Correlation of Talar Anatomy and Subtalar Joint Alignment on Weightbearing Computed Tomography With Radiographic Flatfoot Parameters

Cody, Elizabeth; Williamson, Emilie; Burket, Jayme C.; Deland, Jonathan T.; Ellis, Scott J.

doi:10.1177/1071100716646629

Cited by 84 publications

(67 citation statements)

References 16 publications

(35 reference statements)

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“…Studies using single weight‐bearing CT images showed significant differences in the orientation of the posterior facet from anterior to posterior (screw shape morphology) . We found similar results using DRRs: The posterior aspect of the joint (45/10 degrees Broden view) showed a more varus inclination compared to the anterior aspect, which was in a more neutral alignment.…”

Section: Discussionsupporting

confidence: 73%

“…The role the subtalar joint plays in the development of ankle joint disorders has been investigated extensively in recent years . It has been suggested that the subtalar joint morphology (e.g., convex vs. flat) and orientation (e.g., slope) specifically of the posterior facet may influence the evolution of ankle osteoarthritis .…”

mentioning

confidence: 99%

“…With the introduction of weightbearing computed tomography (CT) scans, a more detailed analysis of the subtalar joint during loading became possible . Recent studies using weightbearing CT have shown that the morphology of the posterior facet in the coronal plane differs between individuals . Although a promising technology for imaging the subtalar joint, weightbearing CT scans have yet to become a clinical standard.…”

mentioning

confidence: 99%

“…The role the subtalar joint plays in the development of ankle joint disorders has been investigated extensively in recent years. [1][2][3][4][5][6][7][8][9][10] It has been suggested that the subtalar joint morphology (e.g., convex vs. flat) and orientation (e.g., slope) specifically of the posterior facet may influence the evolution of ankle osteoarthritis. 6,10 In addition, assessment of the subtalar joint during reconstructive surgery (e.g., fixation of calcaneal or talus fractures, correcting osteotomies, etc.)…”

mentioning

confidence: 99%

“…5,11 Recent studies using weightbearing CT have shown that the morphology of the posterior facet in the coronal plane differs between individuals. 1,2,[5][6][7][8][9]12 Although a promising technology for imaging the subtalar joint, weightbearing CT scans have yet to become a clinical standard. Bearing this in mind, radiographs will continue to serve as the primary means to assess foot and ankle disorders, including subtalar pathology.…”

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confidence: 99%

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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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Section: Discussionsupporting

confidence: 73%

mentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

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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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Unique shape variations of hind and midfoot bones in flatfoot subjects—A statistical shape modeling approach

et al. 2022

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Flatfoot deformity is a prevalent hind‐ and midfoot disorder. Given its complexity, single‐plane radiological measurements omit case‐specific joint interaction and bone shape variations. Three‐dimensional medical imaging assessment using statistical shape models provides a complete approach in characterizing bone shape variations unique to flatfoot condition. This study used statistical shape models to define specific bone shape variations of the subtalar, talonavicular, and calcaneocuboid joints that characterize flatfoot deformity, that differentiate them from healthy controls. Bones of the aforementioned joints were segmented from computed tomography scans of 40 feet. The three‐dimensional hindfoot alignment angle categorized the population into 18 flatfoot subjects (≥7° valgus) and 22 controls. Statistical shape models for each joint were defined using the entire study cohort. For each joint, an average weighted shape parameter was calculated for each mode of variation, and then compared between flatfoot and controls. Significance was set at p < 0.05, with values between 0.05 ≤ p < 0.1 considered trending towards significance. The flatfoot population showed a more adducted talar head, inferiorly inclined talar neck, and posteriorly orientated medial subtalar articulation compare to controls, coupled with more navicular eversion, shallower navicular cup, and more prominent navicular tuberosity. The calcaneocuboid joint presented trends of a more adducted calcaneus, more abducted cuboid, narrower calcaneal roof, and less prominent cuboid beak compared to controls. Statistical shape model analysis identified unique shape variations which may enhance understanding and computer‐aided models of the intricacies of flatfoot, leading to better diagnosis and, ultimately, surgical treatment.

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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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Correlation of Talar Anatomy and Subtalar Joint Alignment on Weightbearing Computed Tomography With Radiographic Flatfoot Parameters

Abstract: Level III, case-control study.

Cited by 84 publications

References 16 publications

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

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

Unique shape variations of hind and midfoot bones in flatfoot subjects—A statistical shape modeling approach

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

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