A high rate of talocalcaneal interosseous ligament tears was found in chronic lateral ankle instability with sinus tarsi pain

Song, Won Tae; Lee, Jongwon; Lee, Jung Ho; Lim, Ji Hong; Im, Jemin; Lee, Dong‐Oh; Jung, Hong-Geun

doi:10.1007/s00167-021-06651-3

Cited by 12 publications

(1 citation statement)

References 35 publications

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“…Subtalar joint instability is an entity commonly neglected within the scope of lateral ankle instability in patients of all ages; up to 25% of chronic ankle instabilities have associated subtalar instability [ 2 , 24 , 30 ], which could account for some of the cases with persistent symptoms after isolated repair or reconstruction of the anterior talo-fibular ligament [ 38 ]. A recent study found 90% of patients with chronic lateral ankle instability and sinus tarsi pain had ITCL tears [ 36 ]. Patients complain of giving way of the ankle, especially over irregular terrain or during athletic activity, and report pain on the lateral side of the hindfoot and the sinus tarsi.…”

Section: Introductionmentioning

confidence: 99%

Reconstruction of the interosseous talocalcaneal ligament using allograft for subtalar joint stabilization is effective

Iglesias‐Durán,

Guerra‐Pinto,

Ojeda‐Thies

et al. 2023

Knee surg. sports traumatol. arthrosc.

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Purpose The aim of this study was to assess the biomechanical effects of subtalar ligament injury and reconstruction on stability of the subtalar joint in all three spatial planes. Methods Fifteen fresh frozen cadaveric legs were used, with transfixed tibiotalar joints to isolate motion to the subtalar joint. An arthrometer fixed to the lateral aspect of the calcaneus measured angular displacement in all three spatial planes on the inversion and eversion stress tests. Stress manoeuvres were tested with the intact joint, and then repeated after sequentially sectioning the inferior extensor retinaculum (IER), cervical ligament (CL), interosseous talocalcaneal ligament (ITCL), arthroscopic graft reconstruction of the ITCL, and sectioning of the calcaneo-fibular ligament (CFL). Results Sectioning the ITCL significantly increased angular displacement upon inversion and eversion in the coronal and sagittal planes. Reconstruction of the ITCL significantly improved angular stability against eversion in the axial and sagittal planes, and against inversion in the axial and coronal planes, at the zero time point after reconstruction. After sectioning the CFL, resistance to eversion decreased significantly in all three planes. Conclusion Progressive injury of ligamentous stabilisers, particularly the ITCL, led to increasing angular displacement of the subtalar joint measured with the inversion and eversion stress tests, used in clinical practice. Reconstruction of the ITCL using tendon graft significantly stabilised the subtalar joint in the axial and sagittal planes against eversion and in the axial and coronal planes against inversion, immediately after surgery.

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Section: Introductionmentioning

confidence: 99%

Reconstruction of the interosseous talocalcaneal ligament using allograft for subtalar joint stabilization is effective

Iglesias‐Durán,

Guerra‐Pinto,

Ojeda‐Thies

et al. 2023

Knee surg. sports traumatol. arthrosc.

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Kinematic alignment matches functional alignment for the extension gap: a consecutive analysis of 749 primary varus osteoarthritic knees with stress radiographs

Sappey‐Marinier

Meynard

Shatrov

et al. 2022

Knee Surg Sports Traumatol Arthrosc

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Purpose The alignment goal in total knee arthroplasty (TKA) remains debated. Two major strategies have emerged based on recreating the native knee: kinematic and functional alignment (KA and FA). Recently a new Coronal Plane Alignment of the Knee (CPAK) classiication for KA, based on bony landmarks, was described considering joint line obliquity and the arithmetic HipKneeAnkle angle (aHKA). Valgus corrected HKA medial angle (vcHKA) was measured on distractive valgus preoperative radiographs compensating for cartilage wear and ligament balance in varus osteoarthritis. The purpose of this study was to determine if aHKA accounts for diferences in medial laxity for the extension gap by comparing vcHKA to aHKA. The hypothesis was that no signiicant diference would be observed between the two measurements. Methods This is a retrospective analysis of 749 knees in consecutive patients presenting to a single-centre with primary medial osteoarthritis. Patients underwent standardized weight bearing long-leg and valgus stress radiographs. Tibial mechanical angle (TMA), femoral mechanical angle (FMA) and vcHKA were measured using digital software. aHKA and vcHKA were compared to determine diferences due to soft tissue balancing. ResultsThe mean FMA was 91.3 ± 2.2° (range 82°-97°), the mean TMA was 85.7 ± 2.5° (range 75°-98°), the mean aHKA was 177.0 ± 3.0° (range 164°-185°) and the mean vcHKA was 176.6 ± 3.1° (range 165°-192°). No signiicant diference was observed between aHKA and vcHKA (p = 0.06). A signiicant correlation was found between vcHKA and TMA (ρ = 0.3; p < 0.001) and between vcHKA and FMA (ρ = 0.41; p < 0.001). Conclusion This study showed that vcHKA was similar to aHKA conirming that aHKA accounts for ligamentous medial laxity. Therefore, kinematic alignment based on the CPAK classiication matches the pre-arthritic coronal alignment of the knee for the extension gap. Level of evidence IV.

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Patellar shift ratio (PSR) is the optimal measurement for characterising lateral patellar shift and a reliable predictor of recurrent patellar dislocation

Chen

et al. 2022

Knee Surg Sports Traumatol Arthrosc

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PurposeTo propose a new measurement, the patellar shift ratio (PSR), for characterising lateral patellar shift; to determine its diagnostic accuracy in predicting recurrent patellar dislocation (RPD); and to identify the effect of patellar tilt and morphology on shift measurements. MethodsVariables including the PSR, bisect offset (BSO), BSO adjusted by trigonometric analysis, linear patellar displacement (LPD) distance and congruence angle were measured on axial computed tomography (CT). Furthermore, PSR was classified into grades determined by the threshold generated by receiver operating characteristic (ROC) curves. Youden’s index was used to identify the ideal threshold on the curve. The area under the ROC curve (AUC) values and likelihood ratios were calculated to assess diagnostic performance in predicting RPD. Correlation analysis was conducted to identify the effects of lateral tilt and the Wiberg index on lateral shift. Intra‐ and interobserver reliability were evaluated using the intraclass correlation coefficient. ResultsThe study included 54 RPD patients and 54 controls matched by sex and age. The threshold for PSR was 24.3% (sensitivity, 96.30%; specificity, 85.19%). AUCs were categorised as excellent for all protocols (P < 0.001). The positive likelihood ratio of the PSR for predicting RPD was 6.50. PSR was categorised in terms of lateral trochlear quadrants consisting of 25% increments. Lateral patellar tilt showed a strong positive correlation with BSO (P < 0.001); moderate correlations with PSR, LPD distance and adjusted BSO (P ≤ 0.001); and a weak correlation with congruence angle (P = 0.034). The Wiberg index presented a positive moderate correlation with BSO (P < 0.001), while no correlation was found with PSR, LPD distance, or congruence angle (n.s.). All parameters showed good repeatability (intraobserver) and reproducibility (interobserver). ConclusionsThe PSR showed excellent diagnostic performance as indicated by likelihood ratios, measurement accuracy (being relatively resistant to the effects of tilt and the Wiberg index), and intra‐ and interobserver reliability. The optimal PSR threshold for predicting RPD risk was 24.3%, and the grade of PSR (normal, 1–4) was also a reliable and easily calculated predictor of RPD. This quantifying method to characterise lateral patellar shift is an alternative useful method for clinical assessments of RPD patients and for research on patellofemoral congruence. Level of evidenceLevel III

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A high rate of talocalcaneal interosseous ligament tears was found in chronic lateral ankle instability with sinus tarsi pain

Cited by 12 publications

References 35 publications

Reconstruction of the interosseous talocalcaneal ligament using allograft for subtalar joint stabilization is effective

Reconstruction of the interosseous talocalcaneal ligament using allograft for subtalar joint stabilization is effective

Kinematic alignment matches functional alignment for the extension gap: a consecutive analysis of 749 primary varus osteoarthritic knees with stress radiographs

Patellar shift ratio (PSR) is the optimal measurement for characterising lateral patellar shift and a reliable predictor of recurrent patellar dislocation

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