Postoperative accuracy quantification of corrective osteotomies: standardisation of Q3D-CT methodology

Sander J C Tabernée Heijtmeijer; Anne M L Meesters; Nico J J Verdonschot; Paul C Jutte; Job N Doornberg; Peter A J Pijpker; Joep Kraeima

doi:10.1007/s00068-024-02684-8

Postoperative accuracy quantification of corrective osteotomies: standardisation of Q3D-CT methodology

Eur J Trauma Emerg Surg. 2025 Jan 24;51(1):81. doi: 10.1007/s00068-024-02684-8.

Authors

Sander J C Tabernée Heijtmeijer^{1

2}, Anne M L Meesters^{3

4}, Nico J J Verdonschot^{5

6}, Paul C Jutte⁷, Job N Doornberg^{7

4

8}, Peter A J Pijpker³, Joep Kraeima^{3

9}

Affiliations

¹ 3D-Lab, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands. s.j.c.tabernee.heijtmeijer@umcg.nl.
² Department of Oral and Maxillofacial Surgery, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands. s.j.c.tabernee.heijtmeijer@umcg.nl.
³ 3D-Lab, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands.
⁴ Department of Trauma Surgery, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands.
⁵ Department of Biomechanical Engineering, University of Twente, Enschede, The Netherlands.
⁶ Orthopaedic Research Laboratory, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands.
⁷ Department of Orthopaedics, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands.
⁸ Department of Orthopaedic and Trauma Surgery, Flinders Medical Centre, Flinders University, Adelaide, South Australia, Australia.
⁹ Department of Oral and Maxillofacial Surgery, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands.

Abstract

Purpose: Currently, no gold standard exists for 3D analysis of virtually planned surgery accuracy postoperatively. The aim of this study was to present a new, validated and standardised methodology for 3D postoperative assessment of surgical accuracy in patients undergoing 3D virtually planned and guided corrective osteotomies.

Methods: All patients who underwent 3D planned corrective osteotomy in 2021-2022 at our center with a postoperative CT were included. Postoperative surgical outcome was analysed with a postoperative CT and compared to the preoperative virtual surgical planning to determine achieved accuracy. Validation of the analysis was performed by evaluating the individual assessment of six experienced observers. A postoperative quantification was performed according to the proposed innovative methodology based on rotation axes of a virtual postoperative bone model aligned to the virtual preoperative bone model and virtual surgical planned bone model. To evaluate the intra-observer variability, one observer performed the assessment twice.

Results: Quantification of 13 patients according resulted in measurements with a median range (and its interquartile range) for 3D translation of: 2.43 mm (3.17), for the angle deviations: 3D rotation, 2D coronal, 2D sagittal and 2D axial were: 0.66° (1.66°), 0.74° (0.44°), 0.99° (1.27°), 2.37° (5.00°), respectively. The inter- and intraobserver reliability established with the Intraclass correlation coefficient was for all measurements excellent (> 0.76).

Conclusion: The proposed 3D CT technique provides an significant more accurate and objective method for assessment of surgical outcome of a guided corrective osteotomy. The present proposed novel methodology showed excellent inter- and intra-observer reliability with clinically acceptable absolute surgical outcome measurements.

Keywords: 3D technology; Accuracy; Osteotomy; Patient-specific; Validation; Virtual surgical planning.

MeSH terms

Adult
Female
Humans
Imaging, Three-Dimensional*
Male
Middle Aged
Osteotomy* / methods
Postoperative Period
Reproducibility of Results
Surgery, Computer-Assisted* / methods
Tomography, X-Ray Computed* / methods