Analysis of a generic talar prosthetic with a biological talus: A cadaver study.

Treatment for talar avascular necrosis is challenging. This study evaluates the feasibility of a generic talar implant by cadaveric assessment. Ten cadaveric ankles were CT-scanned to determine talar implant size. The opposite ankles were CT-scanned with the biological talus and then with the implant. 3D ankle geometry was reconstructed and implant position was compared to the biological talus position. The averages among specimens' positive and negative average-deviations were 0.91 mm and 0.70 mm. Seventy percent of talar dome deviations between the biological talus and implant were within an acceptable range. This study yields promising results to support a generic talus bone prosthetic.

Geometric analysis of the talus and development of a generic talar prosthetic.

BACKGROUND: Trauma to the talus can result in fracture, avascular necrosis and structural collapse. Treatment has been limited to surgical fusion and total ankle arthroplasty. Total ankle arthroplasty may not be an appropriate treatment for avascular necrosis while surgical fusion of the joint limits mobility. Custom-made implants have recently been used to address these limitations but have lengthy delays between injury and surgery and higher associated costs. A generic talar prosthesis available in various sizes may serve as a suitable alternative. METHODS: The geometric variation between shapes of individual tali was determined using 3D geometric models of 91 tali created from CT-scan data. Comparisons were done to determine if tali are one shape. The best shape was determined for each sex, and was compared to determine if a unisex implant would be possible. A geometric template for the implant in multiple sizes was created and compared to the models. RESULTS: The average of the average deviation between tali after volume scaling was found to be less than 1mm on the main articulating surfaces. One shape group was found for the talus. The female and male tali were found to be similar and a unisex implant template was created. CONCLUSIONS: Ten generic talar implant sizes were determined to be sufficient to match the size and shape of the 91 tali examined in this study.

Assessing asymmetry using reflection and rotoinversion in biomedical engineering applications.

Symmetry is a trait that has been extensively reviewed, especially clinically, as an indication of ideal geometry and health. Many geometric symmetry assessment techniques rely on two-dimensional measurements that do not account for the three-dimensional nature of the object. In this article, two methods, reflection and a process termed rotoinversion, a combination of reflection and rotation, are presented as potential methods to assess an object's deviation from symmetry. With reflection, the geometric models are reflected about a calculated best plane of symmetry. With rotoinversion, the models are reflected about an arbitrary plane and then rigidly translated and rotated to best align the translated and original models. The methods give the same results for bilaterally symmetric objects, but different results for bilaterally and rotationally symmetric objects. The two methods are applied to assess asymmetry in adolescent idiopathic scoliosis torso geometric models, producing similar results. There was an angle of 0.408° between the normal to the plane of reflection from the reflection process and the normal from the rotoinversion process and average rotation of 0.067° from rotoinversion. The most appropriate method depends on the purpose of the symmetry assessment and must be determined on a case-by-case basis.