Can Weightbearing Computed Tomography Scans Be Used to Diagnose Subtalar Joint Instability? A Cadaver Study
| Autor: | Nathan P. Davidson, Heath B. Henninger, Chelsea McCarty Allen, Alexej Barg, Charles L. Saltzman, Nicola Krähenbühl, Arne Burssens |
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| Rok vydání: | 2019 |
| Předmět: |
musculoskeletal diseases
Joint Instability Male Radiography 0206 medical engineering 02 engineering and technology Instability 03 medical and health sciences 0302 clinical medicine Cadaver Deltoid ligament Subtalar joint medicine Humans Orthopedics and Sports Medicine Joint (geology) Aged 030203 arthritis & rheumatology Orthodontics business.industry Subtalar Joint Middle Aged 020601 biomedical engineering body regions medicine.anatomical_structure Ligament Ankle business Tomography X-Ray Computed human activities |
| Zdroj: | Journal of orthopaedic research : official publication of the Orthopaedic Research Society. 37(11) |
| ISSN: | 1554-527X |
| Popis: | Chronic hindfoot instability is a frequent problem that includes the ankle and/or the subtalar joint. While ankle joint instability can be diagnosed clinically, accurate assessment of the subtalar joint remains elusive. This study's purpose was to assess the ability of weightbearing computed tomography (CT) scans to detect subtalar joint instability. Seven pairs of fresh frozen male cadavers (tibial plateau to toe-tip) were tested. A radiolucent frame held specimens in a plantigrade position while non-weightbearing and weightbearing CT scans (with and without torque application) were taken. First, intact ankles (Native) were scanned. Second, one specimen from each pair underwent interosseous talo-calcaneal ligament (ITCL) transection, while the contralateral underwent calcaneo-fibular ligament (CFL) transection. Third, the remaining intact ITCL or CFL was transected. Finally, the deltoid ligament was transected in all ankles. Eight radiographic measurements were performed to assess the congruency of the subtalar joint on digitally reconstructed radiographs and single CT images. Axial loading did not impact most measurements, whereas torque did impact most measurements. Radiographic measurements performed at the subtalar joint level were more reliable and better predictors for subtalar joint instability compared with measurements performed at the ankle joint level. While torque application is crucial to identify subtalar joint instability, axial load application should be avoided. Measurements to assess the subtalar joint stability should primarily be performed at the subtalar joint level rather than at the ankle joint level when using weightbearing CT scans. © 2019 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 37:2457-2465, 2019. |
| Databáze: | OpenAIRE |
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