Browsing by Author "Bernasconi, Alessio"
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Item Open Access Foot Alignment in Symptomatic National Basketball Association Players Using Weightbearing Cone Beam Computed Tomography.(Orthopaedic journal of sports medicine, 2019-02) de Cesar Netto, Cesar; Bernasconi, Alessio; Roberts, Lauren; Pontin, Pedro Augusto; Lintz, Francois; Saito, Guilherme Honda; Roney, Andrew; Elliott, Andrew; O'Malley, MartinBackground
Weightbearing cone beam computed tomography (WB CBCT) allows detailed 3-dimensional imaging of the foot and ankle in a weightbearing state and provides improved accuracy and reliability of foot alignment measures, especially when compared with conventional radiographic views.Purpose
To describe the foot alignment in National Basketball Association (NBA) players with different symptomatic foot and ankle injuries using WB CBCT and to determine if any predominant morphotype would be identified.Study design
Cross-sectional study; Level of evidence, 3.Methods
A total of 45 active NBA players (mean age, 24.4 years [range, 20-34 years]; N = 54 feet [29 right, 25 left]) were assessed using WB CBCT. Measurements included the following: (1) foot and ankle offset (FAO), (2) calcaneal offset (CO), (3) hindfoot alignment angle (HAA), (4) angle between the inferior and superior facets of the talus (Inftal-Suptal), (5) angle between the inferior facet of the talus and the horizontal floor line (Inftal-Hor), (6) forefoot arch angle (FAA), (7) navicular-to-floor distance, and (8) medial cuneiform-to-floor distance. Measurements were then compared with values available in the literature for a "normal" foot morphotype.Results
Among the 54 feet, the mean FAO was 0.48% (95% CI, -0.25% to 1.21%), the mean CO was 1.18 mm (95% CI, -0.50 to 2.87 mm), and the mean HAA was 1.42° (95% CI, -0.80° to 3.65°). The mean Inftal-Suptal angle was 5.31° (95% CI, 3.50°-7.12°), while the mean Inftal-Hor angle was 4.04° (95% CI, 2.56°-5.51°). The mean FAA was 15.84° (95% CI, 14.73°-16.92°), the mean navicular-to-floor distance was 38.30 mm (95% CI, 36.19-40.42 mm), and the mean medial cuneiform-to-floor distance was 26.79 mm (95% CI, 25.30-28.28 mm). None of these values were found to be significantly different when comparing forwards, guards, and centers.Conclusion
NBA players presenting with symptomatic foot and ankle injuries had a fairly "normal" foot morphology, with a tendency toward a varus hindfoot and a high-arched morphotype. No significant differences were found between players based on their position on the court. WB CBCT may help to shed light on anatomic risk factors for common injuries in professional players and may aid in the planning of specific prevention programs.Item Open Access FOOT ALIGNMENT IN SYMPTOMATIC NATIONAL FOOTBALL LEAGUE (NFL) ATHLETES: A WEIGHTBEARING CT ANALYSIS.(Acta ortopedica brasileira, 2021-05) Bernasconi, Alessio; Cesar, Cesar DE; Roberts, Lauren; Lintz, François; Godoy-Santos, Alexandre Leme; O'Malley, Martin JosephObjective
Our aim was to describe the foot alignment in National Football League (NFL) players with different symptomatic foot and ankle pathologies using weightbearing cone-beam computed tomography (WBCBCT), comparing them to normally aligned feet as control group.Methods
41 feet (36 active NFL players) were assessed using WBCBCT and compared to 20 normally aligned controls from a normal population. Measurements included: Foot and Ankle Offset (FAO); Calcaneal Offset (CO); Hindfoot Alignment Angle (HAA); angle between inferior and superior facets of the talus (Inftal-Suptal); angle between inferior facet of the talus and the horizontal/floor (Inftal-Hor); Forefoot Arch Angle (FAA); navicular- and medial cuneiform-to-floor distance.Results
NFL athletes showed a neutrally aligned hindfoot when compared to controls (FAO: 1% vs 0.5%; CO: 2.3 mm vs 0.8 mm; HAA: 2.9° vs 0.8° in two groups, with all p > 0.05) and a normal morphology of the subtalar joint (no difference in Inftal-Suptal and Inftal-Hor angles). Conversely, in athletes we found a decreased medial longitudinal arch (FAA: 15° vs 18.3°, p = 0.03) with smaller navicular (38.2 mm vs 42.2 mm, p = 0.03) and medial cuneiform (27 mm vs 31.3 mm, p = 0.01) mean distances to the floor when compared to controls.Conclusion
In our series, NFL players presented a lower medial longitudinal arch than controls but a neutrally aligned hindfoot. WBCBCT may help shed light on anatomical risk factors for injuries in professional players. Level of Evidence III, Retrospective comparative study.Item Open Access Joystick of the Talus for Correcting Malalignment During Arthroscopic Ankle Arthrodesis: A Surgical Tip.(Arthroscopy techniques, 2018-05) Bernasconi, Alessio; Mehdi, Nazim; Laborde, Julien; de Cesar Netto, Cesar; Dagneaux, Louis; Lintz, FrançoisAnkle arthrodesis has been widely reported as an effective solution in treating tibiotalar joint osteoarthritis. The arthroscopic tibiotalar approach for arthrodesis has also been proven to give excellent results in terms of bone fusion rates and reduction of wound-related pain and complications. Historically, ankle malalignment has represented one of the main contraindications for the arthroscopic procedure, but interestingly some investigators have shown that the coronal joint deformity may be addressed arthroscopically as well. Other investigators have also demonstrated that part of the valgus/varus is due to malrotation of the talus within the mortise; therefore, controlling the talar position becomes crucial for correcting more severe deformities. We present here a technique for correcting tibiotalar malalignment during arthroscopic arthrodesis in varus or valgus ankles, performed through a K-wire used as a joystick to manage the talar position on both the coronal and axial planes.Item Open Access Weight-bearing cone-beam computed tomography in the foot and ankle specialty: where we are and where we are going - an update.(Radiologia brasileira, 2021-05) Godoy-Santos, Alexandre Leme; Bernasconi, Alessio; Bordalo-Rodrigues, Marcelo; Lintz, François; Lôbo, Carlos Felipe Teixeira; de Cesar Netto, CesarCone-beam computed tomography (CBCT) has been applied in dentistry and medicine for nearly two decades. Its application in the foot and ankle specialty has grown exponentially in recent years. Weight-bearing CBCT allows clinicians to obtain weight-bearing images that can be viewed in all three planes and to construct three-dimensional models, similar to those constructed from traditional CT scans, as well as exposing patients to less radiation than do traditional CT scans. This technology has revolutionized diagnoses, improving the understanding of various lesions and surgical planning in the foot and ankle specialty. Ongoing studies of the use of weight-bearing CBCT in foot and ankle surgery are focused on fully automated and semi-automated three-dimensional measurements, as well as bone segmentation, mapping of the distances/orientation of the joints, and the production of customized implants. The aims of this review article are to show the evolution of this emerging tool in the foot and ankle specialty, to update those in related specialties on its use in current clinical practice, and to indicate where the research community is heading.