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Can anterior midfoot tarsectomy procedure be improved using patient-specific cutting guide? An experimental study
Julie Mathieu1, Guillaume Lamouroux2, Mathilde Gatti3
1Department of Orthopedic Surgery, Lapeyronie University Hospital of Montpellier, 371 av. Gaston Giraud, 34295 Montpellier Cedex 05, France; Laboratoire de Mécanique et Génie Civil (LMGC), Montpellier University of Excellence, 860 Rue de St-Priest, 34090 Montpellier, France.
Patient-specific cutting guides (PSCG) offer accurate and safe anterior tarsectomy for cavovarus foot correction. This technique minimizes iatrogenic errors and is effective regardless of surgeon experience, improving patient outcomes.
Area of Science:
- Orthopedic surgery
- Biomechanical engineering
- Medical device technology
Background:
- Anterior tarsectomy for cavovarus foot presents surgical challenges.
- Computer-assisted planning and patient-specific cutting guides (PSCG) aim to enhance precision.
- This cadaveric study evaluates the accuracy and safety of PSCG-assisted anterior tarsectomy.
Purpose of the Study:
- To assess the accuracy of PSCG in anterior tarsectomy.
- To evaluate the safety profile of PSCG-assisted procedures.
- To determine if operator experience impacts the accuracy of PSCG use.
Main Methods:
- Ten cadaveric foot specimens underwent anterior tarsectomy using PSCG with a 15° dorsal closed-wedge.
- 3D foot models from CT scans were used for virtual planning and osteotomy.
- Accuracy was measured by comparing planned and postoperative 3D reconstructions using surface-distance mapping and angular correction analysis.
- Specimens were dissected to identify iatrogenic neurovascular lesions.
Main Results:
- Mean sagittal error was 1.1° ± 1.0°, with 2.5° ± 1.7° accuracy in Meary's angle correction.
- 92% of surface distance mapping results were below 2 mm.
- No significant differences in accuracy were observed between operators of varying skill levels.
- No iatrogenic neurovascular lesions were detected post-dissection.
Conclusions:
- PSCG-assisted anterior tarsectomy demonstrates high accuracy and neurovascular safety.
- PSCG use can reduce the risks of flatfoot or undercorrection in cavovarus foot treatment.
- Operator experience does not appear to influence the angular accuracy of PSCG-assisted anterior tarsectomy.
- Future research should focus on guides for pronation-supination monitoring.
