Understanding Foot & Ankle Alignment After Total Ankle Arthroplasty Using WBCT

At the International Weight Bearing CT Society (WBCT) session during the 2024 European Foot & Ankle Society congress in Brussels, Federico Usuelli, MD, a foot and ankle orthopedic surgeon at Humanitas San Pio X in Milan, Italy, discussed the adoption and challenges of using weight-bearing CT (WBCT) scans in their orthopedic practice with a focus on foot and ankle alignment.

Usuelli describes how these scans, combined with software tools like Disior, aid in understanding pathology, planning surgeries, and analyzing outcomes. Despite their benefits, the tools have limitations, such as inaccuracies in semi-automatic segmentation and challenges in measuring complex anatomical structures like the talus. He emphasizes the importance of a collaborative team to manage the time-intensive processes involved in using these technologies effectively.

The discussion also explores new approaches, such as distance mapping and new angles for measuring alignment and internal rotation, to enhance surgical precision. However, these methods are still evolving, with current tools requiring manual oversight to ensure accuracy. Usuelli shares examples of how these techniques inform surgical planning and post-operative evaluation, demonstrating their potential to improve patient outcomes.