Hodel S, Calek A K, Cavalcanti N, Fucentese S F, Vlachopoulos L, Viehöfer A, Wirth S H
Department of Orthopedics, Balgrist University Hospital, University of Zürich, Forchstrasse 340, CH-8008, Zürich, Switzerland.
J Exp Orthop. 2023 Feb 3;10(1):10. doi: 10.1186/s40634-023-00579-y.
The use of total ankle arthroplasty (TAA) is increasing over time, as so will the need for revision TAAs in the future. Restoration of the ankle joint line (JL) in revision TAA is often difficult due to severe bone loss. This study analyzed the accuracy of a three-dimensional (3D) registration of the contralateral tibia and fibula to restore the ankle joint line (JL) and reported side-to-side differences of anatomical landmarks.
3D triangular surface models of 96 paired lower legs underwent a surface registration algorithm for superimposition of the mirrored contralateral lower leg onto the original lower leg to approximate the original ankle JL using a proximal, middle and distal segment. Distances of the distal fibular tip, anterior and posterior medial colliculus to the JL were measured and absolute side-to-side differences reported. Anterior lateral distal tibial angle (ADTA) and lateral distal tibial angle (LDTA) were measured.
Mean JL approximation was most accurate for the distal segment (0.1 ± 1.4 mm (range: -3.4 to 2.8 mm)) and middle segment (0.1 ± 1.2 mm (range: -2.8 to 2.5 mm)) compared to the proximal segment (-0.2 ± 1.6 mm (range: -3.0 to 4.9 mm)) (p = 0.007). Distance of the distal fibular tip, the anterior, and posterior medial colliculus to the JL, ADTA and LDTA yielded no significant side-to-side differences (n.s.).
3D registration of the contralateral tibia and fibula reliably approximated the original ankle JL. The contralateral distal fibular tip, anterior and posterior medial colliculi, ADTA and LDTA can be used reliably for the planning of revision TAA with small side-to-side differences reported.
IV.
随着时间的推移，全踝关节置换术（TAA）的使用越来越多，未来翻修TAA的需求也会增加。由于严重的骨质流失，在翻修TAA中恢复踝关节线（JL）通常很困难。本研究分析了对侧胫骨和腓骨的三维（3D）配准以恢复踝关节线（JL）的准确性，并报告了解剖标志点的左右差异。
对96对小腿的3D三角形表面模型进行表面配准算法，将镜像对侧小腿叠加到原始小腿上，使用近端、中段和远端节段来近似原始踝关节JL。测量腓骨远端尖、前后内侧丘到JL的距离，并报告绝对左右差异。测量胫腓骨远端前外侧角（ADTA）和胫腓骨远端外侧角（LDTA）。
与近端节段（-0.2±1.6mm（范围：-3.0至4.9mm））相比，远端节段（0.1±1.4mm（范围：-3.4至2.8mm））和中段节段（0.1±1.2mm（范围：-2.8至2.5mm））的平均JL近似度最准确（p = 0.007）。腓骨远端尖、前后内侧丘到JL的距离、ADTA和LDTA在左右之间没有显著差异（无统计学意义）。
对侧胫骨和腓骨的3D配准可靠地近似了原始踝关节JL。对侧腓骨远端尖、前后内侧丘、ADTA和LDTA可可靠地用于翻修TAA的规划，左右差异较小。
IV级。
