Recommendation of Minimal Distal Tibial Length for Long Axis Coordinate System Definitions

Authors

• Erika P. Muhlrad, University of Utah
• Andrew C. Peterson, University of Utah
• Abigail M. Anderson, Marquette University
• Katelyn C. Aragon, Marquette University
• Rich J. Lisonbee, University of Utah
• Bruce A. MacWilliams, University of Utah
• Karen M. Kruger, Marquette UniversityFollow
• Amy L. Lenz, University of Utah

Document Type

Article

Publication Date

6-2024

Publisher

Elsevier

Source Publication

Journal of Biomechanics

Source ISSN

0021-9290

Original Item ID

DOI: 10.1016/j.jbiomech.2024.112153

Abstract

Accurate anatomical coordinate systems for the foot and ankle are critical for interpreting their complex biomechanics. The tibial superior-inferior axis is crucial for analyzing joint kinematics, influencing bone motion analysis during gait using CT imaging and biplane fluoroscopy. However, the lack of consensus on how to define the tibial axis has led to variability in research, hindering generalizability. Even as advanced imaging techniques evolve, including biplane fluoroscopy and weightbearing CT, there exist limitations to imaging the entire foot together with the full length of the tibia. These limitations highlight the need to refine axis definitions. This study investigated various superior-inferior axes using multiple distal tibia lengths to determine the minimal field of view for representing the full tibia long-axis. Twenty human cadaver tibias were imaged and segmented to generate 3D bone models. Axes were calculated based on coordinate definitions that required user manual input, and a gold standard mean superior-inferior axis was calculated based on the population’s principal component analysis axis. Four manually calculated superior-inferior tibial axes groups were established based on landmarks and geometric fittings. Statistical analysis revealed that geometrically fitting a cylinder 1.5 times the mediolateral tibial width, starting 5 cm above the tibial plafond, yielded the smallest angular deviation from the gold standard. From these findings, we recommend a minimum field of view that includes 1.5 times the mediolateral tibial width, starting 5 cm above the tibial plafond for tibial long-axis definitions. Implementing these findings will help improve foot and ankle research generalizability and impact clinical decisions.

Comments

Accepted version. Journal of Biomechanics, Vol. 170 (June 2024). DOI. © 2024 Elsevier. Used with permission.

Recommended Citation

Muhlrad, Erika P.; Peterson, Andrew C.; Anderson, Abigail M.; Aragon, Katelyn C.; Lisonbee, Rich J.; MacWilliams, Bruce A.; Kruger, Karen M.; and Lenz, Amy L., "Recommendation of Minimal Distal Tibial Length for Long Axis Coordinate System Definitions" (2024). Biomedical Engineering Faculty Research and Publications. 764.
https://epublications.marquette.edu/bioengin_fac/764