Feasibility of MRI for the evaluation of interosseous ligament vertical segment via subtalar arthroscopy correlation: comparison of 2D and 3D MR images

Jung, Hong-Geun; Moon, Sung Gyu; Yoon, Deuk Young; Jang, Hyemin; Kang, Ji Hee

doi:10.1186/s12891-021-04759-8

Cited by 7 publications

(8 citation statements)

References 31 publications

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“…The footprint of the ACaL is oriented perpendicularly to the axis of motion, which makes the lateral part more vulnerable to injury. This explains the findings in MRI studies reporting a correlation between ACaL lesions and STI (Kim et al, 2017;Yoon et al, 2018;Jung et al, 2021). Besides inversion and eversion, both ITCL and ACaL get tensioned with anterior and posterior translation of the calcaneus and may provide stability in the anteroposterior direction.…”

Section: Multiaxial Motion Conceptmentioning

confidence: 80%

Role of the intrinsic subtalar ligaments in subtalar instability and consequences for clinical practice

Michels

Vereecke

Matricali

2023

Front. Bioeng. Biotechnol.

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Subtalar instability (STI) is a disabling complication after an acute lateral ankle sprain and remains a challenging problem. The pathophysiology is difficult to understand. Especially the relative contribution of the intrinsic subtalar ligaments in the stability of the subtalar joint is still controversial. Diagnosis is difficult because of the overlapping clinical signs with talocrural instability and the absence of a reliable diagnostic reference test. This often results in misdiagnosis and inappropriate treatment. Recent research offers new insights in the pathophysiology of subtalar instability and the importance of the intrinsic subtalar ligaments. Recent publications clarify the local anatomical and biomechanical characteristics of the subtalar ligaments. The cervical ligament and interosseous talocalcaneal ligament seem to play an important function in the normal kinematics and stability of the subtalar joint. In addition to the calcaneofibular ligament (CFL), these ligaments seem to have an important role in the pathomechanics of subtalar instability (STI). These new insights have an impact on the approach to STI in clinical practice. Diagnosis of STI can be performed be performed by a step-by-step approach to raise the suspicion to STI. This approach consists of clinical signs, abnormalities of the subtalar ligaments on MRI and intraoperative evaluation. Surgical treatment should address all the aspects of the instability and focus on a restoration of the normal anatomical and biomechanical properties. Besides a low threshold to reconstruct the CFL, a reconstruction of the subtalar ligaments should be considered in complex cases of instability. The purpose of this review is to provide a comprehensive update of the current literature focused on the contribution of the different ligaments in the stability of the subtalar joint. This review aims to introduce the more recent findings in the earlier hypotheses on normal kinesiology, pathophysiology and relation with talocrural instability. The consequences of this improved understanding of pathophysiology on patient identification, treatment and future research are described.

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Section: Multiaxial Motion Conceptmentioning

confidence: 80%

Role of the intrinsic subtalar ligaments in subtalar instability and consequences for clinical practice

Michels

Vereecke

Matricali

2023

Front. Bioeng. Biotechnol.

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“…18,19 Moreover, subtalar ligament reconstruction surgery, which is a simultaneous reconstruction of the ACL and CFL, has been reported to be useful in the treatment of subtalar instability. 37,38 Jung et al 31 reported that 3D isotropic MRI is reliable in the assessment of ACL injury. According to the other studies using 3D isotropic MRI, absence or complete tear of the ACL was significantly more common in subtalar instability patients than in controls or patients with lateral ankle instability, whereas abnormalities of CL, ITCL, or IER showed no significant difference between the groups.…”

Section: Discussionmentioning

confidence: 99%

“…Jung et al 31 reported that 3D isotropic MRI is reliable in the assessment of ACL injury. According to the other studies using 3D isotropic MRI, absence or complete tear of the ACL was significantly more common in subtalar instability patients than in controls or patients with lateral ankle instability, whereas abnormalities of CL, ITCL, or IER showed no significant difference between the groups 18,19 .…”

Section: Discussionmentioning

confidence: 99%

“…Anterior capsular ligament vertically links the talus and the calcaneus at the anterior border of the posterior subtalar joint, situated lateral and posterior to ITCL 10,11,14,30 . Anterior capsular ligament is also referred to as interosseous ligament vertical segment, and ITCL is referred to as interosseous ligament oblique segment 31 …”

Section: Methodsmentioning

confidence: 99%

“…10,11,14,30 Anterior capsular ligament is also referred to as interosseous ligament vertical segment, and ITCL is referred to as interosseous ligament oblique segment. 31…”

Section: Subtalar Ligaments Of Interestmentioning

confidence: 99%

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Comparative Analysis of Subtalar Ligaments Between Patients With Talocalcaneal Coalition and Control Subjects Using 3-Dimensional Magnetic Resonance Imaging

Kang¹,

Moon²,

Jung

et al. 2022

J Comput Assist Tomogr

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The purpose of this study was to find the differences in the subtalar ligaments between patients with talocalcaneal (TC) coalition and control subjects using 3-dimensional isotropic magnetic resonance imaging.Methods: Magnetic resonance imaging of 27 ankles with TC coalition and 27 age-and sex-matched controls were retrospectively reviewed. Absence of cervical ligament, anterior capsular ligament (ACL), interosseous TC ligament (ITCL), and partial or complete absence of 3 roots of the inferior extensor retinaculum was analyzed. Thickness and width of ACL and ITCL were measured when possible.Results: Absence of ACL and ITCL was significantly more frequent in TC coalition patients than in controls (59.2% vs 7.4%, P < 0.0001; 44.4% vs 7.4%, P = 0.004). Absence of cervical ligament and 3 roots of the inferior extensor retinaculum did not differ between the 2 groups. Thickness and width of ACL were significantly smaller in TC coalition patients than in control subjects (0.81 ± 0.23 vs 1.27 ± 0.41 mm, P < 0.0001; 5.26 ± 1.17 vs 7.07 ± 1.46 mm, P = 0.001). Thickness and width of ITCL did not differ between the 2 groups. In the TC coalition group, the absence of ACL and ITCL did not differ according to coalition type, patient demographics, and magnetic resonance imaging units. Conclusions:Anterior capsular ligament and ITCL are frequently absent in TC coalition patients. Even when present, the ACL is attenuated in TC coalition patients compared with controls.

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Increased subtalar rotational motion in patients with symptomatic ankle instability under load and stress conditions

Fernández‐Marín,

González‐Martín,

Herrera‐Pérez

et al. 2023

Knee surg. sports traumatol. arthrosc.

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Purpose Diferentiating subtalar and ankle instability in the clinical setting is challenging. This study aims to analyze the rotational laxity of the subtalar joint bilaterally in patients with asymptomatic and symptomatic ankle instability under simulated load and stress-induced position of the subtalar joint. Methods A case-control study was conducted using an adjustable load device (ALD). Patients with chronic ankle instability and healthy volunteers were included. Each subject underwent a CT scan under mechanical stress and simulated weightbearing conditions, maintaining maximum eversion and inversion hindfoot positions. The images were obtained in a single model, allowing calculations of the motion vector as well as the helical axis. The helical axis was deined by a rotation angle and a translation distance. Results A total of 72 feet were included in the study. Thirty-one patients with unilateral symptoms and ive healthy controls were selected, deining two groups: symptomatic (n = 31) and asymptomatic (n = 41). An absolute diference of 4.6º (95%CI 2-11.1) rotation angle was found on the helical axis of the symptomatic vs. asymptomatic group (p = 0.001). No signiicant diferences were detected in the translation distance (n.s.) between the groups. Additionally, a signiicant positive correlation was found between the rotation angle and translation distance through the helical axis in the asymptomatic group (r = 0.397, p = 0.027). Conclusion Patients with chronic ankle instability suspected of having subtalar joint instability showed a wider subtalar range of laxity in terms of rotation about the helical axis. Furthermore, diferences in kinematics between symptomatic and asymptomatic hindfeet was demonstrated when both feet were compared. Level of evidence III.

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Feasibility of MRI for the evaluation of interosseous ligament vertical segment via subtalar arthroscopy correlation: comparison of 2D and 3D MR images

Cited by 7 publications

References 31 publications

Role of the intrinsic subtalar ligaments in subtalar instability and consequences for clinical practice

Role of the intrinsic subtalar ligaments in subtalar instability and consequences for clinical practice

Comparative Analysis of Subtalar Ligaments Between Patients With Talocalcaneal Coalition and Control Subjects Using 3-Dimensional Magnetic Resonance Imaging

Increased subtalar rotational motion in patients with symptomatic ankle instability under load and stress conditions

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