Digital Planning of High Tibial Osteotomy Using Dicom versus Jpeg formats

This paper aims to test the reliability of digital osteotomy's correction angle between the two-image formats; Dicom and Jpeg using new software (OsteoAid). This is to ensure that the new software is reliable for both image formats for the correction. The hypothesis is to compare the reliability of the Centre of Rotation of Angulation (CORA) angle for each intra-rater and inter-rater reliability. CORA was defined and the angles of all patients’ legs were checked for correction to determine the accuracy of both image formats using an intra-class correlation coefficient (ICC). Thirteen digital long leg radiographs with longstanding positions from the frontal axis showing patients with both tibia deformities were examined. Those images were accessed from the Picture Archiving and Communication System (PACS). Three medical officers (raters) who were involved in an osteotomy used the same medical image format twice at a two-week interval. Using the Dicom format, the mean correction angle score of each rater is at excellent level: 0.949 (Intra-rater1), 0.987 (Intra-rater2) and 0.968 (Intra-rater3). Scores of each rater for Jpeg format are also excellent: 0.904, 0.928 and 0.962 respectively. The inter-rater reliabilities of the correction angle were 0.979 and 0.972 (p<0.001) respectively for each format. The principal finding of this study was that OsteoAid showed excellent reliabilities and consistency in preoperative planning in finding CORA and correction angle using both image formats. This indicates that the two image formats are comparable in obtaining CORA angles.