Bilateral symmetry of the subtalar joint facets and the relationship between the morphology and osteoarthritic changes

Abstract

There is a paucity in the literature regarding bilateral symmetry between the facets of the subtalar joint. Often surgeons use the contralateral side as a reference when dealing with a fracture or other joint pathology. Moreover, the presence of osteoarthritic (OA) changes in the subtalar joint is suggested to have a relation with its morphology. In this study, we addressed both these issues. Forty pairs of cadaveric tali and calcanei were analyzed by dissection and measurement. Twenty pairs of asymptomatic calcanei were morphologically analyzed by computer tomography imaging. In the cadaveric feet, the length and width of the facets, the number and interfacet connections, the intersection angle, and the presence of OA changes were registered. In the healthy feet, the orientation and curvature of the posterior facet were analyzed based on cylinder fittings. Bilateral symmetry was tested with paired Student's t tests. Significant associations between morphometric parameters and the presence of OA changes were tested with generalized estimating equation logistic regression models. The morphometric data demonstrated a high degree of bilateral symmetry. The types of tali and calcanei between left and right differed in about one‐fifth of the individuals. No significant interactions were found between morphological parameters and the presence of OA changes. Only age had a significant association. There was a high degree of symmetry in the subtalar joints facets. No significant associations were found between OA changes and morphological features, whereas other studies did. Further research is needed to explore this relationship in further detail. Clin. Anat., 33:997–1006, 2020. © 2019 Wiley Periodicals, Inc.

Relationship between Joint and Ligament Structures of the Subtalar Joint and Degeneration of the Subtalar Articular Facet

“…The present study did not find any relationship between joint structure of the subtalar joint (number of articular facets of the talus and calcaneus, joint congruence, or intersecting angle) and degeneration of the subtalar articular facet. These results were similar to those described by Kleipool et al [11], who examined relationships between the number of articular facets, joint congruence, intersecting angle and degeneration of the subtalar articular facet in bone specimens with residual soft tissue. Kleipool et al [11] also considered that the degeneration of the subtalar articular facet observed in bleached bone may reflect secondary features of degeneration, while bone with remaining soft tissue may allow detection of early-stage degeneration of the articular cartilage.…”

“…These results were similar to those described by Kleipool et al [11], who examined relationships between the number of articular facets, joint congruence, intersecting angle and degeneration of the subtalar articular facet in bone specimens with residual soft tissue. Kleipool et al [11] also considered that the degeneration of the subtalar articular facet observed in bleached bone may reflect secondary features of degeneration, while bone with remaining soft tissue may allow detection of early-stage degeneration of the articular cartilage. In this study, articular cartilage degeneration and osteophyte formation were analyzed as degeneration of the subtalar articular facet, which may have allowed more comprehensive evaluation than in previous studies.…”

“…To disarticulate the calcaneus at the transverse tarsal joint, ligaments were cut in the following order: bifurcated ligament, dorsal calcaneocuboid ligament, plantar calcaneonavicular ligament, short plantar ligament, long plantar ligament, and plantar calcaneocuboid ligament. Based on previous studies [8,11,[18][19][20][21], the morphology of articular facets was classified by the number of articular facets in each talus and calcaneus according to the morphology of AF and MF. A morphology in which AF and MF were continuous and PF was isolated was considered a two-facet configuration, and a morphology in which AF, MF, and PF were isolated was considered a three-facet configuration (Figure 1).…”

“…Intersecting angle may therefore also be related to degeneration of the subtalar articular facet [8,9]. However, recent reports on bones with residual soft tissue, including cartilage, have found significant associations between morphology of the articular facet, joint congruence, or intersecting angle and degeneration of the subtalar articular facet [11], and agreement has been lacking among previous studies.…”

Relationship between Joint and Ligament Structures of the Subtalar Joint and Degeneration of the Subtalar Articular Facet

“…Intersecting angles may therefore also be related to degeneration of the subtalar articular facet [ 8 , 9 ]. However, recent reports on bones with residual soft tissue, including cartilage, found significant associations between morphology of the articular facet, joint congruence, or intersecting angle and degeneration of the subtalar articular facet [ 11 ], and agreement is lacking among previous studies.…”