PDF(Pubmed)
Abstract：
OBJECTIVE: Precise preoperative planning is mandatory when a double-level osteotomy (DLO) is required to correct a severe knee deformity. Literature does not report a validated planning method regarding DLO that could be performed directly on digital radiographs using simple measurement tools. This study aims to validate a novel DLO planning method called New Mikulicz-Joint Line (NM-JL) based on essential measurement tools, in which the correction angles are induced by the predicted post-operative joint line obliquity (JLO).
METHODS: Twenty-three patients who satisfied the inclusion criteria were enrolled. NM-JL planning method was performed using basic measurement tools to detect corrective angles and gaps. The correction was then simulated using a Virtual Segmentation Software method to obtain the osteotomy fragments. Both planning procedures were performed independently and later repeated by two orthopaedic surgeons to assess the inter and intra-observer reliability.
RESULTS: The intraclass correlation coefficient (ICC) regarding corrective angles and gaps showed a significant positive correlation between the values determined using the two procedures by both raters (p < 0.05). Pearson\'s correlation analysis revealed a significant correlation between the measured results of the two planning methods. (p < 0.05). Finally, the Bland-Altman analysis showed an excellent agreement (p < 0.05) for all measurements performed.
CONCLUSIONS: The NM-JL method showed high values of intra and inter-rater reliability. The procedure is built up starting from the predicted value of post-operative joint line obliquity, allowing to maintain this parameter fixed. Other advantages include the quickness, adaptability, and possibility to be performed on any Digital Imaging and Communication in Medicine (DICOM) viewer.
METHODS: Level IV.
METHODS: Twenty-three patients who satisfied the inclusion criteria were enrolled. NM-JL planning method was performed using basic measurement tools to detect corrective angles and gaps. The correction was then simulated using a Virtual Segmentation Software method to obtain the osteotomy fragments. Both planning procedures were performed independently and later repeated by two orthopaedic surgeons to assess the inter and intra-observer reliability.
RESULTS: The intraclass correlation coefficient (ICC) regarding corrective angles and gaps showed a significant positive correlation between the values determined using the two procedures by both raters (p < 0.05). Pearson\'s correlation analysis revealed a significant correlation between the measured results of the two planning methods. (p < 0.05). Finally, the Bland-Altman analysis showed an excellent agreement (p < 0.05) for all measurements performed.
CONCLUSIONS: The NM-JL method showed high values of intra and inter-rater reliability. The procedure is built up starting from the predicted value of post-operative joint line obliquity, allowing to maintain this parameter fixed. Other advantages include the quickness, adaptability, and possibility to be performed on any Digital Imaging and Communication in Medicine (DICOM) viewer.
METHODS: Level IV.
摘要：
目的：当需要进行双层截骨术（DLO）以矫正严重的膝关节畸形时，必须进行精确的术前计划。文献没有报道可以使用简单的测量工具直接在数字射线照片上执行的关于DLO的经过验证的计划方法。本研究旨在验证一种基于基本测量工具的新型DLO规划方法，称为NewMikulicz-JointLine（NM-JL）。其中校正角度由预测的术后关节线倾角(JLO)引起。
方法：纳入23例符合纳入标准的患者。使用基本测量工具进行NM-JL计划方法以检测校正角度和间隙。然后使用虚拟分割软件方法模拟矫正以获得截骨碎片。两种计划程序均独立执行，然后由两名整形外科医生重复执行，以评估观察者之间和观察者之间的可靠性。
结果：关于矫正角度和间隙的组内相关系数（ICC）显示，两个评估者使用两种程序确定的值之间存在显着正相关（p<0.05）。Pearson的相关性分析显示，两种规划方法的测量结果之间存在显着相关性。(p<0.05)。最后,Bland-Altman分析显示所有测量结果的一致性(p<0.05)。
结论：NM-JL方法显示出较高的评估者内和评估者间可靠性值。该程序是从术后关节线倾角的预测值开始建立的，允许保持此参数固定。其他优点包括快速，适应性，以及在任何医学数字成像和通信（DICOM）查看器上执行的可能性。
方法：四级。
方法：纳入23例符合纳入标准的患者。使用基本测量工具进行NM-JL计划方法以检测校正角度和间隙。然后使用虚拟分割软件方法模拟矫正以获得截骨碎片。两种计划程序均独立执行，然后由两名整形外科医生重复执行，以评估观察者之间和观察者之间的可靠性。
结果：关于矫正角度和间隙的组内相关系数（ICC）显示，两个评估者使用两种程序确定的值之间存在显着正相关（p<0.05）。Pearson的相关性分析显示，两种规划方法的测量结果之间存在显着相关性。(p<0.05)。最后,Bland-Altman分析显示所有测量结果的一致性(p<0.05)。
结论：NM-JL方法显示出较高的评估者内和评估者间可靠性值。该程序是从术后关节线倾角的预测值开始建立的，允许保持此参数固定。其他优点包括快速，适应性，以及在任何医学数字成像和通信（DICOM）查看器上执行的可能性。
方法：四级。
