{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T00:03:17Z","timestamp":1784246597882,"version":"3.55.0"},"reference-count":32,"publisher":"Georg Thieme Verlag KG","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Knee Surg"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Preoperative planning for high tibial, distal femoral, and tibial tubercle osteotomies has traditionally relied on cross-sectional two-dimensional (2D) images obtained from computed tomography (CT) scans. However, recent studies have underscored the potential advantages of three-dimensional (3D) reconstruction in preoperative planning. The present study aims to compare lower extremity alignment parameters obtained using 2D and 3D measurement techniques before peri-articular osteotomies used to treat patellofemoral disorders. All lower extremity osteotomies performed between 2022 and 2024 at our institution were retrospectively identified. Eligible patients received both 2D and 3D CT measurements prior to surgical intervention. For both imaging modalities, tibial tuberosity-trochlear groove (TT-TG), tibial torsion, and Caton-Deschamps (CD) index measurements were obtained. Paired t-tests were used to assess discrepancies between radiographic measurements obtained from 2D and 3D reconstruction. Statistical significance was defined as p \u2264 0.05. In total, 52 patients (66.0% female) with a mean age of 31.1\u2009\u00b1\u20099.0 years were identified. Median 2D and 3D measurements were similar for TT-TG distance (16.0 vs. 16.3\u2009mm) and CD index (1.1 vs. 1.2), while median tibial torsion was greater on 2D compared with 3D imaging (27.0\u2009degrees vs. 22.7\u2009degrees). The average absolute difference between modalities were 3.1\u2009mm for TT-TG distance (interquartile range [IQR]: 1.0\u20135.0), 5.6\u2009degrees for tibial torsion (IQR: 1.0\u20137.5\u2009degrees), and 0.16 for CD index (IQR: 0.05\u20130.22). Statistically significant differences in tibial torsion measurements highlight potential limitations of 2D CT measurements in capturing 3D complexity. These findings suggest that 3D preoperative planning leads to improved accuracy in postoperative multi-planar alignment goals. Further research is needed to evaluate the clinical implications of these differences and to refine imaging protocols for preoperative planning.<\/jats:p>","DOI":"10.1055\/a-2908-1958","type":"journal-article","created":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T22:51:07Z","timestamp":1783464667000},"source":"Crossref","is-referenced-by-count":0,"title":["A Comparative Analysis of Lower Extremity Deformity Correction: Two-dimensional versus Three-dimensional Computed Tomography"],"prefix":"10.1055","author":[{"given":"Andrew","family":"Dobitsch","sequence":"additional","affiliation":[{"name":"USC Keck School of Medicine, California, United States","place":["Los Angeles"],"department":["Department of Orthopaedic Surgery"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryan C.","family":"Palmer","sequence":"additional","affiliation":[{"name":"USC Keck School of Medicine, California, United States","place":["Los Angeles"],"department":["Department of Orthopaedic Surgery"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Avinash","family":"Iyer","sequence":"additional","affiliation":[{"name":"USC Keck School of Medicine, California, United States","place":["Los Angeles"],"department":["Department of Orthopaedic Surgery"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Parul","family":"Sharma","sequence":"additional","affiliation":[{"name":"USC Keck School of Medicine, California, United States","place":["Los Angeles"],"department":["Department of Orthopaedic Surgery"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mckenzie","family":"Culler","sequence":"additional","affiliation":[{"name":"USC Keck School of Medicine, California, United States","place":["Los Angeles"],"department":["Department of Orthopaedic Surgery"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sahil S.","family":"Telang","sequence":"additional","affiliation":[{"name":"USC Keck School of Medicine, California, United States","place":["Los Angeles"],"department":["Department of Orthopaedic Surgery"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryan","family":"Freshman","sequence":"additional","affiliation":[{"name":"USC Keck School of Medicine, California, United States","place":["Los Angeles"],"department":["Department of Orthopaedic Surgery"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1293-1702","authenticated-orcid":false,"given":"Nathanael D.","family":"Heckmann","sequence":"additional","affiliation":[{"name":"University of Southern California, California, United States","place":["Los Angeles"],"department":["Department of Orthopaedic Surgery"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"George F. Rick","family":"Hatch III","sequence":"additional","affiliation":[{"name":"USC Keck School of Medicine, California, United States","place":["Los Angeles"],"department":["Department of Orthopaedic Surgery"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2026,7,16]]},"reference":[{"issue":"12","key":"ref1","first-page":"CD004019","article-title":"Osteotomy for treating knee osteoarthritis","volume":"2014","author":"R W Brouwer","year":"2014","journal-title":"Cochrane Database Syst Rev"},{"key":"ref2","first-page":"x","article-title":"Osteotomies about the knee: managing rotational deformities","volume":"x","author":"T J Reif","year":"2022","journal-title":"Oper Tech Sports Med"},{"key":"ref3","first-page":"187","article-title":"Correlation of pre-operative planning to surgical correction of opening wedge HTO: a radiographic study utilizing a manual measurement method","volume":"33","author":"S Vasta","year":"2019","journal-title":"J Biol Regul Homeost Agents"},{"issue":"04","key":"ref4","doi-asserted-by":"crossref","first-page":"368","DOI":"10.1055\/s-0032-1314957","article-title":"[Precision in the planning of open wedge HTO]","volume":"150","author":"S Schr\u00f6ter","year":"2012","journal-title":"Z Orthop Unfall"},{"issue":"06","key":"ref5","doi-asserted-by":"crossref","first-page":"1248","DOI":"10.1016\/j.orthres.2004.03.016","article-title":"Effects of rotation on measurement of lower limb alignment for knee osteotomy","volume":"22","author":"H Kawakami","year":"2004","journal-title":"J Orthop Res"},{"issue":"11","key":"ref6","doi-asserted-by":"crossref","first-page":"3169","DOI":"10.1111\/os.70118","article-title":"Comparison of two-dimensional and three-dimensional preoperative planning measurements for high tibial osteotomy","volume":"17","author":"H Bai","year":"2025","journal-title":"Orthop Surg"},{"issue":"11","key":"ref7","doi-asserted-by":"crossref","first-page":"3452","DOI":"10.1007\/s00167-018-4927-1","article-title":"More accurate correction can be obtained using a three-dimensional printed model in open-wedge high tibial osteotomy","volume":"26","author":"H J Kim","year":"2018","journal-title":"Knee Surg Sports Traumatol Arthrosc"},{"issue":"452","key":"ref8","doi-asserted-by":"crossref","first-page":"127","DOI":"10.1097\/01.blo.0000238823.78895.dc","article-title":"Computer-assisted navigation in TKA: where we are and where we are going","volume":"452","author":"R S Laskin","year":"2006","journal-title":"Clin Orthop Relat Res"},{"key":"ref9","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1016\/j.arth.2009.04.034","article-title":"Coronal alignment in total knee arthroplasty: just how important is it?","volume":"24","author":"D M Fang","year":"2009","journal-title":"J Arthroplasty"},{"issue":"09","key":"ref10","doi-asserted-by":"crossref","first-page":"2854","DOI":"10.1007\/s00167-019-05637-6","article-title":"Patient-specific high-tibial osteotomy's \u201ccutting-guides\u201d decrease operating time and the number of fluoroscopic images taken after a Brief Learning Curve","volume":"28","author":"C Jacquet","year":"2020","journal-title":"Knee Surg Sports Traumatol Arthrosc"},{"issue":"06","key":"ref11","doi-asserted-by":"crossref","first-page":"1359","DOI":"10.1016\/j.knee.2017.04.016","article-title":"Three dimensional-printed patient-specific cutting guides for femoral varization osteotomy: do it yourself","volume":"24","author":"J Arnal-Burr\u00f3","year":"2017","journal-title":"Knee"},{"issue":"S 02","key":"ref12","doi-asserted-by":"crossref","first-page":"S51","DOI":"10.1016\/j.injury.2018.07.017","article-title":"Preliminary results using patient-specific 3d printed models to improve preoperative planning for correction of post-traumatic tibial deformities with circular frames","volume":"49","author":"P S Corona","year":"2018","journal-title":"Injury"},{"issue":"02","key":"ref13","doi-asserted-by":"crossref","first-page":"245","DOI":"10.1016\/j.otsr.2016.11.020","article-title":"Can three-dimensional patient-specific cutting guides be used to achieve optimal correction for high tibial osteotomy? 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