Automated vs Manual Measurement of Middle Facet Subluxation in Progressive Collapsing Foot Deformity Using...

Area of Science:

• Orthopedics
• Radiology
• Biomechanical Engineering

Background:

• Peritalar subluxation (PTS) is a key factor in progressive collapsing foot deformity (PCFD) progression.
• Middle facet subluxation (MFS) quantifies PTS using weightbearing computed tomography (WBCT), but manual measurement is time-consuming and variable.
• Automated WBCT tools offer potential for streamlined and reproducible MFS measurements.

Purpose of the Study:

• To evaluate the agreement and interchangeability between manual MFS (mMFS) and automated MFS (aMFS) measurements.
• To assess the reliability of automated MFS in patients with PCFD.
• To compare automated MFS measurements between PCFD patients and healthy controls.

Main Methods:

• Retrospective study of 66 PCFD patients and 25 controls.
• Manual MFS measured by two surgeons; repeated for reliability.
• Automated MFS calculated using BoneLogic software.
• Agreement assessed via paired tests, correlations, ICCs, and Bland-Altman analysis.

Main Results:

• No significant difference between mMFS and aMFS in PCFD (36.4% vs 37.4%, P=.83).
• Automated MFS values were lower in controls (11.9% vs 18.6%, P<.01).
• Moderate-to-good agreement (ICC 0.76) and minimal bias (0.99%) between manual and automated MFS in PCFD.

Conclusions:

• Automated MFS demonstrates moderate-to-good agreement and interchangeability with manual methods in PCFD.
• Agreement was limited in control subjects.
• Automated MFS shows potential for clinical and research use in PCFD assessment, pending validation.