Accuracy of Weightbearing CT Scans for Patient-Specific Instrumentation in Total Ankle Arthroplasty
Background: Total ankle arthroplasty (TAA) is a popular and viable option for end-stage ankle arthritis. Posttraumatic arthritis is the most common etiology of ankle arthritis, which creates the additional challenge of osseus deformity. Accuracy and reproducibility in placing the implant on the mech...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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SAGE Publishing
2021-12-01
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| Series: | Foot & Ankle Orthopaedics |
| Online Access: | https://doi.org/10.1177/24730114211061493 |
| _version_ | 1797772679013466112 |
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| author | Mitchell J. Thompson DPM Devon Consul DPM Benjamin D. Umbel DO Gregory C. Berlet MD |
| author_facet | Mitchell J. Thompson DPM Devon Consul DPM Benjamin D. Umbel DO Gregory C. Berlet MD |
| author_sort | Mitchell J. Thompson DPM |
| collection | DOAJ |
| description | Background: Total ankle arthroplasty (TAA) is a popular and viable option for end-stage ankle arthritis. Posttraumatic arthritis is the most common etiology of ankle arthritis, which creates the additional challenge of osseus deformity. Accuracy and reproducibility in placing the implant on the mechanical axis has been shown to be paramount in all joint arthroplasty including total ankle replacement. Patient-specific preoperative navigation is a relatively new technology for TAA, and up until this past year has been based off of nonweightbearing (NWBCT) or simulated weightbearing computed tomography (WBCT). Our institution has created a protocol to use WBCT in the preoperative patient-specific navigation for TAA using the Prophecy system. The purpose of our study was to compare the accuracy and reproducibility of implant alignment and size using WBCT vs prior studies using NWBCT for the Prophecy reports. Methods: All patients from July 2019 through October 2020 who underwent TAA were evaluated. Inclusion criteria consisted of primary TAA using patient-specific preoperative navigation who had postoperative radiographs in the 4-6-week time frame. Prophecy predictions and measurements were then compared to actual implant placement and size. Results: Ten patients met our inclusion criteria of WBCT Prophecy preoperative planning using 2 different implant systems. Preoperative deformities in this cohort were small. The average postoperative coronal alignment was 0.84 degrees, range 0.19 to 2.4 degrees. Average postoperative sagittal plane deformity was 1.9 degrees, range 0.33 to 5.05 degrees. Tibial component size was properly predicted in all patients, talar component in 9 of 10. Conclusion: This initial report supports accuracy and reproducibility in preoperative patient-specific navigation when using WBCT for TAA with these implants. All TAAs were within the intended target of less than 5 degrees varus or valgus. Level of Evidence: Level III, retrospective comparative analysis. |
| first_indexed | 2024-03-12T21:55:26Z |
| format | Article |
| id | doaj.art-c191f524f821453b84ca9a070dec87aa |
| institution | Directory Open Access Journal |
| issn | 2473-0114 |
| language | English |
| last_indexed | 2024-03-12T21:55:26Z |
| publishDate | 2021-12-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Foot & Ankle Orthopaedics |
| spelling | doaj.art-c191f524f821453b84ca9a070dec87aa2023-07-25T18:06:27ZengSAGE PublishingFoot & Ankle Orthopaedics2473-01142021-12-01610.1177/24730114211061493Accuracy of Weightbearing CT Scans for Patient-Specific Instrumentation in Total Ankle ArthroplastyMitchell J. Thompson DPM0Devon Consul DPM1Benjamin D. Umbel DO2Gregory C. Berlet MD3Orthopedic Foot and Ankle Center, Worthington, OH, USAOrthopedic Foot and Ankle Center, Worthington, OH, USADepartment of Orthopedic Surgery, OhioHealth, Columbus, OH, USAOrthopedic Foot and Ankle Center, Worthington, OH, USABackground: Total ankle arthroplasty (TAA) is a popular and viable option for end-stage ankle arthritis. Posttraumatic arthritis is the most common etiology of ankle arthritis, which creates the additional challenge of osseus deformity. Accuracy and reproducibility in placing the implant on the mechanical axis has been shown to be paramount in all joint arthroplasty including total ankle replacement. Patient-specific preoperative navigation is a relatively new technology for TAA, and up until this past year has been based off of nonweightbearing (NWBCT) or simulated weightbearing computed tomography (WBCT). Our institution has created a protocol to use WBCT in the preoperative patient-specific navigation for TAA using the Prophecy system. The purpose of our study was to compare the accuracy and reproducibility of implant alignment and size using WBCT vs prior studies using NWBCT for the Prophecy reports. Methods: All patients from July 2019 through October 2020 who underwent TAA were evaluated. Inclusion criteria consisted of primary TAA using patient-specific preoperative navigation who had postoperative radiographs in the 4-6-week time frame. Prophecy predictions and measurements were then compared to actual implant placement and size. Results: Ten patients met our inclusion criteria of WBCT Prophecy preoperative planning using 2 different implant systems. Preoperative deformities in this cohort were small. The average postoperative coronal alignment was 0.84 degrees, range 0.19 to 2.4 degrees. Average postoperative sagittal plane deformity was 1.9 degrees, range 0.33 to 5.05 degrees. Tibial component size was properly predicted in all patients, talar component in 9 of 10. Conclusion: This initial report supports accuracy and reproducibility in preoperative patient-specific navigation when using WBCT for TAA with these implants. All TAAs were within the intended target of less than 5 degrees varus or valgus. Level of Evidence: Level III, retrospective comparative analysis.https://doi.org/10.1177/24730114211061493 |
| spellingShingle | Mitchell J. Thompson DPM Devon Consul DPM Benjamin D. Umbel DO Gregory C. Berlet MD Accuracy of Weightbearing CT Scans for Patient-Specific Instrumentation in Total Ankle Arthroplasty Foot & Ankle Orthopaedics |
| title | Accuracy of Weightbearing CT Scans for Patient-Specific Instrumentation in Total Ankle Arthroplasty |
| title_full | Accuracy of Weightbearing CT Scans for Patient-Specific Instrumentation in Total Ankle Arthroplasty |
| title_fullStr | Accuracy of Weightbearing CT Scans for Patient-Specific Instrumentation in Total Ankle Arthroplasty |
| title_full_unstemmed | Accuracy of Weightbearing CT Scans for Patient-Specific Instrumentation in Total Ankle Arthroplasty |
| title_short | Accuracy of Weightbearing CT Scans for Patient-Specific Instrumentation in Total Ankle Arthroplasty |
| title_sort | accuracy of weightbearing ct scans for patient specific instrumentation in total ankle arthroplasty |
| url | https://doi.org/10.1177/24730114211061493 |
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