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Recommendation of minimal distal tibial length for long axis coordinate system definitions. J Biomech 2024 Jun;170:112153

Date

05/26/2024

Pubmed ID

38795543

Pubmed Central ID

PMC11220913

DOI

10.1016/j.jbiomech.2024.112153

Scopus ID

2-s2.0-85193974737 (requires institutional sign-in at Scopus site)

Abstract

Accurate anatomical coordinate systems for the foot and ankle are critical for interpreting their complex biomechanics. The tibial superior-inferior axis is crucial for analyzing joint kinematics, influencing bone motion analysis during gait using CT imaging and biplane fluoroscopy. However, the lack of consensus on how to define the tibial axis has led to variability in research, hindering generalizability. Even as advanced imaging techniques evolve, including biplane fluoroscopy and weightbearing CT, there exist limitations to imaging the entire foot together with the full length of the tibia. These limitations highlight the need to refine axis definitions. This study investigated various superior-inferior axes using multiple distal tibia lengths to determine the minimal field of view for representing the full tibia long-axis. Twenty human cadaver tibias were imaged and segmented to generate 3D bone models. Axes were calculated based on coordinate definitions that required user manual input, and a gold standard mean superior-inferior axis was calculated based on the population's principal component analysis axis. Four manually calculated superior-inferior tibial axes groups were established based on landmarks and geometric fittings. Statistical analysis revealed that geometrically fitting a cylinder 1.5 times the mediolateral tibial width, starting 5 cm above the tibial plafond, yielded the smallest angular deviation from the gold standard. From these findings, we recommend a minimum field of view that includes 1.5 times the mediolateral tibial width, starting 5 cm above the tibial plafond for tibial long-axis definitions. Implementing these findings will help improve foot and ankle research generalizability and impact clinical decisions.

Author List

Muhlrad EP, Peterson AC, Anderson AM, Aragon KC, Lisonbee RJ, MacWilliams BA, Kruger KM, Lenz AL

Author

Karen Kruger PhD Research Assistant Professor in the MU-MCW Department of Biomedical Engineering department at Marquette University




MESH terms used to index this publication - Major topics in bold

Aged
Aged, 80 and over
Ankle Joint
Biomechanical Phenomena
Cadaver
Female
Foot
Gait
Humans
Imaging, Three-Dimensional
Male
Middle Aged
Tibia
Tomography, X-Ray Computed
Weight-Bearing