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Three-Dimensional Preoperative Virtual Planning in Derotational Proximal Femoral Osteotomy

Three-Dimensional Preoperative Virtual Planning in Derotational Proximal Femoral Osteotomy

Published on: February 17, 2023

Radiographic sizing for meniscal transplantation using 3-D CT reconstruction.

Mark McConkey¹, Craig Lyon, D Lee Bennett

¹Department of Orthopaedics and Rehabilitation, University of Iowa, 2701 Prairie Meadow Drive, Iowa City, IA 52242, USA. mark_mcconkey@hotmail.com

The Journal of Knee Surgery

|October 13, 2012

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Three-dimensional computed tomography (3-D CT) scans provide more accurate tibial plateau measurements than plain radiographs (XR) for meniscus transplantation. This improved accuracy in sizing may reduce allograft mismatch and subsequent knee degeneration.

Area of Science:

Orthopedic surgery
Biomedical imaging
Knee biomechanics

Background:

Allograft size mismatch in meniscus transplantation leads to elevated contact pressures and premature knee degeneration.
Accurate preoperative assessment of tibial plateau dimensions is crucial for successful meniscus allograft sizing.

Purpose of the Study:

To compare the accuracy and reliability of three-dimensional computed tomography (3-D CT) versus plain radiographs (XR) for sizing the tibial plateau in the context of meniscus transplantation.

Main Methods:

16 cadaveric knees underwent anteroposterior (AP) and lateral XR, 3-D CT reconstructions, and direct anatomic measurements of sagittal and coronal hemiplateau dimensions.
Measurements from imaging modalities were compared against disarticulated specimen measurements.

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Main Results:

3-D CT measurements were significantly closer to anatomic values than XR measurements across all dimensions (p < 0.0001).
CT achieved 100% accuracy within 5 mm and 71.9% within 2 mm, compared to 76.5% and 34.4% for XR, respectively.
CT demonstrated significantly higher accuracy within 2 mm for the lateral meniscus on AP and lateral views (p = 0.0011, p = 0.0039).

Conclusions:

3-D CT offers superior accuracy and reliability in measuring tibial plateau dimensions compared to plain XR.
Utilizing 3-D CT for preoperative planning can potentially minimize allograft size mismatch in meniscus transplantation, thereby reducing the risk of knee degeneration.