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Influence of Investigator Experience on Reliability of Adult-Acquired Flatfoot Deformity Measurements Using Weight Bearing Computed Tomography

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Weight Bearing Cone Beam Computed Tomography (WBCT) in the Foot and Ankle

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Abstract

Our purpose was to assess the reliability of measurements of adult-acquired flatfoot deformity (AAFD) taken by investigators of different levels of clinical experience using weight bearing computed tomography (WBCT). Nineteen AAFD patients underwent WBCT. Three investigators with different levels of clinical experience made AAFD measurements. Intra- and interobserver reliability was assessed. Substantial to perfect intra- and interobserver reliability was observed for most measures, regardless of the investigator’s experience level. Significant differences between investigators were observed in 2 of 21 measured parameters. AAFD radiographic measurements can be performed reliably by investigators with different levels of clinical experience using WBCT.

Based on de Cesar Netto C, Shakoor D, Dein EJ, Zhang H, Thawait GK, Richter M, Ficke JR, Schon LC, Weightbearing CT International Study Group, Demehri S. Hindfoot Alignment of Adult Acquired Flatfoot Deformity: A Comparison of Clinical Assessment and Weight bearing Cone Beam CT Examinations. Foot Ankle Surg. 2018 Mar 12. pii: S1268-7731(18)30058-4. doi: https://doi.org/10.1016/j.fas.2018.03.001. [Epub ahead of print]

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References

  1. de Cesar Netto C, Shakoor D, Dein EJ, Zhang H, Thawait GK, Richter M, Ficke JR, Schon LC, Weightbearing CTISG, Demehri S. Influence of investigator experience on reliability of adult acquired flatfoot deformity measurements using weightbearing computed tomography. Foot Ankle Surg. 2019;25(4):495–502. https://doi.org/10.1016/j.fas.2018.03.001. Epub 2018 Mar 12

    Article  PubMed  Google Scholar 

  2. Toullec E. Adult flatfoot. Orthop Traumatol Surg Res. 2015;101:S11–7.

    Article  CAS  Google Scholar 

  3. Peeters K, Schreuer J, Burg F, Behets C, Van Bouwel S, Dereymaeker G, Sloten JV, Jonkers I. Alterated talar and navicular bone morphology is associated with pes planus deformity: a CT-scan study. J Orthop Res. 2013;31:282–7.

    Article  Google Scholar 

  4. Basioni Y, El-Ganainy AR, El-Hawary A. Double calcaneal osteotomy and percutaneous tenoplasty for adequate arch restoration in adult flexible flat foot. Int Orthop. 2011;35:47–51.

    Article  Google Scholar 

  5. Johnson KA, Strom DE. Tibialis posterior tendon dysfunction. Clin Orthop Relat Res. 1989;1(239):196–206.

    Google Scholar 

  6. Myerson MS. Adult acquired flatfoot deformity. Treatment of dysfunction of the posterior tibial tendon. J Bone Joint Surg Am. 1996;78:780–92.

    Article  Google Scholar 

  7. Lin YC, Mhuircheartaigh JN, Lamb J, Kung JW, Yablon CM, Wu JS. Imaging of adult flatfoot: correlation of radiographic measurements with MRI. AJR Am J Roentgenol. 2015;204:354–9.

    Article  Google Scholar 

  8. Richter M, Zech S. Lengthening osteotomy of the calcaneus and flexor digitorum longus tendon transfer in flexible flatfoot deformity improves talo-1st metatarsal-index, clinical outcome and pedographic parameter. Foot Ankle Surg. 2013;19:56–61.

    Article  Google Scholar 

  9. Deland JT. Adult-acquired flatfoot deformity. J Am Acad Orthop Surg. 2008;16:399–406.

    Article  Google Scholar 

  10. Cody EA, Williamson ER, Burket JC, Deland JT, Ellis SJ. Correlation of talar anatomy and subtalar joint alignment on weightbearing computed tomography with radiographic flatfoot parameters. Foot Ankle Int. 2016;37:874–81.

    Article  Google Scholar 

  11. Sensiba PR, Coffey MJ, Williams NE, Mariscalco M, Laughlin RT. Inter- and intraobserver reliability in the radiographic evaluation of adult flatfoot deformity. Foot Ankle Int. 2010;31:141–5.

    Article  Google Scholar 

  12. American Association of Physicists in Medicine. Comprehensive methodology for the evaluation of radiation does in x-ray computed tomography. AAPM Report No. 111. Available at http://www.aapm.org/pubs/reports/RPT_111.pdf. Accessed on July 28. In. 2017.

  13. Kido M, Ikoma K, Imai K, Maki M, Takatori R, Tokunaga D, Inoue N, Kubo T. Load response of the tarsal bones in patients with flatfoot deformity: in vivo 3D study. Foot Ankle Int. 2011;32:1017–22.

    Article  Google Scholar 

  14. Richter M, Seidl B, Zech S, Hahn S. PedCAT for 3D-imaging in standing position allows for more accurate bone position (angle) measurement than radiographs or CT. Foot Ankle Surg. 2014;20:201–7.

    Article  Google Scholar 

  15. Richter M, Zech S. Arthrorisis with calcaneostop screw in children corrects Talo-1st Metatarsal-Index (TMT-Index). Foot Ankle Surg. 2013;19:91–5.

    Article  Google Scholar 

  16. Carrino JA, Al Muhit A, Zbijewski W, Thawait GK, Stayman JW, Packard N, Senn R, Yang D, Foos DH, Yorkston J, Siewerdsen JH. Dedicated cone-beam CT system for extremity imaging. Radiology. 2014;270:816–24.

    Article  Google Scholar 

  17. de Cesar Netto C, Schon LC, Thawait GK, da Fonseca LF, Chinanuvathana A, Zbijewski WB, Siewerdsen JH, Demehri S. Flexible adult acquired flatfoot deformity: comparison between weight-bearing and non-weight-bearing measurements using cone-beam computed tomography. J Bone Joint Surg Am. 2017;99(18):e98. https://doi.org/10.2106/JBJS.16.01366.

    Article  Google Scholar 

  18. Demehri S, Muhit A, Zbijewski W, Stayman JW, Yorkston J, Packard N, Senn R, Yang D, Foos D, Thawait GK, Fayad LM, Chhabra A, Carrino JA, Siewerdsen JH. Assessment of image quality in soft tissue and bone visualization tasks for a dedicated extremity cone-beam CT system. Eur Radiol. 2015;25:1742–51.

    Article  CAS  Google Scholar 

  19. Sangeorzan BJ, Mosca V, Hansen ST Jr. Effect of calcaneal lengthening on relationships among the hindfoot, midfoot, and forefoot. Foot Ankle Int. 1993;14:136–41.

    Article  CAS  Google Scholar 

  20. Younger AS, Sawatzky B, Dryden P. Radiographic assessment of adult flatfoot. Foot Ankle Int. 2005;26:820–5.

    Article  Google Scholar 

  21. Ferri M, Scharfenberger AV, Goplen G, Daniels TR, Pearce D. Weightbearing CT scan of severe flexible pes planus deformities. Foot Ankle Int. 2008;29:199–204.

    Article  Google Scholar 

  22. Coughlin MJ, Kaz A. Correlation of Harris mats, physical exam, pictures, and radiographic measurements in adult flatfoot deformity. Foot Ankle Int. 2009;30:604–12.

    Article  Google Scholar 

  23. Ellis SJ, Deyer T, Williams BR, Yu JC, Lehto S, Maderazo A, Pavlov H, Deland JT. Assessment of lateral hindfoot pain in acquired flatfoot deformity using weightbearing multiplanar imaging. Foot Ankle Int. 2010;31:361–71.

    Article  Google Scholar 

  24. Iossi M, Johnson JE, McCormick JJ, Klein SE. Short-term radiographic analysis of operative correction of adult acquired flatfoot deformity. Foot Ankle Int. 2013;34:781–91.

    Article  Google Scholar 

  25. Arangio GA, Wasser T, Rogman A. Radiographic comparison of standing medial cuneiform arch height in adults with and without acquired flatfoot deformity. Foot Ankle Int. 2006;27:636–8.

    Article  Google Scholar 

  26. Chadha H, Pomeroy G, Manoli A 2nd. Radiologic signs of unilateral pes planus. Foot Ankle Int. 1997;18:603–4.

    Article  CAS  Google Scholar 

  27. Fleiss JL. Statistical methods for rates and proportions. New York: Wiley, John and Sons, Inc.; 1981.

    Google Scholar 

  28. Apostle KL, Coleman NW, Sangeorzan BJ. Subtalar joint axis in patients with symptomatic peritalar subluxation compared to normal controls. Foot Ankle Int. 2014;35:1153–8.

    Article  Google Scholar 

  29. Colin F, Horn Lang T, Zwicky L, Hintermann B, Knupp M. Subtalar joint configuration on weightbearing CT scan. Foot Ankle Int. 2014;35:1057–62.

    Article  Google Scholar 

  30. Krahenbuhl N, Tschuck M, Bolliger L, Hintermann B, Knupp M. Orientation of the subtalar joint: measurement and reliability using weightbearing CT scans. Foot Ankle Int. 2016;37:109–14.

    Article  Google Scholar 

  31. Malicky ES, Crary JL, Houghton MJ, Agel J, Hansen ST Jr, Sangeorzan BJ. Talocalcaneal and subfibular impingement in symptomatic flatfoot in adults. J Bone Joint Surg Am. 2002;84:2005–9.

    Article  Google Scholar 

  32. Probasco W, Haleem AM, Yu J, Sangeorzan BJ, Deland JT, Ellis SJ. Assessment of coronal plane subtalar joint alignment in peritalar subluxation via weight-bearing multiplanar imaging. Foot Ankle Int. 2015;36:302–9.

    Article  Google Scholar 

  33. Hirschmann A, Pfirrmann CW, Klammer G, Espinosa N, Buck FM. Upright cone CT of the hindfoot: comparison of the non-weight-bearing with the upright weight-bearing position. Eur Radiol. 2014;24:553–8.

    Article  Google Scholar 

  34. Arunakul M, Amendola A, Gao Y, Goetz JE, Femino JE, Phisitkul P. Tripod index: a new radiographic parameter assessing foot alignment. Foot Ankle Int. 2013;34:1411–20.

    Article  Google Scholar 

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Authors and Affiliations

  1. Department of Orthopedics and Rehabilitation, University of Iowa, Iowa City, IA, USA

    Cesar de Cesar Netto

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de Cesar Netto, C. (2020). Influence of Investigator Experience on Reliability of Adult-Acquired Flatfoot Deformity Measurements Using Weight Bearing Computed Tomography. In: Weight Bearing Cone Beam Computed Tomography (WBCT) in the Foot and Ankle. Springer, Cham. https://doi.org/10.1007/978-3-030-31949-6_17

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  • DOI: https://doi.org/10.1007/978-3-030-31949-6_17

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-31948-9

  • Online ISBN: 978-3-030-31949-6

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