MRI features most often associated with surgically proven tears of the spring ligament complex

Williams, Glynn D.; Widnall, James; Evans, Paul; Platt, Simon

doi:10.1007/s00256-013-1618-3

Cited by 31 publications

(13 citation statements)

References 24 publications

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“…In addition, associated pathologies such as spring ligament (Yao et al 1999; Williams et al 2013) and sinus tarsi abnormalities are seen on MRI especially in advanced PTT dysfunction and could then be addressed during surgery (Balen and Helms 2001; Shibuya et al 2008). For these indications, the use of MRI partially competes with other imaging modalities.…”

Section: Discussionmentioning

confidence: 99%

Comparison of preoperative MRI and intraoperative findings of posterior tibial tendon insufficiency

et al. 2016

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BackgroundThe purpose of this study was to investigate the radiological and surgical correlation between preoperative magnetic resonance images (MRI) and the intraoperative findings in patients with acquired adult flatfoot.ResultsThe overall radiological–surgical correlation between preoperative MRI and the intraoperative findings for posterior tibial tendon insufficiency was only slight to fair in our patient’s series. Comparing the most commonly used posterior tibial tendon classification systems, the classification of Rosenberg et al. and Kong et al. showed higher interobserver agreement than our modified classification system and the classification system of Conti et al.ConclusionFurther prospective studies are needed to evaluate the importance of preoperative MRI before surgical repair of posterior tibial tendon dysfunction.

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Section: Discussionmentioning

confidence: 99%

Comparison of preoperative MRI and intraoperative findings of posterior tibial tendon insufficiency

et al. 2016

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“…4 Compromise of the SL has been implicated as a primary causative factor in peritalar subluxation. 6,16 Therefore surgical repair or reconstruction of the ligament has become an important adjunct to treating posterior tibial tendon abnormalities. [17][18][19][20] This requires extensive soft-tissue dissection because the ligament is a deep structure.…”

Section: Discussionmentioning

confidence: 99%

“…The fibrocartilaginous articular surface and integrity of the SL can be examined from its calcaneal insertion to its navicular insertion (Fig 4, Video 1). 6,8 If a tear of the SL is confirmed, the ligament can be exposed and repair performed either in an open manner or arthroscopically.…”

Section: Techniquementioning

confidence: 99%

“…Preoperatively, SL tears can be assessed by sonography 5 and magnetic resonance imaging. 6,7 However, the sensitivity of preoperative investigations is only moderate. 6 We report a technique for arthroscopic assessment of the integrity of the SL that can be incorporated into posterior tibial tendoscopy, as shown in the illustrated case, or during open exploration and reconstruction of the posterior tibial tendon.…”

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confidence: 99%

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Posterior Tibial Tendoscopy: Endoscopic Synovectomy and Assessment of the Spring (Calcaneonavicular) Ligament

Lui¹

2015

Arthroscopy Techniques

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A tear of the spring ligament is frequently associated with posterior tibial tendon dysfunction. Repair of the damaged spring ligament is an important component of surgical reconstruction in the treatment of posterior tibial tendon dysfunction because it is a major anatomic contributor to the integrity of the medial longitudinal arch, particularly if the dynamic support of the posterior tibial tendon is compromised. Extensive dissection is required for exposure and repair of the ligament because it is a deep-seated structure. It is beneficial to confirm the presence of ligament tears before surgical exploration to avoid unnecessary dissection. Preoperative magnetic resonance imaging and ultrasound studies have moderate sensitivity in the detection of these tears. We report an arthroscopic technique for assessment of the integrity of the spring ligament during endoscopic or open reconstruction of the posterior tibial tendon. This allows the surgeon to confirm the presence of a ligament tear before additional dissection to explore and repair the ligament.

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“…Limited literature exists regarding the MRI appearance of spring ligament tears. [27][28][29][30] In 1999 Yao et al reported 13 surgically proven cases of rupture or laxity of the spring ligament complex, a moderate sensitivity (55-77%) but a high specificity (100%) of MR imaging. 27 The best criteria of an insufficient spring ligament was thickening of >6 mm and signal heterogeneity of the smCNL best depicted on proton-weighted images.…”

Section: Mr Findings Of Spring Ligament Complex Injuriesmentioning

confidence: 99%

Spring Ligament Complex and Posterior Tibial Tendon: MR Anatomy and Findings in Acquired Adult Flatfoot Deformity

Mengiardi

Pinto

Zanetti

2016

Semin Musculoskelet Radiol

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The spring ligament complex is an important stabilizer of the medial ankle, together with the posterior tibial tendon (PTT) and the deltoid ligament complex. Lesions in these stabilizers result in acquired adult flatfoot deformity. The spring ligament complex includes three ligaments: the superomedial calcaneonavicular ligament, the medioplantar oblique calcaneonavicular ligament, and the inferoplantar longitudinal calcaneonavicular ligament. Normal MR imaging anatomy of the spring ligament complex and the PTT are described and illustrated in detail. Isolated lesions of the spring ligament complex are rare. In most cases, spring ligament complex lesions are secondary to PTT dysfunction. The best criteria for an injury of the clinically relevant superomedial calcaneonavicular ligament are increased signal on proton-density or T2-weighted sequences with thickening (> 5 mm), thinning (< 2 mm), or partial or complete discontinuity. A thickened ligament can be simulated by the gliding layer between the PTT and the superomedial calcaneonavicular ligament (thickness: 1?3 mm). The most common location of injury is the superior and distal portion of the superomedial calcaneonavicular ligament. A lesion seen by the orthopedic foot surgeon at the junction between the tibiospring ligament and the superomedial portion of the calcaneonavicular ligament is commonly classified as a spring ligament injury. In addition, an overview of MR imaging findings in different stages of the acquired adult flatfoot deformity is provided.

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MRI features most often associated with surgically proven tears of the spring ligament complex

Cited by 31 publications

References 24 publications

Comparison of preoperative MRI and intraoperative findings of posterior tibial tendon insufficiency

Comparison of preoperative MRI and intraoperative findings of posterior tibial tendon insufficiency

Posterior Tibial Tendoscopy: Endoscopic Synovectomy and Assessment of the Spring (Calcaneonavicular) Ligament

Spring Ligament Complex and Posterior Tibial Tendon: MR Anatomy and Findings in Acquired Adult Flatfoot Deformity

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