Acute and Chronic Subtalar Joint Instability

Bell, Kerri Lynne; King, Brandon William; Sangeorzan, Bruce J.

doi:10.1016/j.fcl.2022.12.008

Cited by 2 publications

(1 citation statement)

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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 ].…”

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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