Arbabi Saeed, Seevinck Peter, Weinans Harrie, de Jong Pim A, Sturkenboom Joran, van Hamersvelt Robbert W, Foppen Wouter, Arbabi Vahid
Image Sciences Institute, University Medical Center Utrecht, Utrecht, The Netherlands.
Department of Orthopedics, University Medical Center Utrecht, Utrecht, The Netherlands.
J Orthop Res. 2023 Jan;41(1):183-195. doi: 10.1002/jor.25328. Epub 2022 Mar 28.
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.
踝关节撞击症的诊断主要通过临床检查进行，而医学影像则用于严重程度分期和治疗指导。撞击症状与医学影像中可见的区域三维（3D）骨形态变化之间的关联尚未得到系统研究，我们也不清楚这种关系的类型和程度。在这项横断面病例对照研究中，我们假设3D距骨形态可用于定量描述有撞击的踝关节与无撞击的踝关节之间的鉴别性形态变化，并且我们旨在对这些变化进行表征和量化。我们使用统计形状建模（SSM）方法来确定区分受撞击和未受撞击踝关节的最常见形状变化模式。对统计形状模型进行的紧致性和平行分析测试结果确定了8种突出的形状变化模式（MoV），约占形状总体3D变化的78%，其中两种模式捕捉到了受撞击和未受撞击踝关节之间的鉴别特征（p值分别为0.023和0.042）。目视检查证实，这两种形状模式捕捉到了距骨前后部的异常，代表了踝关节前后撞击的两个主要骨危险因素。总之，在这项使用SSM的研究中，我们确定了与踝关节骨撞击显著相关的形状MoV。我们还展示了SSM对手术规划的潜在指导作用。
