Novel approach to determine components size in a total ankle replacement

Area of Science:

• Orthopedic surgery
• Biomedical engineering
• Medical imaging analysis

Background:

• Total ankle replacement (TAR) aims for functional restoration but faces complications due to biomechanical and design misunderstandings.
• Accurate prosthesis sizing is crucial for successful TAR outcomes, yet current methods may be suboptimal.

Purpose of the Study:

• To develop and evaluate a novel digital templating software approach for determining total ankle replacement (TAR) prosthesis size.
• To compare the accuracy of prosthesis size prediction using X-ray versus CT images.

Main Methods:

• Utilized orthopedic digital templating software (Orthoview™) to compare X-ray and CT images from 55 ankle osteoarthritis patients.
• Predicted TAR component sizes (HINTEGRA prosthesis) using the software and compared them with specialist surgeon selections.
• Employed Cohen's Kappa coefficient for statistical analysis of agreement between predicted and selected component sizes.

Main Results:

• Digital templating software demonstrated higher agreement rates using CT images (over 77%) compared to X-ray images.
• The highest agreement was observed for the tibial component in the coronal plane (nearly 80%) and talar components (over 76%).
• CT-based predictions showed greater consistency with specialist surgeon selections than X-ray-based predictions.

Conclusions:

• Orthopedic digital templating software, particularly when utilizing CT images, offers enhanced visualization for predicting appropriate TAR component sizes.
• This CT-based approach may lead to more precise surgical planning for total ankle replacements compared to conventional X-ray methods.
• Improved prosthesis sizing accuracy can potentially reduce complications and improve functional outcomes in total ankle replacement surgery.