The Battleship technique: A reliable method to quantify intraarticular distance maps patterns and correlate hindfoot alignment
Abstract Purpose Weight‐bearing computed tomography (WBCT) creates colour‐coded distance maps (DM) to analyze intraarticular contact areas, offering a detailed assessment of joint surface interactions. However, clinical applications of DM remain underexplored. This study introduces the ‘Battleship t...
Saved in:
| Main Authors: | , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2025-01-01
|
| Series: | Journal of Experimental Orthopaedics |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/jeo2.70190 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849716126395662336 |
|---|---|
| author | Ben Efrima Agustin Barbero Amit Benady Yair Green Halimi Jari Dahmen Gino M. M. J. Kerkhoffs Jon Karlsson Cristian Indino Camila Maccario Federico G. Usuelli |
| author_facet | Ben Efrima Agustin Barbero Amit Benady Yair Green Halimi Jari Dahmen Gino M. M. J. Kerkhoffs Jon Karlsson Cristian Indino Camila Maccario Federico G. Usuelli |
| author_sort | Ben Efrima |
| collection | DOAJ |
| description | Abstract Purpose Weight‐bearing computed tomography (WBCT) creates colour‐coded distance maps (DM) to analyze intraarticular contact areas, offering a detailed assessment of joint surface interactions. However, clinical applications of DM remain underexplored. This study introduces the ‘Battleship technique (BST)’ to evaluate contact area patterns in patients with osteoarthritis (OA) of the talar dome, producing a single point representing the distance map weighted sum (DMWS). The DMWS serves as a potential reference for assessing hindfoot deformities and guiding clinical decisions, including surgical planning and alignment correction. We hypothesize that the BST is reliable for calculating the DMWS and that the DMWS correlates with hindfoot alignment, providing a novel tool to improve the evaluation of complex deformities. The primary aim was to evaluate the reliability of the BST, and the secondary aim was to determine whether the DMWS is influenced by hindfoot alignment. Methods Two raters independently calculated DMWS using BST for forty ankle OA patients. Based on DMWS location relative to the joint centre, patients were categorized into coronal (varus/valgus) and sagittal (anterior/posterior) groups. Hindfoot alignment was statistically compared between groups. Results Excellent interobserver and intraobserver agreement was observed. Significant differences were found in α angle, tibiotalar surface angle (TSA), hindfoot alignment angle (HFA) and talar tilt (TT) (p = 0.047, p < 0.001, p = 0.003 and p = 0.04) between coronal groups, and in β angle and tibiotalar ratio (TTR) (p < 0.001) between sagittal groups. Correlations were identified between DMWS and TSA (r = 0.6, p < 0.001), TT (r = −0.6, p < 0.001), β angle (r = 0.2, p < 0.001) and TTR (r = −0.4, p < 0.001). Conclusion The BST reliably calculates the DMWS, correlating with foot and ankle alignment. BST provides a standardized, non‐invasive method to evaluate intraarticular contact patterns, offering valuable insights for preoperative planning and post‐operative assessment. Its integration into practice may enhance surgical precision in complex realignment procedures. Level of Evidence Level IV. |
| format | Article |
| id | doaj-art-fd962be6c6b043bc88673506f5d7450d |
| institution | DOAJ |
| issn | 2197-1153 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of Experimental Orthopaedics |
| spelling | doaj-art-fd962be6c6b043bc88673506f5d7450d2025-08-20T03:13:07ZengWileyJournal of Experimental Orthopaedics2197-11532025-01-01121n/an/a10.1002/jeo2.70190The Battleship technique: A reliable method to quantify intraarticular distance maps patterns and correlate hindfoot alignmentBen Efrima0Agustin Barbero1Amit Benady2Yair Green Halimi3Jari Dahmen4Gino M. M. J. Kerkhoffs5Jon Karlsson6Cristian Indino7Camila Maccario8Federico G. Usuelli9Sackler School of Medicine Tel Aviv University Tel Aviv IsraelFoot and Ankle Department Humanitas San Pio X Hospital Milan ItalySackler School of Medicine Tel Aviv University Tel Aviv IsraelSackler School of Medicine Tel Aviv University Tel Aviv IsraelDepartment of Orthopedic Surgery and Sports Medicine, Amsterdam Movement Sciences, Amsterdam UMC, Location AMC University of Amsterdam Amsterdam the NetherlandsDepartment of Orthopedic Surgery and Sports Medicine, Amsterdam Movement Sciences, Amsterdam UMC, Location AMC University of Amsterdam Amsterdam the NetherlandsDepartment of Orthopaedics, Sahlgrenska Academy Gothenburg University Gothenburg SwedenFoot and Ankle Department Humanitas San Pio X Hospital Milan ItalyFoot and Ankle Department Humanitas San Pio X Hospital Milan ItalyFoot and Ankle Department Humanitas San Pio X Hospital Milan ItalyAbstract Purpose Weight‐bearing computed tomography (WBCT) creates colour‐coded distance maps (DM) to analyze intraarticular contact areas, offering a detailed assessment of joint surface interactions. However, clinical applications of DM remain underexplored. This study introduces the ‘Battleship technique (BST)’ to evaluate contact area patterns in patients with osteoarthritis (OA) of the talar dome, producing a single point representing the distance map weighted sum (DMWS). The DMWS serves as a potential reference for assessing hindfoot deformities and guiding clinical decisions, including surgical planning and alignment correction. We hypothesize that the BST is reliable for calculating the DMWS and that the DMWS correlates with hindfoot alignment, providing a novel tool to improve the evaluation of complex deformities. The primary aim was to evaluate the reliability of the BST, and the secondary aim was to determine whether the DMWS is influenced by hindfoot alignment. Methods Two raters independently calculated DMWS using BST for forty ankle OA patients. Based on DMWS location relative to the joint centre, patients were categorized into coronal (varus/valgus) and sagittal (anterior/posterior) groups. Hindfoot alignment was statistically compared between groups. Results Excellent interobserver and intraobserver agreement was observed. Significant differences were found in α angle, tibiotalar surface angle (TSA), hindfoot alignment angle (HFA) and talar tilt (TT) (p = 0.047, p < 0.001, p = 0.003 and p = 0.04) between coronal groups, and in β angle and tibiotalar ratio (TTR) (p < 0.001) between sagittal groups. Correlations were identified between DMWS and TSA (r = 0.6, p < 0.001), TT (r = −0.6, p < 0.001), β angle (r = 0.2, p < 0.001) and TTR (r = −0.4, p < 0.001). Conclusion The BST reliably calculates the DMWS, correlating with foot and ankle alignment. BST provides a standardized, non‐invasive method to evaluate intraarticular contact patterns, offering valuable insights for preoperative planning and post‐operative assessment. Its integration into practice may enhance surgical precision in complex realignment procedures. Level of Evidence Level IV.https://doi.org/10.1002/jeo2.70190ankle jointBattleship techniquedistance mappingosteoarthritisweight‐bearing computed tomography |
| spellingShingle | Ben Efrima Agustin Barbero Amit Benady Yair Green Halimi Jari Dahmen Gino M. M. J. Kerkhoffs Jon Karlsson Cristian Indino Camila Maccario Federico G. Usuelli The Battleship technique: A reliable method to quantify intraarticular distance maps patterns and correlate hindfoot alignment Journal of Experimental Orthopaedics ankle joint Battleship technique distance mapping osteoarthritis weight‐bearing computed tomography |
| title | The Battleship technique: A reliable method to quantify intraarticular distance maps patterns and correlate hindfoot alignment |
| title_full | The Battleship technique: A reliable method to quantify intraarticular distance maps patterns and correlate hindfoot alignment |
| title_fullStr | The Battleship technique: A reliable method to quantify intraarticular distance maps patterns and correlate hindfoot alignment |
| title_full_unstemmed | The Battleship technique: A reliable method to quantify intraarticular distance maps patterns and correlate hindfoot alignment |
| title_short | The Battleship technique: A reliable method to quantify intraarticular distance maps patterns and correlate hindfoot alignment |
| title_sort | battleship technique a reliable method to quantify intraarticular distance maps patterns and correlate hindfoot alignment |
| topic | ankle joint Battleship technique distance mapping osteoarthritis weight‐bearing computed tomography |
| url | https://doi.org/10.1002/jeo2.70190 |
| work_keys_str_mv | AT benefrima thebattleshiptechniqueareliablemethodtoquantifyintraarticulardistancemapspatternsandcorrelatehindfootalignment AT agustinbarbero thebattleshiptechniqueareliablemethodtoquantifyintraarticulardistancemapspatternsandcorrelatehindfootalignment AT amitbenady thebattleshiptechniqueareliablemethodtoquantifyintraarticulardistancemapspatternsandcorrelatehindfootalignment AT yairgreenhalimi thebattleshiptechniqueareliablemethodtoquantifyintraarticulardistancemapspatternsandcorrelatehindfootalignment AT jaridahmen thebattleshiptechniqueareliablemethodtoquantifyintraarticulardistancemapspatternsandcorrelatehindfootalignment AT ginommjkerkhoffs thebattleshiptechniqueareliablemethodtoquantifyintraarticulardistancemapspatternsandcorrelatehindfootalignment AT jonkarlsson thebattleshiptechniqueareliablemethodtoquantifyintraarticulardistancemapspatternsandcorrelatehindfootalignment AT cristianindino thebattleshiptechniqueareliablemethodtoquantifyintraarticulardistancemapspatternsandcorrelatehindfootalignment AT camilamaccario thebattleshiptechniqueareliablemethodtoquantifyintraarticulardistancemapspatternsandcorrelatehindfootalignment AT federicogusuelli thebattleshiptechniqueareliablemethodtoquantifyintraarticulardistancemapspatternsandcorrelatehindfootalignment AT benefrima battleshiptechniqueareliablemethodtoquantifyintraarticulardistancemapspatternsandcorrelatehindfootalignment AT agustinbarbero battleshiptechniqueareliablemethodtoquantifyintraarticulardistancemapspatternsandcorrelatehindfootalignment AT amitbenady battleshiptechniqueareliablemethodtoquantifyintraarticulardistancemapspatternsandcorrelatehindfootalignment AT yairgreenhalimi battleshiptechniqueareliablemethodtoquantifyintraarticulardistancemapspatternsandcorrelatehindfootalignment AT jaridahmen battleshiptechniqueareliablemethodtoquantifyintraarticulardistancemapspatternsandcorrelatehindfootalignment AT ginommjkerkhoffs battleshiptechniqueareliablemethodtoquantifyintraarticulardistancemapspatternsandcorrelatehindfootalignment AT jonkarlsson battleshiptechniqueareliablemethodtoquantifyintraarticulardistancemapspatternsandcorrelatehindfootalignment AT cristianindino battleshiptechniqueareliablemethodtoquantifyintraarticulardistancemapspatternsandcorrelatehindfootalignment AT camilamaccario battleshiptechniqueareliablemethodtoquantifyintraarticulardistancemapspatternsandcorrelatehindfootalignment AT federicogusuelli battleshiptechniqueareliablemethodtoquantifyintraarticulardistancemapspatternsandcorrelatehindfootalignment |