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Is the contralateral tibia a reliable template for reconstruction: a three-dimensional anatomy cadaveric study

Knee Surgery, Sports Traumatology, Arthroscopy volume 26, pages 2324–2331 (2018)Cite this article

Abstract

Purpose

The contralateral anatomy is regularly used as a reconstruction template for corrective osteotomies of several deformities and pathological conditions. However, there is lack of evidence that the intra-individual differences between both tibiae are sufficiently small to use the contralateral tibia as a 3D reconstruction template for complex osteotomies. The aim of this study was to evaluate the intra-individual side differences of the tibia in length, torsion, angulation, and translation using 3D measurement techniques.

Methods

3D surface models of both tibiae were created from computed tomography data of 51 cadavers. The (mirrored) models of the right tibiae were divided into two halves at the centre of the shaft. Thereafter, the proximal and distal segments were aligned to the left (contralateral) tibia in an automated fashion. The relative 3D transformation between both aligned segments was measured to quantify the side difference in 6° of freedom (3D translation vector, 3 angles of rotation).

Results

The mean side difference in tibia length was 2.1 mm (SD 1.3 mm; range 0.2–5.9 mm). The mean side difference in torsion was 4.9° (SD 4.1°; range 0.2°–17.6°). The mean side difference in the coronal and sagittal planes was 1.1° (SD 0.9°; range 0.0°–4.6°) and 1.0° (SD 0.8°; range 0.1°–2.9°), respectively.

Conclusion

The present study confirms small side differences in torsion between the left and right tibia, while the side differences in the coronal and sagittal plane are probably negligible. The contralateral tibia seems to be a reliable reconstruction template for the 3D preoperative planning of complex corrective osteotomies of the tibia. However, torsional differences should be interpreted with caution, as a single cut-off value of a clinically relevant torsional side difference cannot be defined. The presented results are relevant to surgeons considering the contralateral tibia as a 3D reconstruction template for corrective osteotomies of the tibia.

Level of evidence

Basic science.

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Acknowledgements

This work was funded by the Swiss Canton of Zurich through a Highly Specialized Medicine Grant. We also thank Prof. Burkhardt Seifert for his support in the statistical evaluation.

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Affiliations

  1. Department of Orthopaedics, Balgrist University Hospital, University of Zurich, Forchstrasse 340, 8008, Zurich, Switzerland

    Pascal Schenk, Lazaros Vlachopoulos, Andreas Hingsammer & Sandro F. Fucentese

  2. Computer Assisted Research and Development Group, Balgrist University Hospital, University of Zurich, Forchstrasse 340, 8008, Zurich, Switzerland

    Lazaros Vlachopoulos & Philipp Fürnstahl

Authors
  1. Pascal Schenk
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  2. Lazaros Vlachopoulos
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  3. Andreas Hingsammer
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  4. Sandro F. Fucentese
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Correspondence to Pascal Schenk.

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Conflict of interest

The author declares that the research for and communication of this independent body of work does not constitute any financial or other conflict of interest.

Funding

Part of this work was founded by a Highly Specialized Medicine (HSM2) grant of the Canton Zürich, Switzerland.

Ethical approval

The ethics committee of the canton Zurich approved the acquisition of the data. The CT data were provided by the Surgical Institute for Computer Assisted Surgery (SICAS) in an anonymized fashion and, therefore, an individual approval of the study was not necessary.

Informed consent

According to SiCas, the subjects gave informed consent that the data can be used ex-vivo for research purpose like this study.

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Schenk, P., Vlachopoulos, L., Hingsammer, A. et al. Is the contralateral tibia a reliable template for reconstruction: a three-dimensional anatomy cadaveric study. Knee Surg Sports Traumatol Arthrosc 26, 2324–2331 (2018). https://doi.org/10.1007/s00167-016-4378-5

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  • DOI: https://doi.org/10.1007/s00167-016-4378-5

Keywords

  • Tibia osteotomy
  • Three-dimensional analysis
  • Contralateral comparison
  • Cadaveric study