Browsing by Author "Lintz, François"
Now showing 1 - 5 of 5
- Results Per Page
- Sort Options
Item Open Access Distance mapping and volumetric assessment of the ankle and syndesmotic joints in progressive collapsing foot deformity.(Scientific reports, 2023-03) Dibbern, Kevin; Vivtcharenko, Victoria; Salomao Barbachan Mansur, Nacime; Lalevée, Matthieu; Alencar Mendes de Carvalho, Kepler; Lintz, François; Barg, Alexej; Goldberg, Andrew J; de Cesar Netto, CesarThe early effects of progressive collapsing foot deformity (PCFD) on the ankle and syndesmotic joints have not been three-dimensionally quantified. This case-control study focused on using weight bearing CT (WBCT) distance (DM) and coverage maps (CM) and volumetric measurements as 3D radiological markers to objectively characterize early effects of PCFD on the ankle and syndesmotic joints. Seventeen consecutive patients with symptomatic stage I flexible PCFD and 20 matched controls that underwent foot/ankle WBCT were included. Three-dimensional DM and CM of the ankle and syndesmotic joints, as well volumetric assessment of the distal tibiofibular syndesmosis was performed as possible WBCT markers of early PCFD. Measurements were compared between PCFD and controls. Significant overall reductions in syndesmotic incisura distances were observed in PCFD patients when compared to controls, with no difference in the overall syndesmotic incisura volume at 1, 3, 5 and 10 cm proximally to the ankle joint. CMs showed significantly decreased articular coverage of the anterior regions of the tibiotalar joint as well as medial/lateral ankle joint gutters in PCFD patients. This study showed syndesmotic narrowing and decreased articular coverage of the anterior aspect of the ankle gutters and talar dome in stage I PCFD patients when compared to controls. These findings are consistent with early plantarflexion of the talus within the ankle Mortise, and absence of true syndesmotic overload in early PCFD, and support DM and CM as early 3D PCFD radiological markers.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 CT scans in the foot and ankle.(EFORT open reviews, 2018-05) Lintz, François; de Cesar Netto, Cesar; Barg, Alexeij; Burssens, Arne; Richter, Martinus; Weight Bearing CT International Study GroupThe 3D anatomical complexity of the foot and ankle and the importance of weight-bearing in diagnosis have required the combination of conventional radiographs and medical CT.Conventional plain radiographs (XR) have demonstrated substantial limitations such as perspective, rotational and fan distortion, as well as poor reproducibility of radiographic installations. Conventional CT produces high levels of radiation exposure and does not offer weight-bearing capabilities.The literature investigating biometrics based on 2D XR has inherent limitations due to the technology itself and thereby can focus only on whether measurements are reproducible, when the real question is whether the radiographs are.Low dose weight-bearing cone beam CT (WBCT) combines 3D and weight-bearing as well as 'built in' reliability validated through industry-standardized processes during production and clinical use (quality assurance testing).Research is accumulating to validate measurements based on traditional 2D techniques, and new 3D biometrics are being described and tested.Time- and cost-efficient use in medical imaging will require the use of automatic measurements. Merging WBCT and clinical data will offer new perspectives in terms of research with the help of modern data analysis techniques. Cite this article: EFORT Open Rev 2018;3 DOI: 10.1302/2058-5241.3.170066.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.