A Minimally Disruptive Model and Three-Dimensional Evaluation of Lisfranc Joint Diastasis

Panchbhavi, Vinod K.; Andersen, Clark R.; Vallurupalli, Santaram; Yang, Jinping

doi:10.2106/jbjs.g.01420

Cited by 43 publications

(34 citation statements)

References 10 publications

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“…Ligament damage in OA has traditionally been associated with secondary traumatic OA, such as that following anterior cruciate ligament rupture. Recent MRI and in vitro studies, however, suggest that ligaments and insertions can play a role in the degenerative joint process at other sites (16,17). In this study, we observed that ligament damage along with bone marrow edema and fractures were common in patients with early NJD.…”

Section: Discussionmentioning

confidence: 47%

Ligament and bone pathologic abnormalities more frequent in neuropathic joint disease in comparison with degenerative arthritis of the foot and ankle: Implications for understanding rapidly progressive joint degeneration

Halstead¹,

Bergin²,

Keenan³

et al. 2010

Arthritis & Rheumatism

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Objective. The variable disease progression of osteoarthritis (OA) and the basis for rapid joint deterioration in some subgroups of patients are poorly understood. To explore an anatomic basis for rapidly progressive OA, this observational study compared the magnetic resonance imaging (MRI) patterns of disease between patients with neuropathic joint disease (NJD) and patients with degenerative arthritis of the ankle and foot.Methods. MR images of the foot and ankle of patients with early NJD (n ‫؍‬ 7) and patients with OA (n ‫؍‬ 15) were assessed. The anonomized MR images were dichotomously scored by a musculoskeletal radiologist for the presence of the following abnormalities per bone (of a total of 14 bones): cartilage defects, bone cysts, bone marrow edema, fractures, joint debris, joint effusions, tendinopathy, tendinitis, and ligament tears.Results. Although the degree of cartilage damage and joint cyst formation was comparable between the groups, the degree of ligament tears, or change in MRI signal intensity in the ligaments, was significantly greater in patients with NJD compared with patients with OA (median of 3 tears versus 0, of 14 total bones; P < 0.01). Moreover, in patients with early NJD compared with patients with OA, there was a significantly greater degree of diffuse bone marrow edema (median of 6.5 tarsal bones versus 2 adjacent bones, of 14 total bones; P < 0.01), a greater number of bone fractures (median 4 versus 0; P < 0.01), and more frequent bone debris (median 4.5 versus 0; P ‫؍‬ 0.013).Conclusion. This analysis of NJD in the foot and ankle shows the predominance of bone and ligament abnormalities in NJD compared with the pattern of involvement in OA. These findings highlight the importance of structures other than articular cartilage in OA of the ankle and foot, and suggest that rapid joint degeneration in NJD may be more ligamentogenic or osteogenic in nature.Osteoarthritis (OA) is a major cause of morbidity and suffering, particularly in the older population. In advanced cases, OA may lead to severe functional impairment and disability. The progression of OA is heterogeneous, and its course may be rapidly progressive at one extreme and remain relatively stable at the other. The basis for this variable prognosis is poorly understood, but scintigraphic (1) and magnetic resonance imaging (MRI) studies have shown that synovitis and bone marrow edema (attributed to inflammatory infiltrates, extracellular fluid, and fibrosis) can be associated with disease progression (2). There are only limited imaging data on the anatomic factors that may be predictive of progressive degenerative joint disease at the time that the radiographic findings are still normal.

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Section: Discussionmentioning

confidence: 47%

Ligament and bone pathologic abnormalities more frequent in neuropathic joint disease in comparison with degenerative arthritis of the foot and ankle: Implications for understanding rapidly progressive joint degeneration

Halstead¹,

Bergin²,

Keenan³

et al. 2010

Arthritis & Rheumatism

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“…The TMT joint was easy to be injured when the load was axially loaded to the ankle in an extreme plantar flexion state. Therefore, in this study the specimen was axially loaded in 30° plantar flexion of the ankle with the maximum load of 600N (body weight of a normal adult) 6. Actually, in gait cycle, the TMT joint bears more than 600N, however, when the load exceeded 600N, the fixation of ankle in 30°plantar flexion would easily failed.…”

Section: Discussionmentioning

confidence: 99%

The biomechanical study of the influence to the forefoot plantar pressure of the first tarsometatarsal joint fracture-dislocation fixed by three different implants

Pang

Chen

2017

Pak J Med Sci

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Objectives:To study the influence of forefoot plantar pressure of the first tarsometatarsal joint fracture-dislocation by three different implants to provide experimental reference in selecting implants.Methods:Eight fresh foot specimens were made into the models of the first tarsometatarsal joint fracture-dislocation, which were fixed with 3.5 mm cortical screw, 1/4 tubular plate and compressive staple in turn. After the loading of 600N, the changes of the plantar pressure in forefoot were measured by the method of the F-scan plantar pressure system.Results:After first tarsometatarsal joint fracture-dislocation, the peak pressure under the first metatarsal head would decrease, while the pressure under the second metatarsal head would increase(P<0.05). When the first tarsometatarsal joint was fixed with screw or plate respectively; the peak pressure under the two metatarsal heads would tend to be normal. However, the staple fixation would show the statistical significant difference, although the peak pressure under the first and second metatarsal heads were recovered in some extent(P<0.05).Conclusions:After the first tarsometatarsal joint fracture-dislocation, the plantar pressure might be compensated partly by the adjacent metatarsal heads. While the first tarsometatarsal joint fracture-dislocation was fixed by screw or plate, the plantar pressure of the forefoot would return to the normal state. However, if the joint was fixed by the staple, it would still be difficult to return the plantar pressure to be normal.

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“…T he objective of the present study was to compare the stability provided by a suture button with that provided by a screw when used to stabilize the diastasis associated with a Lisfranc ligament injury with use of a three-dimensional analysis technique and a minimally disruptive model 21 . Our results demonstrated that, in these cadaveric specimens with a simulated static weight-bearing load, reduction and stabilization of the Lisfranc joint with the suture button achieved fixation equivalent to that achieved with a cannulated screw following isolated transection of the Lisfranc ligament.…”

Section: Discussionmentioning

confidence: 99%

Screw Fixation Compared with Suture-Button Fixation of Isolated Lisfranc Ligament Injuries

Panchbhavi

Vallurupalli

Yang

et al. 2009

The Journal of Bone and Joint Surgery-American Volume

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104

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A Minimally Disruptive Model and Three-Dimensional Evaluation of Lisfranc Joint Diastasis

Abstract: Isolated sectioning of the Lisfranc ligament is sufficient to consistently create diastasis at the Lisfranc joint. Dorsal displacements between the first cuneiform and second metatarsal are a modest predictor of plantar displacements.

Cited by 43 publications

References 10 publications

Ligament and bone pathologic abnormalities more frequent in neuropathic joint disease in comparison with degenerative arthritis of the foot and ankle: Implications for understanding rapidly progressive joint degeneration

Ligament and bone pathologic abnormalities more frequent in neuropathic joint disease in comparison with degenerative arthritis of the foot and ankle: Implications for understanding rapidly progressive joint degeneration

The biomechanical study of the influence to the forefoot plantar pressure of the first tarsometatarsal joint fracture-dislocation fixed by three different implants

Screw Fixation Compared with Suture-Button Fixation of Isolated Lisfranc Ligament Injuries

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