Poster 273: Three-Dimensional Imaging Compared to Conventional Radiographs for Corrective Osteotomy Planning: An Advanced Imaging Analysis
Notice bibliographique
Résumé
Objectives: Preoperative tibial and femoral osteotomy planning using three-dimensional (3D) patient-specific instrumentation (PSIs) has been gaining popularity in deformity correction surgery. However, the variability between advanced imaging modalities and conventional two-dimensional (2D) radiographs for measuring limb alignment and corrective osteotomy angle remains unknown. Though CT is generally considered the gold standard for osseous imaging, radiographs remain the most common means for assessing preoperative coronal and sagittal alignment. Emerging data suggest there may be inaccuracies with this technique. In particular, multiple studies have found that sagittal slope measurements can vary greatly depending on modality used. The present study aims to characterize alignment measurements within a cohort of patients undergoing corrective osteotomy and to assess differences in preoperative planned alignment and correction angles between an advanced 3D imaging modality (Bodycad, Quebec, CA) and conventional 2D radiographs. Methods: Preoperative computed tomography (CT) scans of consecutive patients undergoing high tibial osteotomies (HTOs) and/or distal femoral osteotomies (DFOs) between January 1 st , 2016, and December 1 st , 2022 with preoperative x-ray and CT scans were retrospectively reviewed using advanced 3D PSI software. Equivalent 2D radiographs were independently analyzed using conventional imaging software. Manual 2D radiograph measurements, including hip-to-ankle weightbearing axis and posterior tibial slope were compared to 3D PSI measurements and variances were analyzed calculating Root Mean Square Error (RMSE). Results: A total of 97 patients (47 female, 50 males) with a mean age of 37 years (range, 15.8 to 60 years) were included in the final analysis. Fifty percent of the cohort had a lateral posterior tibial slope (LPTS) that was greater than medial posterior tibial slope (MPTS). Mean absolute posterior slope difference (aPTSD) did not vary significantly according to osteotomy type. For manual measurements, interclass correlation coefficients among raters was excellent (0.97, 95% CI 0.944, 0.988) in the coronal plane, while interclass correlation coefficient for the sagittal plane was poor. Mean hip-to-ankle corrective angle using conventional 2D radiographs was 6.02° (range, 0.45° to 19.62°), versus 7.31° on Bodycad (range, 3.25° to 10.63°) (p=0.022). Conclusions: Preoperative corrective osteotomy angles between advanced imaging software and conventional radiographs measurements are significantly different, with 3D CT predicting a significantly higher overall correction angle for all parameters. Despite excellent interrater reliability for coronal plane measurements using radiographs, reliability for slope measurements was poor. Surgeons should be mindful when using conventional 2D radiographs for osteotomy planning, which may underestimate correction angles and inaccurately assess preoperative sagittal alignment.
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Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,002 | 0,007 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,001 |
| Bibliométrie | 0,002 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,001 | 0,000 |
| Science ouverte | 0,000 | 0,001 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,008 | 0,001 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».