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The e-mémoires of the Académie Nationale de Chirurgie

Le cone beam orthopédique dans la planification chirurgicale sur mesure

Kris BUEDTS

Seance of wednesday 10 january 2024 (Le Cône-Beam Orthopédique en charge)

DOI number : 10.26299/nha6-4460/emem.2024.01.03

Abstract

Surgical correction of lower limb alignment deviations is a proven intervention. Before incorporating an innovative technique into our planning arsenal, we must validate it. We know that our body strives for a neutral position relative to the support surface in the lower limb. We have demonstrated this through a study using cone beam CT scans.
We have also studied the relationship in the coronal plane between the ankle and the knee joint and have been able to conclude that if there is valgus osteoarthritis present in the ankle, the knee joint tends to varus, and vice versa. This once again proves that our lower limb aims for a neutral position.

From here, we examined how to achieve a better pre-operative planning for deformity corrections, based on volumetric 3D images generated from the Cone Beam CT scan. For this purpose, we developed a volumetric plane system on the X, Y, and Z axes. Subsequently, we determined the various axes and angles.

The added value lies in the fact that these are loaded recordings, where the ground reaction force is present, which is lacking in conventional CT scans. This enables us to perform a more accurate calculation during pre-operative virtual planning.
Based on this, we then create PSI guides with a reduction guide to achieve an accurate, patient-specific axis correction, taking the weightbearing dimension in our calculation.
Surgical correction of lower limb alignment deviations is a proven intervention. Before incorporating an innovative technique into our planning arsenal, we must validate it. We know that our body strives for a neutral position relative to the support surface in the lower limb. We have demonstrated this through a study using cone beam CT scans.
We have also studied the relationship in the coronal plane between the ankle and the knee joint and have been able to conclude that if there is valgus osteoarthritis present in the ankle, the knee joint tends to varus, and vice versa. This once again proves that our lower limb aims for a neutral position.

From here, we examined how to achieve a better pre-operative planning for deformity corrections, based on volumetric 3D images generated from the Cone Beam CT scan. For this purpose, we developed a volumetric plane system on the X, Y, and Z axes. Subsequently, we determined the various axes and angles.

The added value lies in the fact that these are loaded recordings, where the ground reaction force is present, which is lacking in conventional CT scans. This enables us to perform a more accurate calculation during pre-operative virtual planning.
Based on this, we then create PSI guides with a reduction guide to achieve an accurate, patient-specific axis correction, taking the weightbearing dimension in our calculation.
Surgical correction of lower limb alignment deviations is a proven intervention. Before incorporating an innovative technique into our planning arsenal, we must validate it. We know that our body strives for a neutral position relative to the support surface in the lower limb. We have demonstrated this through a study using cone beam CT scans.
We have also studied the relationship in the coronal plane between the ankle and the knee joint and have been able to conclude that if there is valgus osteoarthritis present in the ankle, the knee joint tends to varus, and vice versa. This once again proves that our lower limb aims for a neutral position.

From here, we examined how to achieve a better pre-operative planning for deformity corrections, based on volumetric 3D images generated from the Cone Beam CT scan. For this purpose, we developed a volumetric plane system on the X, Y, and Z axes. Subsequently, we determined the various axes and angles.

The added value lies in the fact that these are loaded recordings, where the ground reaction force is present, which is lacking in conventional CT scans. This enables us to perform a more accurate calculation during pre-operative virtual planning.
Based on this, we then create PSI guides with a reduction guide to achieve an accurate, patient-specific axis correction, taking the weightbearing dimension in our calculation.
Surgical correction of lower limb alignment deviations is a proven intervention. Before incorporating an innovative technique into our planning arsenal, we must validate it. We know that our body strives for a neutral position relative to the support surface in the lower limb. We have demonstrated this through a study using cone beam CT scans.
We have also studied the relationship in the coronal plane between the ankle and the knee joint and have been able to conclude that if there is valgus osteoarthritis present in the ankle, the knee joint tends to varus, and vice versa. This once again proves that our lower limb aims for a neutral position.

From here, we examined how to achieve a better pre-operative planning for deformity corrections, based on volumetric 3D images generated from the Cone Beam CT scan. For this purpose, we developed a volumetric plane system on the X, Y, and Z axes. Subsequently, we determined the various axes and angles.

The added value lies in the fact that these are loaded recordings, where the ground reaction force is present, which is lacking in conventional CT scans. This enables us to perform a more accurate calculation during pre-operative virtual planning.
Based on this, we then create PSI guides with a reduction guide to achieve an accurate, patient-specific axis correction, taking the weightbearing dimension in our calculation.