3-dimensional Model Research Articles

Initial experience with augmented reality in planning renal access for PCNL

Achieving renal access during percutaneous nephrolithotomy is challenging, with a complication rate of 10–20%. This study aims to assess a novel technique for planning access to the renal collecting system using augmented reality (AR). Using Digital Imaging and Communications in Medicine software (DICOM 2-print), we generated 3-dimensional (3D) models of patients with different types of kidney stones (staghorn, lower pole, and pelvic stones) who underwent PCNL between 2018 and 2022. After viewing the patient’s CT scans, surgeons explored the anatomical models using an AR system with a stereoscopic 3D lens array display. Using questionnaires, we quantitatively estimated the model’s contribution on a scale of “1” (“poor”) to “5” (“excellent”) to the surgeon’s understanding of stone location, patient anatomy, and ease of access compared to 2D CT imaging. A total of 38 questionnaires were completed by 13 urologists. Estimating renal location, renal pelvis, and stone mass were better demonstrated by AR (5 vs. 4, p < 0.001). The orientation of adjacent organs was better understood using AR (5 vs. 4, p = 0.004). In 86.8% of cases, surgeons preferred using AR models both before and during surgery, with 69.2% suggesting that AR could enhance procedural safety. The time frames for testing the models differed between senior and junior practitioners (p = 0.016) and were significantly reduced with model experience (p < 0.001). When comparing CT to 3D imaging, AR models provide a better understating of stone location, patient anatomy, and route of access to the collecting system. Further research is required to implement this innovative technique preoperatively and intra-operatively.

A New Explicit Solver for MODFLOW Enabling Small Time Step Simulations.

Surface water (SW) and groundwater (GW) models, such as MODFLOW and HEC-RAS, have been explored to simulate the complexities of SW-GW interactions. However, individual models are not capable of capturing the full complexity of these interactions. To overcome individual models' shortcomings, researchers introduced the model coupling concept. This concept helps compensate for each individual model's shortcomings and incorporates the models' advantages. However, challenges arise from temporal scale disparities between SW and GW models. To tackle the temporal scale issue, this study introduces the novel explicit solver (EXP1) for MODFLOW 2005, enabling GW modeling using small time steps matching SW models (i.e., 15 min) by reducing runtime and computational burden. The EXP1 solver incorporates an integrated stability criterion to ensure the stability of explicit schemes, and it was systematically evaluated against the Preconditioned Conjugate Gradient (PCG) solver across various scenarios, including a 1-dimensional, 2-dimensional, and a vast 3-dimensional model. Results demonstrated the efficiency and accuracy of EXP1 in predicting groundwater heads and water budget, along with considerably reduced runtimes of up to 33% compared with the PCG solver, with less than 0.4% discrepancy in the water budget. These findings underscore the effectiveness of EXP1 in facilitating groundwater small time step simulations and bridging the temporal scale gap between SW and GW models.

Better Scapulohumeral Rhythm is Associated with Superior Patient-Reported Outcome Measures in Shoulders with Semi-Inlay Type Reverse Shoulder Arthroplasty.

Better Scapulohumeral Rhythm is Associated with Superior Patient-Reported Outcome Measures in Shoulders with Semi-Inlay Type Reverse Shoulder Arthroplasty.

The effect of acetabular shell and liner design on posterior horizontal dislocation distance in modern dual-mobility implants.

The posterior horizontal dislocation distance (PHDD) is a 3-dimensional jump distance measurement that is relevant to the risk of dislocation. There are a number of dual-mobility (DM) constructs with varying designs available. The present study identifies design factors associated with increased PHDD and evaluates the PHDD of 3 DM implants. 3 different computer-aided implant designs were virtually implanted within a 3-dimensional CT-derived pelvic model. Each design represented an analogue of a DM system (MDM, OR3O, and G7) according to specific variations in acetabular liner rim build-up and femoral head centre location. The effective head diameters and PHDD values were calculated for each size acetabular shell and DM design. The positive rim build-up design (MDM) showed higher PHDD values as compared to the other 2 hemispherical rim designs with no build-up, across all studied shell sizes. Specifically, the MDM design analogue had 16.4-29.0% greater PHDD values than the OR3O design analog and 15.2-30.5% greater PHDD values than the G7 design analogue The effect of a sfemoral head centre location relative to the liner head centre (OR3O) was negated by a larger effective head diameter to shell diameter ratio of the G7 design, resulting in similar PHDD values. Design parameters affect the PHDD values of DM cups. The use of an elevated rim was associated with greater PHDD values. A medialised femoral head centre should also improve PHDD values, but the effect was nullified due to consecutive lower effective head diameters.

Optimization of Land and Building Tax Absorption Through 3-Dimensional Modeling and Digital Twin Visualization from Aerial Photogrammetry

The era of digitalization and the advancement of information technology for mapping and modeling three-dimensional (3D) space has become an important factor in various sectors, including in land and building management. In Indonesia, the potential for utilizing 3D mapping technology can be used to optimize the absorption of Land and Building Tax (PBB) which is still not optimal. This is caused by various factors, one of which is the lack of accurate and comprehensive mapping. Aerial photo mapping is the main technology often used in 3D GIS (Geographic Information System) modeling. Visualization of the results of 3D modeling and digital twins in Jawa Village, Samarinda is modeled as an interactive tool for policy makers to improve operational efficiency in property tax management. The results of this study reveal how the geodatabase is compiled, the creation of 3D multipatch from oblique aerial photo acquisition to digital twin visualization with CE90 accuracy of 0.139 m and LE90 of 0.282 m. In addition, the quality of this accurate digital twin is indicated by mean difference 0.473 m and RMSE value of the building height of 0.561 m. The results of the photogrammetry method compared to BAPENDA data on an area of 92 Ha have a mean difference in building area of 73.98 m² and a total area difference of 114,747 m². Finally, this study was able to optimize regional income related to land and building tax from IDR 949,962,806 to IDR 1,112,471,515. This was able to optimize land and building tax in order to increase regional income by IDR 162,508,709 or 17.10%. This study clearly has a significant financial impact on the local government.

Aortic shape and diameter variations are predictive of short-term complications in transcatheter aortic valve replacement.

Anatomic and geometric considerations are critical components for transcatheter aortic valve replacement (TAVR) procedural planning. Aortic root geometry and 3-dimensional orientation have been previously associated with short-term complications but with mixed and inconsistent results. The purpose of this study was to investigate aortic 3-dimensional anatomical shape variants identified by principal component analysis (PCA) and whether these variants are associated with short-term complications. Pre-TAVR planning chest CT angiograms (N = 100) were analyzed to create 3-dimensional anatomic aortic models were subjected to PCA. Aortic shape variants described by principal components (PCs) and their respective scores were calculated for each patient in addition to standard planning geometric parameters. A short-term composite complication outcome within 1-month from the implantation included major and minor stroke, life-threatening and major bleeding, stage 3 acute kidney injury, new heart block and moderate plus paravalvular leak (PVL). A total of 25 patients (25%) experienced perioperative complications following TAVR. Shape based PCs were: PC1 - variation in aortic arch height, isthmic angle, and aortic arch angle; PC2 aortic length; PC3- aortic tilt. Diameter based PCs described: PC1- diameter size along the entire aortic length; PC2- aortic diameter tapering, PC3- ascending to arch diameter ratio. On univariable logistic regression, four variables were predictive of periprocedural complications, including the ascending aortic diameter at the level of Valsalva sinuses (OR: 0.88 (95%CI: 0.78-1.00), P = 0.044), PC1-shape scores (OR: 1.01 (95%CI: 1.00-1.02), P = 0.011), PC2-shape scores (OR: 0.98 (95%CI: 0.97-1.00), P = 0.034), and PC-1 diameter scores (OR: 0.98 (95%CI: 0.96-1.00), P = 0.023). An optimized multivariable model considering only PC1-shape and PC1-diameter revealed a C-statistic of 0.76 with a sensitivity of 92.0% and specificity of 32.0%. Aortic shape variants combining increased aortic arch height, acute isthmic angle, and mild aortic arch angle as identified by PCA were associated along with aortic size with higher rates of periprocedural complications in patients undergoing transfemoral TAVR. PCA identified shape variations outperformed standard 2-dimensional geometric measurements and could be considered as part of risk stratification prior to TAVR planning.

A crustal thermal model of the conterminous United States constrained by multiple data sets: A Monte-Carlo approach

Summary The thermal structure of the continental crust plays a critical role in understanding its elastic and rheologic properties as well as its dynamic processes. Thermal parameter datasets on continental scales have been used to constrain the crustal thermal structure, including both the direct (e.g., temperature, heat flux, and heat conductivity measured at the surface) and indirect (e.g., seismically derived Mohorovičić discontinuity (Moho) temperature, geomagnetically derived Curie depth) observations. In this study, we present a new continental scale crustal heat generation model with additional information from seismologically-inferred crustal composition. Together with previous direct and indirect thermal parameter datasets in the conterminous United States, we use the new crustal heat generation model to construct a 3-dimensional (3-D) crustal temperature model under a newly developed Bayesian framework. Specifically, we first derive profiles of crustal heat generation based on an empirical geochemical relationship at 1683 locations where seismologically derived crustal composition information is available. Then for each of these locations, the average heat generation values in the upper, middle, and lower crust are combined with other thermal parameters through a Markov Chain Monte-Carlo inversion for a conductive, vertically smooth temperature profile. The results, posterior distributions of temperature profiles, are used to generate a 3-D crustal thermal model with the uncertainties systematically assessed. The new temperature model overall exhibits similar patterns to that from the U.S. Geological Survey National Crustal Model, but also reduces possible biases and the model's dependence on a single thermal parameter.

EP5.23 Lateral Center Edge Angle and the Wall Indices Predict Acetabular Coverage on 3-Dimensional Hip Models

Abstract Purpose: To compare regional acetabular coverage as measured on, 3-dimensional (3D) models in patients with acetabular dysplasia and femoroacetabular impingement syndrome (FAIS) versus those with isolated FAIS, and to evaluate the relationship between 2-dimensional radiographic parameters and 3D model-based measures of coverage. Methods: Hips that underwent periacetabular osteotomy (PAO) for dysplasia (LCEA&amp;lt;25°, Tönnis&amp;gt;10°) and hip arthroscopy for FAIS were identified and propensity-matched at a 1:1 ratio controlling for age, sex, and BMI to patients who underwent HA for FAIS without dysplasia (LCEA&amp;gt;25°, Tönnis&amp;lt;10°). 3D models were derived from preoperative computerized tomography (CT) scans. The acetabular rim was projected onto the surface of the superior half of the femoral head. The femoral head was divided into quadrants based on anatomic landmarks. Percent coverage by region was determined. On standing radiograph, lateral center edge angle (LCEA), Tönnis angle, anterior center edge angle (ACEA), anterior wall index (AWI), and posterior wall index (PWI) were measured. The relationship between 2D and 3D measures of coverage were evaluated using Pearson’s correlations. Multivariate linear regression analysis was performed to identify 2D predictors of 3D coverage. Results: Twenty-six dysplastic hips were matched to 26 non-dysplastic hips. Three-dimensional acetabular coverage was decreased in dysplastic patients globally (Dysplastic:54.1±4.2%, Non-Dysplastic:61.7±2.6%), in the anterolateral (Dysplastic:9.4±4.7%, Non-Dysplastic:22.3±5.4%), posterolateral (Dysplastic:24.8±8.7%, Non-Dysplastic:36.2±5.8%), and anteromedial (Dysplastic:77.2±7.0%, Non-Dysplastic:85.7±9.0%) quadrants compared to the non-dysplastic group (p&amp;lt;0.001, for all). LCEA, Tönnis angle, AWI, and PWI demonstrated strong correlations 3D coverage (r≥|0.655|,for all). On multiple linear regression, LCEA, AWI, and PWI emerged as independent predictors of 3D coverage (p≤0.032,for all), whereas Tönnis angle and ACEA did not (p≥0.058, for all). Conclusions: Dysplastic hips show lower AL, PL, AM, and global 3D acetabular coverage of the femoral head in decreasing magnitude, than non-dysplastic hips. Two-dimensional LCEA, AWI, Tönnis angle, and PWI correlate most strongly with 3D coverage. When considered together, LCEA and the wall indices emerged as significant predictors of 3D coverage, whereas Tönnis angle and ACEA did not.

A 3-Dimensional Paper Model of the Pterygopalatine Fossa for Anatomy Education

A 3-Dimensional Paper Model of the Pterygopalatine Fossa for Anatomy Education

Anatomic characteristics of the vertebrobasilar artery: A three-dimensional reconstruction study based on computed tomography angiography.

The vertebrobasilar artery (VBA) exhibits substantial inter-individual variation that must be considered in diagnosis and surgical planning. We conducted 3-dimensional reconstruction of the bilateral VBA based on head and neck computed tomography angiography (CTA) to assess bilateral, individual, age-dependent, and sex-dependent differences in anatomical parameters. A retrospective study was performed. Individual 3-dimensional models of the VBA and skull were constructed and morphology evaluated based on head and neck CTA data from 199 adults. According to morphological and anatomical variation, the VBA was divided into 3 types: balanced, L, and S. The diameters and lengths of basilar and bilateral vertebral artery (VA) intracranial segments as well as VBA blending length, and bilateral distances of the vertebral arteries moving up the atlas were measured and statistically compared. The L-type was the most common VBA morphology, and anatomic type distribution differed significantly by age (P < .05). VA diameter was 3.34 ± 0.68 mm on the left side and 3.09 ± 0.71 mm on the right side, while bending length was 5.62 ± 3.35 mm on the left and 4.94 ± 3.41 mm on the right side. Balanced basilar arteries measured 3.41 ± 0.61 mm in diameter, 2.83 ± 0.33 cm in length, and 2.55 ± 2.45 mm in bending length. The L-type basilar artery measured 3.48 ± 0.71 mm in diameter, 3.06 ± 0.44 cm in length, and 2.78 ± 0.37 mm in bending length. Finally, S-type basilar arteries measured 3.84 ± 0.86 mm in diameter, 3.38 ± 0.61 cm in length, and 3.67 ± 4.39 mm in bending length. The distance traveled by the VA across the atlas differed significantly between left and right sides as well as between males and females (P < .05). The vertebrobasilar arteries in the general healthy population were successfully fused and 3-dimensionally reconstructed based on the CTA, and an observational study was conducted on their morphological and anatomical characteristics. Three-dimensional reconstruction of the VBA using CTA is feasible for anatomical research and also has diagnostic value for the variations and anatomical parameters of the VBA.

Profile line accuracy in cephalometric radiographs.

This study investigates the accuracy of facial soft-tissue profile lines in lateral cephalometric radiographs by comparing them to true profile lines derived from 3-dimensional photographs. This prospective methodological study was performed on preexisting records of 100 orthodontic patients. The true profiles were obtained by defining the true midsagittal plane through best-fit approximation of mirrored 3-dimensional surface models. Two curves were drawn on each profile image, and landmarks and sliding semilandmarks were placed on them. This resulted in 2 profile landmark configurations per patient, which were superimposed using Procrustes superimposition. The Procrustes distances between corresponding landmarks were used as a metric to assess the accuracy of the cephalometric profile line, as compared with the true reference. On average, there were small statistically significant differences between the cephalometric and the actual profile lines (100,000 permutations; P= 0.031; median interlandmark distance, 0.84 mm). However, when assessing individual patients, the cephalometric profile line deviated significantly from the true profile, with 40% of the distances between corresponding landmarks being>1 mm and 10% being>2 mm. There were no differences between the sexes or between younger and older patients (aged 8.0-12.5 vs 12.5-55.0 years). However, there were small differences between 2 x-ray devices (median, 0.18 mm; P<0.001), which often exceeded 1 mm at the soft-tissue nasion area, probably because of the cephalostat. On average, the lateral cephalometric radiographs might provide an adequate representation of the facial profile, but when individual patients are considered, there is often a clinically significant error. Thus, lateral cephalograms should be used with caution to evaluate the facial soft-tissue profile.

Catecholaminergic Polymorphic Ventricular Tachycardia: Advancing From Molecular Insights to Preclinical Models.

Inherited cardiac channelopathies are linked to a heightened risk of sudden cardiac death. Despite evolving knowledge on different genes for these inherited conditions, for certain subtypes, such as catecholaminergic polymorphic ventricular tachycardia syndrome, the specific genetic causes remain unidentified. The research of the pathophysiological mechanisms underlying catecholaminergic polymorphic ventricular tachycardia syndrome has been conducted through different invitro and invivo models, including genetically modified animal models, cardiac-specific transgenic models, pharmacological interventions in animal models, human-induced pluripotent stem cell-derived cardiomyocytes in 2- and 3-dimensional cardiac models. Recent research predominantly utilizes human-induced pluripotent stem cell-derived cardiomyocytes, focusing on genotype-phenotype correlations and pharmacological screening. The integration of cutting-edge techniques such as clustered regularly interspaced short palindromic repeats/Cas9 genome editing and 3-dimensional-engineered heart tissues has shed new light on the pathophysiological mechanisms of catecholaminergic polymorphic ventricular tachycardia, potentially enhancing drug therapies as part of personalized medicine approaches. This review emphasizes the diverse insights gained from both invivo and invitro studies of catecholaminergic polymorphic ventricular tachycardia, along with the application of these models in various research contexts.

Presentation of rare genetic disorders: case series using segmented 3-dimensional (3D) models from cone beam computed tomography

Presentation of rare genetic disorders: case series using segmented 3-dimensional (3D) models from cone beam computed tomography

Predicting Surgical Outcomes in Patients With Recurrent Patellar Dislocations

Background: A lateral dislocation of the patella is a common injury in adolescents and young adults that is largely caused by underlying anatomic risk factors. Surgically managed patients have a significantly lower risk of recurrent dislocations. However, determining the optimal surgical treatment remains a challenge, with patients sometimes undergoing multiple surgical procedures before achieving successful stabilization. Purpose: To computationally evaluate patients who have undergone multiple surgical procedures to treat recurrent lateral patellar dislocations and predict their clinical outcomes. Study Design: Controlled laboratory study. Methods: Our cohort consisted of 16 patients with trochlear dysplasia and recurrent lateral patellar dislocations. We used magnetic resonance imaging to create 3-dimensional patient-specific finite element models of the knee joint and evaluated patellofemoral stability before and after surgery. We applied these models to computationally predict the clinical outcome of each surgical procedure. We simulated a knee extension activity coupled with external tibial torsion to assess patellofemoral stability. We also included a healthy control group of 12 participants in the computational evaluation. Finally, we developed and trained a logistic regression model based on anatomic risk factors and applied this model to classify whether patients had a likelihood of a dislocation to efficiently differentiate between surgical outcomes. Results: Of 12 control, 12 preoperative, and 9 postoperative scans, the finite element model correctly predicted 29 of 33 surgical outcomes (87.9% accuracy). Postoperative simulations predicted patellofemoral stability metrics similar to those of the control group. Specifically, patients after trochleoplasty were associated with increased constraint force on the patellar lateral facet and lower involvement of the medial patellofemoral ligament. The logistic regression model demonstrated 81.8% accuracy in classification. Conclusion: Preliminary results are promising, but an improvement of the model and a larger clinical dataset are necessary to increase accuracy and comprehensively validate model performance. Clinical Relevance: The aim of this study was to provide surgeons with a useful computational tool that can predict the likelihood of a patellar dislocation and differentiate, before a clinical intervention, between successful versus unsuccessful surgery to determine the optimal treatment pathway for individual patients.

Custom design of a temporomandibular joint prosthesis: A kinematic approach evaluated by finite element analysis.

Custom design of a temporomandibular joint prosthesis: A kinematic approach evaluated by finite element analysis.

Effect of solid abutment diameter and implant placement depth on stress distribution in the posterior mandible: A finite element analysis study.

Effect of solid abutment diameter and implant placement depth on stress distribution in the posterior mandible: A finite element analysis study.

The Prediction of Hematoma Growth in Acute Intracerebral Hemorrhage: From 2-Dimensional Shape to 3-Dimensional Morphology

Introduction: The relationship between the 3-dimensional morphological features of hematoma and hematoma growth (HG) remains unclear. We aimed to quantitatively assess the predictive value of 3-dimensional hematoma morphology for HG among patients with intracerebral hemorrhage (ICH). Methods: Our study comprised 312 consecutive ICH patients. Using semi-automated volumetric analysis software, we measured hematoma volumes and delineated the region of interest. We employed Python software to extract shape features and receiver operating characteristic curve analysis to assess the predictive performance of hematoma morphology for HG. p < 0.05 was considered statistically significant. Results: Sphericity and SurfaceArea emerged as the most effective 3-dimensional hematoma morphological predictors for HG. Optimal cutoff points relating to HG were Sphericity ≤0.56 and SurfaceArea >55 cm2. We subsequently constructed the 3-dimensional morphology models, including the probability of hematoma morphology (PHM) and the probability of comprehensive model (PCM), to predict HG. The PHM model outperformed the irregular hematoma (p = 0.007), island sign (p = 0.032), and satellite sign (p < 0.001) in predictive accuracy for HG. Among all prediction models, the PCM presented the highest predictive value for active bleeding. Conclusions: The Sphericity ≤0.56 and SurfaceArea >55 cm2 could represent the optimal threshold for HG prediction. PHM was considered a reliable 3-dimensional morphology model for HG prediction. PCM tended to be a better model for risk stratification of active bleeding in acute ICH patients.

Multiview angle UAV infrared image simulation with segmented model and object detection for traffic surveillance

With the rapid development of infrared (IR) imaging UAV technology, infrared aerial image processing technology has been applied in different fields. But it is not very convenient to obtain real aerial images in some cases because of flight limitations, acquisition costs and other factors. So, it is necessary to simulate UAV infrared images by computer. This paper proposed an improved infrared aerial image simulation method based on open source AirSim. By improving the original AirSim infrared image simulation method, the simulation quality of the infrared image is improved via 3-dimensional segmented model processing. The infrared aerial images of the traffic scene with different viewing angles are simulated via the proposed method in this paper and we constructed infrared traffic scene simulation dataset (IR-TSS) containing seven types of objects. We propose the efficient EfficientNCSP-Net net for the IR-TSS dataset and use popular methods for comparative experiments. The experimental results show that the proposed EfficientNCSP-Net has an mAP50 greater than 96% for object detection on IR-TSS dataset, which is better than those of the existing methods. This paper not only contributes to research on infrared image simulations of traffic scenes, but also has referential significance in other aerial image simulation fields.

Postoperative Sexual Function After Vaginal Surgery and Clitoral Size, Position, and Shape

Transvaginal surgery is commonly performed to treat pelvic organ prolapse. Little research focuses on how sexual function relates to clitoral anatomy after vaginal surgery despite the clitoris' role in the sexual response. To determine how postoperative sexual function after vaginal surgery is associated with clitoral features (size, position, shape). This was a cross-sectional ancillary study of magnetic resonance imaging (MRI) data from the Defining Mechanisms of Anterior Vaginal Wall Descent (DEMAND) study. The setting comprised 8 clinical sites in the US Pelvic Floor Disorders Network and included the MRI data of 88 women with uterovaginal prolapse previously randomized to either vaginal mesh hysteropexy or vaginal hysterectomy with uterosacral ligament suspension between 2013 and 2015. Data were analyzed between September 2021 and June 2023. Participants underwent postoperative pelvic MRI at 30 to 42 months (or earlier if reoperation was desired) between June 2014 and May 2018. Sexual activity and function at baseline (preoperatively) and 24- to 48-month follow-up (postoperatively) were assessed using the Pelvic Organ Prolapse/Incontinence Sexual Questionnaire, International Urogynecological Association Revised (PISQ-IR). Clitoral features were derived from postoperative MRI-based 3-dimensional models. Correlations between (1) PISQ-IR mean, subscale, and item scores and (2) clitoral size, position, and shape (principal component scores). A total of 82 women (median [range] age, 65 [47-79] years) were analyzed (41 received hysteropexy and 41 received hysterectomy). Postoperatively, 37 were sexually active (SA), and 45 were not SA (NSA). Among SA women, better overall postoperative sexual function (higher PISQ-IR summary score) correlated with a larger clitoral glans width (Spearman ρ = 0.37; 95% CI, 0.05-0.62; P = .03) and thickness (Spearman ρ = 0.38; 95% CI, 0.06-0.63; P = .02). Among NSA women, sexual inactivity related to postoperative dyspareunia correlated with a more lateral clitoral position (Spearman ρ = 0.45; 95% CI, 0.18-0.66; P = .002), and sexual inactivity related to incontinence/prolapse correlated with a more posterior clitoral position (Spearman ρ = -0.36; 95% CI, -0.60 to -0.07; P = .02) (farther from the pubic symphysis). Shape analysis demonstrated that poorer postoperative sexual function outcomes in SA women and sexual inactivity in NSA women correlated with a more posteriorly positioned glans, anteriorly oriented clitoral body, medially positioned crura, and lateral vestibular bulbs. Results of this cross-sectional study suggest that postoperative sexual function after vaginal surgery was associated with clitoral glans size, position, and shape. Results warrant prospective studies on surgery-induced changes in clitoral anatomy and sexual function.

In Vivo Kinematics of the Distal Tibiofibular Syndesmosis With Different Loading Weights.

The distal tibiofibular syndesmosis (DTS) is crucial for maintaining ankle stability and distributing stress in the ankle joint. However, the in vivo kinematics of the DTS during high-impact activities remain unknown. This study aims to explore these kinematics and investigate the influence of additional trunk load using a high-speed dual fluoroscopy imaging system (DFIS). It was hypothesized that the maximum lateral translation of the DTS would not exceed the diagnostic threshold, and the range of motion (ROM) would increase with the addition of load. This study included 14 healthy participants. Magnetic resonance imaging (MRI) was used to create 3-dimensional models of the distal tibia and fibula. High-speed DFIS was employed to capture continuous fluoroscopic images of the DTS while participants performed single-leg landing jumps. A weighted vest was used to introduce additional load. DFIS data and 3D models were imported into virtual environment software to obtain kinematic data. A 1-way analysis of variance was conducted to compare 3-dimensional 6 degree-of-freedom kinematics and the joint's ROM before and after adding trunk load. The primary rotational movements of the DTS after ground contact were eversion and external rotation, whereas translational movements included lateral and downward translation. After adding additional load, the DTS showed a significantly greater maximum extension angle (2.70 ± 0.56 degrees vs 3.17 ± 0.59 degrees, P = .038) and flexion-extension ROM (2.74 ± 0.61 degrees vs 3.32 ± 0.83 degrees, P = .044) compared to preload conditions. The maximum internal rotation angle (0.25 ± 0.73 degrees vs 1.51 ± 0.86 degrees, P < .001) and internal-external rotation ROM (-2.09 ± 1.39 degrees vs 3.88 ± 1.10 degrees, P = .004) of the DTS were significantly greater after adding load. During single-leg landing, the primary movements of the DTS involve eversion and external rotation. With additional loading, the rotational angles of the DTS increase. The distal tibiofibular syndesmosis increases its rotational motion angle to accommodate higher loads.