Abstract
Purpose
EOS 2D/3D is an integrated, low-dose orthopedic digital radioimaging solution, which, due to its groundbreaking properties, has recently shown an increasing application in scoliosis surgery. Its integrated sterEOS 3D software allows creation of patient-specific three-dimensional (3D) lower limb models, and can produce geometrical parameters in 3D. Currently there are a limited number of reports on EOS for lower limb applications.
Methods
Three-dimensional reconstructions of 256 hip and knee joints of 128 healthy subjects, as well as 53 hips and 46 knees of 69 patients with hip or knee arthritis, were evaluated based on orthogonal EOS two-dimensional (2D) images. Measurements for hips included femur and tibia length, total length of the extremity, femoral antetorsion and offset, femoral neck length, neck-shaft and hip-knee-shaft (HKS) angles. Lower limb alignment in both frontal and sagittal planes were determined in normal and arthritic knees. Values were compared with those obtained by standard methods published by others.
Results
Normal hip and knee geometrical parameters were found in our healthy subjects. In osteoarthritic cases, values for neck-shaft angle, femoral antetorsion, femur length and total length of the extremity were shown to decrease non-significantly. Evaluation of lower limb alignment in healthy and arthritic knees showed normal values in healthy subjects apart from three cases with an average six degrees varus. Arthritic knees were most frequently found to have a varus angulation, with the exception of 11 cases with normal or valgus alignment.
Conclusion
EOS 2D/3D with its sterEOS 3D reconstruction is useful for a comprehensive 3D examination of the lower limb. In the near future it may be suitable for daily routine diagnostics of orthopedic lower limb deformities as a primary examination method.
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References
Charpak G (1981) La detection des particules. Recherche 128:1384–1396
Kalifa G, Charpak G, Maccia C, Fery-Lemonnier E, Bloch J, Boussard JM, Attal M, Dubousset J, Adamsbaum C (1998) Evaluation of a new low-dose digital x-ray device: first dosimertric and clinical result in children. Pediatr Radiol 28:557–561
Aubin C-É, Dansereau J, Petit Y, Parent F, de Guise JA, Labelle H (1998) 3D measurement of wedge scoliotic vertebrae and intervertebral disks. Eur Spine J 7:59–65
Delorme S, Labelle H, Aubin C-É, De Guise JA, Rivard C, Poitras B, Dansereau J (2000) A three-dimensional radiographic comparison of Cotrel-Dubousset and Colorado Instrumentations for the correction of idiopathic scoliosis. Spine 25:205–210
Liljenqvist UR, Link TM, Halm HF (2000) Morphometric analysis of thoracic and lumbar vertebrae in idiopathic scoliosis. Spine 25:1247–1253
Petit Y, Aubin C-É, Labelle H (2002) Three-dimensional imaging for the surgical treatment of idiopathic scoliosis in adolescents. Can J Surg 45:453–458
Illés T, Tunyogi-Csapó M, Somoskeöy S (2011) Breakthrough in three-dimensional scoliosis diagnosis: significance of horizontal plane view and vertebra vectors. Eur Spine J 20:135–143
Toogood BS, Skalak A, Cooperman DR (2009) Proximal femoral anatomy in the normal human population. Clin Orthop Relat Res 467:876–885
Bråten M, Terjesen T, Rossvoll I (1992) Femoral anteversion in normal adults. Ultrasound measurements in 50 men and 50 women. Acta Orthop Scand 63:29–32
Lecerf G, Fessy MH, Philippot R, Massin P, Giraud F, Flecher X, Girard J, Mertl P, Marchetti E, Stindel E (2009) Femoral offset: Anatomical concept, definition, assessment, implications for preoperative templating and hip arthroplasty. Orthop Traumatol Surg Res 95:210–219
Massé JP, Glimet T, Alpérovitch A, Kuntz D (1985) Value of the femorotibial angle in 244 patients without knee arthritis. Rev Rheum Mal Osteoartic 52:91–94
Hsu RW, Himeno S, Coventry MB, Chao EY (1990) Normal axial alignment of the lower extremity and load-bearing distribution at the knee. Clin Orthop Relat Res 255:215–227
Strecker W, Keppler P, Gebhard F, Kinzl L (1997) Length and torsion of the lower limb. J Bone Joint Surg Br 79:1019–1023
Lazennec J-Y, Rangel A, Baudoin A, Skalli W, Catonne Y, Rousseau MA (2011) The EOS imaging system for understanding a patellofemoral disorder following THR. Orthop Traumatol Surg Res 97:98–101
Lazennec J-Y, Rousseau MA, Rangel A, Gorin M, Belicourt A, Brusson A, Catonné Y (2011) Pelvis and total hip arthroplasty acetabular component orientations in sitting and standing positions: Measurements reproductibility with EOS imaging system versus conventional radiographies. Orthop Traumatol Surg Res 97:373–380
Byrne DP, Mulhall KJ, Baker JF (2010) Anatomy & biomechanics of the hip. The Open Sports Med J 4:44–50
Sariali E, Mouttet A, Pasquier G, Durante E (2009) Three-dimensional hip anatomy in osteoarthritis. Analysis of the femoral offset. J Arthroplasy 24:990–997
Chitnavis J, Sinsheimer JS, Suchard MA, Clipsham K, Carr AJ (2000) End-stage coxarthritis and gonarthritis. Aetiology, clinical patterns and radiological features of idiopathic osteoarthritis. Rheumatol (Oxford) 39:612–619
Derek T, Cooke V, Kelly B, Li J (1998) Prosthetic reconstruction of the arthritic knee: considerations for limb alignment, geometry and soft tissue reconstruction. Knee 5:165–174
Kraus VB, Vail TP, Worrell T, McDaniel G (2005) A comparative assessment of alignment angle of the knee by radiographic and physical examination methods. Arth Rheum 52:1730–1735
Acknowledgement
Part of this work was supported by grant ETT287-10/2009 from the Health Science Council of Hungary (Dr. P. Than).
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The authors declare that they have no conflict of interest.
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Than, P., Szuper, K., Somoskeöy, S. et al. Geometrical values of the normal and arthritic hip and knee detected with the EOS imaging system. International Orthopaedics (SICOT) 36, 1291–1297 (2012). https://doi.org/10.1007/s00264-011-1403-7
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DOI: https://doi.org/10.1007/s00264-011-1403-7