795/jfootankle.2022.v16.1677
    Language: Unknown
    Publisher: Associacao Brasileira de Medicina e Cirurgia do Tornozelo e Pe (ABTPe)
    Publication Date: 2022
    detail.hit.zdb_id: 3040308-X
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  • 6
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    Ankle syndesmotic instability assessment using a three-dimensional distance mapping algorithm: a cadaveric pilot WBCT study
    Associacao Brasileira de Medicina e Cirurgia do Tornozelo e Pe (ABTPe) ; 2022
    In:  Journal of the Foot & Ankle Vol. 16, No. 3 ( 2022-12-20), p. 190-194
    Details
    In: Journal of the Foot & Ankle, Associacao Brasileira de Medicina e Cirurgia do Tornozelo e Pe (ABTPe), Vol. 16, No. 3 ( 2022-12-20), p. 190-194
    Abstract: Objective: This cadaveric pilot study was to develop a weight bearing computed tomography (WBCT) three-dimensional (3D) distance mapping algorithm that would allow for detection of syndesmotic instability. Methods: Pilot study, two cadaveric specimens. Syndesmotic instability was induced by release of all syndesmotic ligaments through a conventional lateral ankle approach. WBCT imaging under simulated weight bearing was acquired before and after syndesmotic destabilization. Syndesmotic incisura and ankle gutter distances were assessed using a 3D distance mapping WBCT algorithm. Results: We found increases in the overall mean syndesmotic distances in the injured syndesmosis when compared to pre-injury state, and color coded distance maps allowed easy interpretation of the syndesmotic widening following ligament sectioning and destabilization of the syndesmotic joint. Conclusion: The WBCT 3D distance mapping algorithm has the potential to allow detection of mild syndesmotic instability with a relatively ease of interpretation by using color-coded distance maps. Level of Evidence V; Cadaveric Study.
    Type of Medium: Online Resource
    ISSN: 2675-2980
    URL: Article
    DOI: 10.30795/jfootankle.2022.v16.1673
    Language: Unknown
    Publisher: Associacao Brasileira de Medicina e Cirurgia do Tornozelo e Pe (ABTPe)
    Publication Date: 2022
    detail.hit.zdb_id: 3040308-X
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  • 7
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    Agreement between semiautomatic and manual measurement of selected parameters on weight-bearing computed tomography images in total ankle replacement: a retrospective study
    Associacao Brasileira de Medicina e Cirurgia do Tornozelo e Pe (ABTPe) ; 2022
    In:  Journal of the Foot & Ankle Vol. 16, No. 1 ( 2022-04-30), p. 72-78
    Details
    In: Journal of the Foot & Ankle, Associacao Brasileira de Medicina e Cirurgia do Tornozelo e Pe (ABTPe), Vol. 16, No. 1 ( 2022-04-30), p. 72-78
    Abstract: Objective: To assess the agreement between semiautomatic 3D measurements and manual measurements derived from WBCT images in patients with end-stage ankle osteoarthritis (AO) who underwent total ankle replacement (TAR). Methods: In this retrospective, IRB-approved study (ID #201904825), we evaluated patients who underwent TAR via the lateral trans-fibular approach for end-stage ankle OA. The study included 14 ankles from 14 patients. Raw multiplanar data were analyzed using CubeVue® software. Lateral talar station (LTS) was obtained in the sagittal plane, while hindfoot moment arm (HMA) and talar tilt angle (TTA) were calculated in the coronal view. Semiautomatic 3D measurements were performed using Disior® software. Intra-rater reliabilities were analyzed using the intraclass correlation coefficient (ICC). Agreement between methods was tested with Bland-Altman plots. Each measurement was assessed using the Wilcoxon signed-rank test. Alpha risk was set to 5% (α=0.05). P-values of ≤0.05 were considered significant. Results: ICC-measured reliabilities ranged from moderate to almost perfect for manual and semiautomatic WBCT measurements in the preoperative and postoperative groups for HMA and LTS. There was high correlation between parameters calculated from manual and semiautomatic measurements, and strong agreement between the readers and software in both groups. Conclusions: Manual (M) and semiautomatic (SA) 3D measurements expressed excellent agreement for pre- and postoperative groups, indicating a high correlation between the parameters calculated and strong agreement between the readers and the software in both groups. Level of Evidence III; Therapeutic Studies; Comparative Retrospective Study.
    Type of Medium: Online Resource
    ISSN: 2675-2980
    URL: Article
    DOI: 10.30795/jfootankle.2022.v16.1631
    Language: Unknown
    Publisher: Associacao Brasileira de Medicina e Cirurgia do Tornozelo e Pe (ABTPe)
    Publication Date: 2022
    detail.hit.zdb_id: 3040308-X
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  • 8
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    Online Resource
    Reliability of coronal plane rotation measurements in the medial column of the foot: a cadaveric study
    Associacao Brasileira de Medicina e Cirurgia do Tornozelo e Pe (ABTPe) ; 2021
    In:  Journal of the Foot & Ankle Vol. 15, No. 3 ( 2021-12-20), p. 252-258
    Details
    In: Journal of the Foot & Ankle, Associacao Brasileira de Medicina e Cirurgia do Tornozelo e Pe (ABTPe), Vol. 15, No. 3 ( 2021-12-20), p. 252-258
    Abstract: Objective: To assess interobserver reliability of previously described coronal plane rotation measurements of medial column bones and to assess their ability to accurately quantify changes in rotational profile. Methods: Two cadaveric below-knee specimens were implanted with pins in each bone of the medial column. Weight-bearing computed tomography (CT) scans were acquired in a simulated standing position under neutral, supinated, and pronated conditions. For each specimen and condition, 2 observers measured the coronal plane rotation of the navicular, medial cuneiform, first metatarsal base, shaft, and head, and proximal phalanx of the hallux as previously described. The rotation of each pin was measured relative to the ground in the coronal plane for each condition. These measurements were defined as benchmarks for the rotational profile of each bone. The correlation between these benchmarks and direct bone measurements was then assessed. Intraclass correlation coeficiente was used to assess interobserver reliability. Pearson’s coefficient was used to evaluate correlations. Results: The interobserver reliability of direct bone measurements ranged from 0.98 to 0.99. Correlations between pin rotation and direct measurements ranged from ρ=0.87 to 0.99 across the neutral, supinated, and pronated conditions. Conclusion: Coronal plane rotation measurements of medial column bones described in this study are reliable tools. Level of Evidence III; Case-Control Study.
    Type of Medium: Online Resource
    ISSN: 2675-2980
    URL: Article
    DOI: 10.30795/jfootankle.2021.v15.1598
    Language: Unknown
    Publisher: Associacao Brasileira de Medicina e Cirurgia do Tornozelo e Pe (ABTPe)
    Publication Date: 2021
    detail.hit.zdb_id: 3040308-X
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  • 9
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    Coverage maps demonstrate 3D Chopart joint subluxation in weightbearing CT of progressive collapsing foot deformity
    Springer Science and Business Media LLC ; 2022
    In:  Scientific Reports Vol. 12, No. 1 ( 2022-11-12)
    Details
    In: Scientific Reports, Springer Science and Business Media LLC, Vol. 12, No. 1 ( 2022-11-12)
    Abstract: A key element of the peritalar subluxation (PTS) seen in progressive collapsing foot deformity (PCFD) occurs through the transverse tarsal joint complex. However, the normal and pathological relations of these joints are not well understood. The objective of this study to compare Chopart articular coverages between PCFD patients and controls using weight-bearing computed tomography (WBCT). In this retrospective case control study, 20 patients with PCFD and 20 matched controls were evaluated. Distance and coverage mapping techniques were used to evaluate the talonavicular and calcaneocuboid interfaces. Principal axes were used to divide the talar head into 6 regions (medial/central/lateral and plantar/dorsal) and the calcaneocuboid interface into 4 regions. Repeated selections were performed to evaluate reliability of joint interface identification. Surface selections had high reliability with an ICC  〉  0.99. Talar head coverage decreases in plantarmedial and dorsalmedial (− 79%, p  = 0.003 and − 77%, p  = 0.00004) regions were seen with corresponding increases in plantarlateral and dorsolateral regions (30%, p  = 0.0003 and 21%, p  = 0.002) in PCFD. Calcaneocuboid coverage decreased in plantar and medial regions (− 12%, p  = 0.006 and − 9%, p  = 0.037) and increased in the lateral region (13%, p  = 0.002). Significant subluxation occurs across the medial regions of the talar head and the plantar medial regions of the calcaneocuboid joint. Coverage and distance mapping provide a baseline for understanding Chopart joint changes in PCFD under full weightbearing conditions.
    Type of Medium: Online Resource
    ISSN: 2045-2322
    URL: Article
    DOI: 10.1038/s41598-022-23638-3
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2022
    detail.hit.zdb_id: 2615211-3
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  • 10
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    Distance mapping and volumetric assessment of the ankle and syndesmotic joints in progressive collapsing foot deformity
    Springer Science and Business Media LLC ; 2023
    In:  Scientific Reports Vol. 13, No. 1 ( 2023-03-23)
    Details
    In: Scientific Reports, Springer Science and Business Media LLC, Vol. 13, No. 1 ( 2023-03-23)
    Abstract: The early effects of progressive collapsing foot deformity (PCFD) on the ankle and syndesmotic joints have not been three-dimensionally quantified. This case-control study focused on using weight bearing CT (WBCT) distance (DM) and coverage maps (CM) and volumetric measurements as 3D radiological markers to objectively characterize early effects of PCFD on the ankle and syndesmotic joints. Seventeen consecutive patients with symptomatic stage I flexible PCFD and 20 matched controls that underwent foot/ankle WBCT were included. Three-dimensional DM and CM of the ankle and syndesmotic joints, as well volumetric assessment of the distal tibiofibular syndesmosis was performed as possible WBCT markers of early PCFD. Measurements were compared between PCFD and controls. Significant overall reductions in syndesmotic incisura distances were observed in PCFD patients when compared to controls, with no difference in the overall syndesmotic incisura volume at 1, 3, 5 and 10 cm proximally to the ankle joint. CMs showed significantly decreased articular coverage of the anterior regions of the tibiotalar joint as well as medial/lateral ankle joint gutters in PCFD patients. This study showed syndesmotic narrowing and decreased articular coverage of the anterior aspect of the ankle gutters and talar dome in stage I PCFD patients when compared to controls. These findings are consistent with early plantarflexion of the talus within the ankle Mortise, and absence of true syndesmotic overload in early PCFD, and support DM and CM as early 3D PCFD radiological markers.
    Type of Medium: Online Resource
    ISSN: 2045-2322
    URL: Article
    DOI: 10.1038/s41598-023-31810-6
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2023
    detail.hit.zdb_id: 2615211-3
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