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Weight Bearing CT Advances Planning for Forefoot Reconstructive Surgery

Think of a surgical procedure like a construction project. No contractor would build a building without a full set of plans, cross-sectional diagrams and 3D renderings. Dr. Bob Baravarian, DPM, feels foot surgeons should be just as prepared.

As he explained in Podiatry Today, Dr. Baravarian has always been interested in architecture and real estate, yet was drawn to 159682158975132.Zfw2RIZiU5Lh04gznDby_height640medicine.

Dr. Baravarian sometimes works next to a hip & knee surgeon in the OR. One day, he observed the hip & knee surgeon had a digital tool that laid out an exact surgical plan for the osteotomy he was performing. The plan rendered leg length and acetabular rotation a non-issue.

Soon after, Dr. Baravarian incorporated a pedCAT weight bearing CT imaging system into his podiatric practice. He found he could plan angular corrections to the degree, calculate the exact size of a graft for an Evans procedure, and could even plan the amount of rotation necessary for anatomic alignment of the hindfoot.


Overtime, he began to apply the same methods to forefoot procedures as well.

  • For hallux valgus cases, he scans the patient in the post-corrected position so he can determine if a hindfoot alignment correction is also needed.
  • For hallux rigidus cases, he uses weight bearing CT to evaluate the level of articular damage and the possibility of cartilage graft procedures. “This is impossible to do at such high levels with plain radiographs,” Dr. Baravarian said in the Podiatry Today article.

pt07treatment1 (1)Bilateral, weight bearing three dimensional views of the foot and ankle give specialists the data they need to create optimal treatment plans. The pedCAT, with a scan time of one minute, is a compact, ultra-low dose CT imaging system that is ideal for orthopedic and podiatric clinics. Patients benefit from the convenience of point-of-care advanced diagnostic imaging, and the pedCAT automatically generates all standard X-Ray views in addition to the full CT volume.

As software programs become more advanced, Dr. Baravarian said, surgeons may be able to perform osteotomies and shift the bones in preoperative planning, which will allow even more advanced planning along with far less operative time and less risk to the pt07treatment3 (1)patient.

Dr. Baravarian is the Chief of Podiatric Foot and Ankle Surgery at the Santa Monica UCLA Medical Center and Orthopedic Hospital, and Director of the University Foot and Ankle Institute in Los Angeles.

Read the entire article here.

Exclusive Video From The First pedCAT Weight Bearing CT Scientific Users’ Meeting in Berlin

meeting-83519_960_720 (1)The first pedCAT Weight Bearing CT Scientific User’s Meeting recently convened at the 2016 Foot International (EFAS, DAF, I-FAB) in Berlin. The meeting focused on weight bearing cone beam CT (WBCT) technology and the potential applications and challenges it presents.

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Look for several interesting items as you watch:

  • Professor Martinus Richter’s work included a time workflow study on the use of X-Ray,  conventional medical CT, and the pedCAT; the results will surprise you. His study also showed how weight-bearing  CT measurements are more accurate than X-Ray measurements.
  • Dr. Arne Burssens’ study on hindfoot alignment answered critical questions: How do we identify varus and valgus, how do we accurately measure them, and how can we be sure that the measurements are clinically useful and reproducible?
  • Dr. Francois Lintz gives us a sneak peek at a new weight-bearing measurement CT tool that will be available exclusively in CubeVue, pedCAT’s software. It will enable users to measure alignment in three dimensions, and distinguish between normal and pathological cases.
  • Dr. Cesar Netto’s study focused on adult acquired flatfoot deformity, comparing  measurements on weight bearing CT vs non-weight bearing CT.
  • Dr. Michael Wachowsky’s study focused on the use of weight bearing CT  with pediatric patients, and asks: With the new weight bearing CT technology, what will be the exact definitions of the measurements?

The challenge created by this new technology is clear: How do we now define what we are measuring, since the current X-Ray methods have just been rendered obsolete?

“We can’t have non-weight bearing CTs and say anything about alignment – that’s over,” concluded Dr. Charles Saltzman. “What do we want to measure, and how do we know what we’re measuring represents reality?”

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