Department of Orthopedics Surgery, Shaanxi Provincial People's Hospital, Xi'an Jiaotong University, Xi'an, China.
The College of Life Sciences and Medicine, Northwest University, xi'an, China.
Orthop Surg. 2022 Jul;14(7):1378-1384. doi: 10.1111/os.13287. Epub 2022 Jun 3.
To establish a digital model of the ankle joint through 3D imaging technology and explore the preoperative placement of ankle replacement prostheses.
Computed tomography images of intact ankle joints from 54 cases in the outpatient and inpatient departments of our hospital were collected; according to the INBONE® total ankle system surgery process, the surgery model and surgical osteotomy were finished using MIMICS based on computer simulation method. The shortest distance was measured between the center point and the anterior, posterior, medial, and lateral, respectively, to ensure the precise position of the ankle replacement prosthesis by digital simulation surgery. The relationship between the two variables was analyzed by bivariate correlation analysis.
The dataset of this study included 48 cases of the sub-data set (26 males and 22 females) and included 27 cases of left ankle and 21 cases of right ankle. The average medial malleolar angle was 18.67°± 2.87°, the average amount of bone resection was 12.13 ± 1.86 cm , the mid-anterior distance was 1.72 ± 0.19 cm, the mid-posterior distance was 2.00 ± 0.19 cm, the ratio of mid-anterior to mid-posterior was 0.87, the mid-medial distance was 1.26 ± 0.17 cm, the mid-lateral distance was 1.19 ± 0.16 cm, and the ratio of mid-medial to mid-lateral was 1.06. After osteotomy, the anteroposterior diameter was 3.73 ± 0.32 cm, the transverse diameter was 2.46 ± 0.27 cm, and the ratio of anteroposterior diameter to transverse diameter was 1.53. In the bottom view, the shape after osteotomy is rectangular. The mid-anterior distance was strongly negatively correlated with age, the mid-anterior distance and the amount of bone resection, the mid-medial distance and the amount of bone resection, the mid-lateral distance and the amount of bone resection, the mid-lateral distance and the anteroposterior diameter, the anteroposterior diameter and the transverse diameter were all strongly positively correlated.
The projection point of the lower tibia centerline on the tibial horizontal osteotomy surface is located at a position slightly anterior to the midpoint of the transverse diameter after ankle arthroplasty. The rational positioning of the total ankle replacement is located at both a position slightly anterior to the midpoint of the transverse diameter and midpoint of the anteroposterior diameter, which can be used as a reference method before total ankle arthroplasty surgery.
通过 3D 成像技术建立踝关节数字模型，并探讨踝关节置换假体的术前放置。
收集我院门诊和住院部 54 例完整踝关节的计算机断层扫描图像；根据 INBONE®全踝关节系统手术流程，采用计算机模拟方法，基于 Mimics 完成手术模型和手术截骨。通过数字模拟手术测量中心点与前、后、内、外侧的最短距离，以保证踝关节置换假体的精确位置。采用双变量相关分析分析两变量之间的关系。
本研究数据集包括 48 例亚数据集（26 例男性和 22 例女性），包括 27 例左侧踝关节和 21 例右侧踝关节。内踝平均角度为 18.67°±2.87°，平均骨切除量为 12.13±1.86cm，前中距为 1.72±0.19cm，后中距为 2.00±0.19cm，前中距与后中距的比值为 0.87，中内距为 1.26±0.17cm，中外距为 1.19±0.16cm，中内距与中外距的比值为 1.06。截骨后，前后径为 3.73±0.32cm，横径为 2.46±0.27cm，前后径与横径的比值为 1.53。在底视图中，截骨后的形状为矩形。前中距与年龄、前中距与骨切除量、中内距与骨切除量、中外距与骨切除量、中外距与前后径、前后径与横径均呈强负相关。
踝关节置换术后胫骨中轴线在胫骨水平截骨面的投影点位于截骨后横径中点稍前的位置。全踝关节置换的合理定位位于横径中点稍前和前后径中点，可作为全踝关节置换术前的参考方法。
