Correlation of Compensatory Alignment of the Subtalar Joint to the Progression of Primary Osteoarthritis of the Ankle

Hayashi, Kôji; Tanaka, Yasuhito; Kumai, Tsukasa; Sugimoto, Kazuya; Takakura, Yoshinori

doi:10.3113/fai.2008.0400

Cited by 114 publications

(138 citation statements)

References 9 publications

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“…As reported by Stufkens et al [28], measurement of the medial distal tibial angle depends on radiograph technique and could be different. Our study therefore confirms and quantifies the observations of others who have indicated the common occurrence of coronal plane deformity compensation through the subtalar joint in patients with end-stage ankle arthritis [12,14,21,23]. It adds to the literature how much the coronal plane deformity is for the tibiotalar joint and subtalar joint in patients of end-stage ankle osteoarthritis, thus guiding physicians in achieving optimal positions of these joints.…”

Section: Discussionsupporting

confidence: 90%

“…However, there is a paucity of published Data presented as mean ± SD; using independent-samples t test; using Mann-Whitney U test; *negative values in talar tilting angle and tibiocalcaneal axis angle indicated varus position; **negative values in moment arm of calcaneus indicated the lowest point of the calcaneus was medial to the bisecting axis line of the tibia. data describing weightbearing ankle and hindfoot alignment in patients with end-stage ankle arthritis [12,21]. We therefore (1) compared ankle and hindfoot alignment of our study cohort with end-stage ankle arthritis with those of a control group; (2) explored the frequency of compensated malalignment between the tibiotalar and subtalar joints in our study cohort; and (3) assessed the intraobserver and interobserver reliability of classification methods of hindfoot alignment used in this study.…”

Section: Discussionmentioning

confidence: 99%

“…They postulated that ankle arthritis may progress after the subtalar compensatory function is lost based on their observations of a relatively small cohort with end-stage ankle arthritis [29]. Hayashi et al [12] documented subtalar joint inclination at the various arthritis stages by measuring the angle between the tibial shaft axis and the articular surface of the posterior facet of the calcaneus. They concluded that the subtalar compensation was found especially in patients with intermediate ankle arthritis [12].…”

Section: Discussionmentioning

confidence: 99%

“…The angle between the tibial axis and calcaneal axis (defined as line parallel to the lateral calcaneal wall) was measured as described by Seltzer et al [27] using the hindfoot alignment view. The moment arm of the calcaneus was measured as described by Saltzman and el-Khoury [25], positive values were defined as valgus alignment [2,12,21,25]. The subtalar joint was assessed using a Kellgren-Lawrence scoring system for arthritis [19].…”

Section: Methodsmentioning

confidence: 99%

“…To date, limited attention has been given to weightbearing hindfoot alignment [1,2,4,11,18,22,24,25,28,30,31] or possible compensatory mechanisms of the subtalar joint in patients with end-stage ankle arthritis [12,14,21,23]. Similarly, classification methods of hindfoot alignment remain controversial and are based mainly on clinical visual judgment or on radiographic measurement (eg, quantification of the tibiocalcaneal axis or the hindfoot ''apparent moment arm'') [8,9,21,25].…”

Section: Introductionmentioning

confidence: 99%

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Does the Subtalar Joint Compensate for Ankle Malalignment in End-stage Ankle Arthritis?

Wang

Saltzman

Chalayon

et al. 2015

Clinical Orthopaedics &Amp; Related Research

108

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Background Patients with ankle arthritis often present with concomitant hindfoot deformity, which may involve the tibiotalar and subtalar joints. However, the possible compensatory mechanisms of these two mechanically linked joints are not well known. Questions/purposes In this study we sought to (1) compare ankle and hindfoot alignment of our study cohort with end-stage ankle arthritis with that of a control group; (2) explore the frequency of compensated malalignment between the tibiotalar and subtalar joints in our study cohort; and (3) assess the intraobserver and interobserver reliability of classification methods of hindfoot alignment used in this study. Methods Between March 2006 and September 2013, we performed 419 ankle arthrodesis and ankle replacements (380 patients). In this study, we evaluated radiographs for 233 (56%) ankles (226 patients) which met the following inclusion criteria: (1) no prior subtalar arthrodesis; (2) no previously failed total ankle replacement or ankle arthrodesis; (3) with complete conventional radiographs (all three ankle views were required: mortise, lateral, and hindfoot alignment view). Ankle and hindfoot alignment was assessed by measurement of the medial distal tibial angle, tibial talar surface angle, talar tilting angle, tibiocalcaneal axis angle, and moment arm of calcaneus. The obtained values were compared with those observed in the control group of 60 ankles from 60 people. Only those without obvious degenerative changes of the tibiotalar and subtalar joints and without previous surgeries of the ankle or hindfoot were included in the control group. Demographic data for the patients with arthritis and the control group were comparable (sex, p = 0.321; age, p = 0.087). The frequency of compensated malalignment between the tibiotalar and subtalar joints, defined as tibiocalcaneal angle or moment arm of the calcaneus being greater or smaller than the same 95% CI statistical cutoffs from the control group, was tallied. All ankle radiographs were independently measured by two observers to determine the interobserver reliability. One of Each author certifies that he or she has no commercial associations (eg, consultancies, stock ownership, equity interest, patent/licensing arrangement etc) that might pose a conflict of interest in connection with the submitted article. All ICMJE Conflict of Interest Forms for authors and Clinical Orthopaedics and Related Research editors and board members are on file with the publication and can be viewed on request. Clinical Orthopaedics and Related Research neither advocates nor endorses the use of any treatment, drug, or device. Readers are encouraged to always seek additional information, including FDAapproval status, of any drug or device prior to clinical use. Each author certifies that his or her institution approved the human protocol for this investigation, that all investigations were conducted in conformity with ethical principles of research, and that informed consent for participation in the study was obtained. This ...

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Does the Subtalar Joint Compensate for Ankle Malalignment in End-stage Ankle Arthritis?

Wang

Saltzman

Chalayon

et al. 2015

Clinical Orthopaedics &Amp; Related Research

108

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Study on the three‐dimensional orientation of the posterior facet of the subtalar joint using simulated weight‐bearing CT

Kleipool

Dahmen

Vuurberg

et al. 2018

Journal Orthopaedic Research

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The purpose of this study was to describe the normal 3D orientation and shape of the subtalar calcaneal posterior facet. This is not adequately described in current literature. In a supine position both feet of 20 healthy subjects were imaged in a simulated weight‐bearing CT. A cylinder and plane were fitted to the posterior facet of the surface model. The orientation of both shapes was expressed by two angles in (1) the CT‐based coordinate system with the axis of the foot aligned with the sagittal axis and (2) a coordinate system based on the geometric principal axes of the subject's calcaneus. The subtalar vertical angle was determined in the intersection in three different coronal planes of the cylinder. The cylinder's axis oriented from supero‐postero‐laterally to infero‐antero‐medially. The plane's normal directed supero‐antero‐medially in the CT‐based coordinate system, and supero‐antero‐laterally in the other coordinate system. The subtalar vertical angle was significantly different (p < 0.001) between the three defined coronal planes and increased from anterior to posterior. The mean diameter of the fitted cylinder was 42.0 ± 7.7 mm and the root mean square error was 0.5 ± 0.1 mm. The posterior facet can be modelled as a segment of a cylinder with a supero‐postero‐lateral to infero‐antero‐medial orientation. The morphometry of the posterior facet in a healthy population serves as a reference in identifying abnormal subtalar joint morphology. More generally this study shows the need to include the full 3D morphology in assessing the orientation of the subtalar posterior facet. © 2018 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 9999:1–8, 2018.

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Imaging of the subtalar joint: A novel approach to an old problem

Krähenbühl

Lenz

Lisonbee

et al. 2019

Journal Orthopaedic Research

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Evaluation of the subtalar joint using conventional radiographs is difficult. The purpose of this study was to assess how the posterior facet of the subtalar joint is projected on eight standard radiographic views of the foot and ankle. Weightbearing computed tomography (CT) scans of 27 volunteers without ankle pathology were performed. Eight standard views of the foot and ankle (antero‐posterior [AP] view, mortise view, subtalar view, four different Broden views) were reconstructed using digitally reconstructed radiographs (DRRs). The appearance of the posterior facet of the subtalar joint was assessed for each view. In addition, the position of the joint line was projected onto three‐dimensional (3‐D) models of the calcaneus. We found (i) on the AP view of the ankle joint, the posterior part of the posterior facet is visualized and appears convex (calcaneal side); (ii) on the mortise view of the ankle joint, a slightly more anterior part (compared to the AP view) is visualized and appears either convex or flat; (iii) on the subtalar view, the anterior part of the posterior facet is visualized and appears either convex, flat or concave; and (iv) using the Broden views, the posterior and anterior part of the posterior facet can be visualized. This study clarifies which parts of the posterior facet of the subtalar joint are visualized on eight standard views of the foot and ankle. © 2019 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res

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Correlation of Compensatory Alignment of the Subtalar Joint to the Progression of Primary Osteoarthritis of the Ankle

Cited by 114 publications

References 9 publications

Does the Subtalar Joint Compensate for Ankle Malalignment in End-stage Ankle Arthritis?

Does the Subtalar Joint Compensate for Ankle Malalignment in End-stage Ankle Arthritis?

Study on the three‐dimensional orientation of the posterior facet of the subtalar joint using simulated weight‐bearing CT

Imaging of the subtalar joint: A novel approach to an old problem

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