Defining Reference Values for the Normal Adult Lisfranc Joint Using Weightbearing Computed Tomography

Wijetunga, Chatura Gihan; Roebert, Justin; Hiscock, Dr Richard John; Bedi, Mr. Harvinder S; Roshan-Zamir, Mr. Sasha; Wang, Mr. Otis; Fraval, Andrew; Tate, Ms. Julie; Eden, Ms. Maggie; Rotstein, Andrew

doi:10.1053/j.jfas.2022.09.008

Cited by 3 publications

(5 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Wijetunga et al 25 found that healthy Lisfranc area measurement increased from 87.0 ± 21.0 mm 2 in NWB CT to 90.0 ± 21.0 mm 2 via WBCT with high intraobserver (0.998) and interobserver agreement (0.964). The same study found that the area difference (WB area – NWB area) was 1.0 ± 1.9 mm 2 and the area ratio (WB area divided by NWB area) was 1.0 ± 0.1 mm 2 for the healthy cohort (n = 91 patients; n = 91 feet) via CT. 25 This study demonstrates that the Lisfranc complex experiences changes in morphology under weightbearing, indicating that studying the Lisfranc pathology under weightbearing may reveal widening not detected on conventional CT.…”

Section: Resultsmentioning

confidence: 99%

“…A total of 9 articles met the inclusion criteria from a total of 489 articles retrieved during the initial search process (Figure 1). 1,5,7,13,16,19,20,22,25 All articles were graded according to the MINORS scale for quality (Table 1). 18 The mean MINORS score for the 9 included articles was 12.4 ± 3.4 (range: 8.0-16.0).…”

Section: Resultsmentioning

confidence: 99%

“…18 The mean MINORS score for the 9 included articles was 12.4 ± 3.4 (range: 8.0-16.0). 1,5,7,13,16,19,20,22,25 Six articles were retrospective observational studies, and 3 articles were cadaveric studies.…”

Section: Initial Search Results and Quality Gradingmentioning

confidence: 99%

“…In this review, 4 of 9 studies analyzed the Lisfranc complex using both conventional and WBCT. 13,19,20,25 Although 1 of these studies simply analyzed the Lisfranc area in NWB and WB, the remaining 3 were cadaveric studies that evaluated image modality success at detecting instability with varying degrees of severity. 25 All 3 cadaveric studies found that partial or total WBCT was significantly more successful at detecting instability at lower levels of ligamentous injury.…”

Section: Wbct Onlymentioning

confidence: 99%

“…13,19,20,25 Although 1 of these studies simply analyzed the Lisfranc area in NWB and WB, the remaining 3 were cadaveric studies that evaluated image modality success at detecting instability with varying degrees of severity. 25 All 3 cadaveric studies found that partial or total WBCT was significantly more successful at detecting instability at lower levels of ligamentous injury. 13,19,20 When assessing asymmetry, Sripanich et al 19 found that WBCT was able to detect a higher percentage of injury for all included levels of Lisfranc injury.…”

Section: Wbct Onlymentioning

confidence: 99%

See 4 more Smart Citations

Weightbearing Computed Tomography vs Conventional Tomography for Examination of Varying Degrees of Lisfranc Injures: A Systematic Review of the Literature

Talaski,

Baumann,

Walley

et al. 2023

Foot & Ankle Orthopaedics

View full text Add to dashboard Cite

Background Lisfranc injuries, if not accurately diagnosed, can result in chronic pain and instability. Previous studies have examined ultrasonographs, radiographs, magnetic resonance imaging (MRI), and conventional computed tomography (CT) scan to differentiate Lisfranc instability, but they focused on a healthy/injured scale without differentiating subtle injury. Weightbearing CT (WBCT) has emerged as a diagnostic tool for detecting subtle Lisfranc injuries. This systematic review aimed to compare WBCT with conventional CT in diagnosing Lisfranc injury, and the ability to differentiate injuries of varying severities. Methods: The review encompassed PubMed, CINAHL, MEDLINE, SPORTDiscus, and Web of Science databases from inception until July 5, 2023. Inclusion criteria involved studies on CT and/or WBCT for Lisfranc injuries and nonoperative studies. Exclusion criteria composed case reports, commentaries, postoperative imaging studies, pediatric patients, studies with nonobjective radiographic measurements, studies exclusively focused on injury classification, and studies with fewer than 5 patients because of poor statistical power. Data extraction focused on radiographic measurements of the Lisfranc complex, categorized into conventional CT, partial WBCT, and total WBCT. Results: Out of the initially retrieved 489 articles, 9 met the inclusion criteria. Several studies consistently demonstrate that WBCT provides a higher level of accuracy in measuring the Lisfranc area, offering enhanced sensitivity to detect subtle alterations in joint structure. Moreover, WBCT exhibits superior sensitivity in distinguishing between healthy Lisfranc joints and those with injuries, particularly when identifying dorsal ligament damage. This imaging modality allows for the detection of significant variations in critical measurements like first-second metatarsal (M1-M2) distance, first cuneiform (C1)-M2 distance, and joint volumes, enabling a more comprehensive assessment of Lisfranc joint health especially with subtle instability. Conclusion This review evaluates the extant literature on WBCT’s utility in diagnosing Lisfranc injuries and compares its effectiveness to CT in distinguishing between injuries of varying severity. WBCT, with reliable measurement techniques, appears more adept at detecting subtle Lisfranc instability compared to CT, likely by allowing the assessment of injury under load.

show abstract

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Initial Search Results and Quality Gradingmentioning

confidence: 99%

Section: Wbct Onlymentioning

confidence: 99%

Section: Wbct Onlymentioning

confidence: 99%

See 3 more Smart Citations

Weightbearing Computed Tomography vs Conventional Tomography for Examination of Varying Degrees of Lisfranc Injures: A Systematic Review of the Literature

Talaski,

Baumann,

Walley

et al. 2023

Foot & Ankle Orthopaedics

View full text Add to dashboard Cite

show abstract

Cone-beam computed tomography imaging and three-dimensional analysis of midfoot joints during non-weightbearing and weightbearing in 11 healthy feet

Kettunen,

Partio,

Salo

et al. 2024

Acta Radiol

View full text Add to dashboard Cite

Background Studies report that Lisfranc injury is more common than thought. Several imaging methods for assessing the stability of Lisfranc injury have been described but many are impossible to standardize and not accurate enough. Purpose To present a three-dimensional (3D) method for analyzing the changes in the joint space width of the midfoot joint and the joints of the medial part of the Lisfranc complex in healthy individuals. Material and Methods Non-weightbearing and weightbearing cone-beam computed tomography (CBCT) images of 11 healthy feet were acquired and analyzed with 3D software. The mean range of joint space width changes of each joint was computed from the changes in individual image pairs. Results 3D analysis software was used to analyze the medial part of the Lisfranc complex. In this sample of healthy feet, the changes in the joint spaces in the medial part of Lisfranc complex, calculated with 3D analysis software, was less than 0.6 mm. The distance between bones increased or decreased, depending on which part of the joint surface the measurements were taken. Conclusion In this study, we present a 3D analysis method to evaluate midfoot joint space width changes. Our analysis revealed that in healthy feet there are only minimal changes in the joint space width between weightbearing and non-weightbearing indicating minimal movement of the midtarsal joints. The 3D analysis of weightbearing CBCT data provides a promising tool for analyzing the small midfoot joints in a variety of conditions.

show abstract

Trends in the Use of Weightbearing Computed Tomography

Bernasconi,

Dechir,

Izzo

et al. 2024

JCM

View full text Add to dashboard Cite

Background: This review aimed to critically appraise the most recent orthopedic literature around cone beam weightbearing computed tomography (WBCT), summarizing what evidence has been provided so far and identifying the main research trends in the area. Methods: This scoping review was performed on studies published between January 2013 and December 2023 on the Pubmed database. All studies (both clinical and nonclinical) in which WBCT had been used were critically analyzed to extract the aim (or aims) of the study, and the main findings related to the role of this imaging modality in the diagnostic pathway. Results: Out of 1759 studies, 129 were selected. One hundred five manuscripts (81%) dealt with elective orthopedic conditions. The majority of the analyses (88 studies; 84%) were performed on foot and ankle conditions, while 13 (12%) studies looked at knee pathologies. There was a progressive increase in the number of studies published over the years. Progressive Collapsing Foot Deformity (22 studies; 25%) and Hallux Valgus (19 studies; 21%) were frequent subjects. Twenty-four (19%) manuscripts dealt with traumatic conditions. A particular interest in syndesmotic injuries was documented (12 studies; 60%). Conclusions: In this review, we documented an increasing interest in clinical applications of weightbearing CT in the orthopedic field between 2013 and 2023. The majority of the analyses focused on conditions related to the foot and the ankle; however, we found several works investigating the value of WBCT on other joints (in particular, the knee).

show abstract

Defining Reference Values for the Normal Adult Lisfranc Joint Using Weightbearing Computed Tomography

Cited by 3 publications

References 10 publications

Weightbearing Computed Tomography vs Conventional Tomography for Examination of Varying Degrees of Lisfranc Injures: A Systematic Review of the Literature

Weightbearing Computed Tomography vs Conventional Tomography for Examination of Varying Degrees of Lisfranc Injures: A Systematic Review of the Literature

Cone-beam computed tomography imaging and three-dimensional analysis of midfoot joints during non-weightbearing and weightbearing in 11 healthy feet

Trends in the Use of Weightbearing Computed Tomography

Contact Info

Product

Resources

About