MR imaging findings in spring ligament insufficiency

Yao, Lawrence; Gentili, Amilcare; Cracchiolo, Andrea

doi:10.1007/s002560050510

Cited by 80 publications

(45 citation statements)

References 8 publications

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“…In our study, the mean thickness of the proximal and distal measurements of the superomedial CNL in patients with insufficiency were 5.1 and 6.1 mm. This is quite a different result from an MRI study [5] in which the mean thickness of the abnormal superomedial ligament was 6.5 mm. However, in that study, the maximum ligament thickness was measured, and therefore some measurements were obtained at the proximal portion and some at the distal portion of the superomedial CNL.…”

Section: Discussioncontrasting

confidence: 56%

“…Heterogeneous increase in signal and thickening of ligament may be seen in patients with associated posterior tibial tendinosis [5,6]. In two different anatomical [2] and ultrasound studies [12], the mean width of the normal ligament at the talar head was 2.5 and 3 mm respectively as compared to 3.6 mm (distal measurement) in our study.…”

Section: Discussionmentioning

confidence: 57%

“…A lax or ruptured spring ligament permits the talus to plantar flex, and a valgus alignment of the calcaneus, or pes planovalgus, results [5,[15][16][17][18]. The condition is typically seen in middle-aged women and may result in an acquired flatfoot [5]. There is usually no history of trauma, although acute injury of the spring ligament has been reported [19,20].…”

Section: Discussionmentioning

confidence: 96%

“…In this situation, the talar head repeatedly loads the spring ligament, contributing to accelerated attrition of this static restraint. A lax or ruptured spring ligament permits the talus to plantar flex, and a valgus alignment of the calcaneus, or pes planovalgus, results [5,[15][16][17][18]. The condition is typically seen in middle-aged women and may result in an acquired flatfoot [5].…”

Section: Discussionmentioning

confidence: 98%

“…The area affected is usually confined to the superomedial part of the spring ligament where the ligament becomes thickened [5]. In PTT dysfunction, surgical management may include plication of the spring ligament in addition to repair or reconstruction of the tendon to stabilise the medial column of the foot.…”

Section: Introductionmentioning

confidence: 99%

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Ultrasound assessment of the spring ligament complex

et al. 2008

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This study was conducted to document the normal ultrasound anatomy of the spring ligament in asymptomatic subjects and to prospectively determine the frequency of ultrasound abnormality of the spring ligament in patients with suspected posterior tibial tendinopathy. The superomedial calcaneonavicular ligament (CNL) of 10 healthy volunteers was examined by ultrasound. Nineteen patients with a clinical diagnosis of suspected posterior tibial tendinopathy and/or chronic pain along the course of the tendon were examined by ultrasound. The superomedial CNL thickness was measured. Normal anatomy of the superomedial CNL could be demonstrated in all the volunteers. The mean of the combined proximal measurements was 4 mm and of the distal measurements 3.6 mm. Sixteen patients with posterior tibial tendinopathy had increased thickness of the spring ligament, which was more evident on its distal portion over the talar head. One patient had superomedial CNL insufficiency with normal posterior tibial tendon. The mean proximal measurement in the study group was 5.1 mm and the distal measurement 6.1 mm. The differences between the measurements in the study group and controls were highly significant (proximal site P < 0.01, distal site P < 0.001). Spring-ligament laxity or tear is characterised by thickening. There is a strong association between posterior tibial tendinopathy and abnormality of the spring ligament.

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Section: Discussioncontrasting

confidence: 56%

Section: Discussionmentioning

confidence: 57%

Section: Discussionmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 98%

Section: Introductionmentioning

confidence: 99%

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Ultrasound assessment of the spring ligament complex

et al. 2008

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A computational model of force within the ligaments and tendons in progressive collapsing foot deformity

Malakoutikhah

Madenci

Latt

2022

Journal Orthopaedic Research

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Progressive collapsing foot deformity results from degeneration of the ligaments and posterior tibial tendon (PTT). Our understanding of the relationship between their failures remains incomplete. We sought to improve this understanding through computational modeling of the forces in these soft tissues. The impact of PTT and ligament failures on force changes in the remaining ligaments was investigated by quantifying ligament force changes during simulated ligament and tendon cutting in a validated finite element model of the foot. The ability of the PTT to restore foot alignment was also evaluated by increasing the PTT force in a foot with attenuated ligaments and comparing the alignment angles to the intact foot. We found that failure of any one of the ligaments led to overloading the remaining ligaments, except for the plantar naviculocuneiform, first plantar tarsometatarsal, and spring ligaments, where removing one led to unloading the other two. The combined attenuation of the plantar fascia, long plantar, short plantar, and spring ligaments significantly overloaded the deltoid and talocalcaneal ligaments. Isolated PTT rupture had no effect on foot alignment but did increase the force in the deltoid and spring ligaments. Moreover, increasing the force within the PTT to 30% of body weight was effective at restoring foot alignment during quiet stance, primarily through reducing hindfoot valgus and forefoot abduction as opposed to improving arch collapse. Our findings suggest that early intervention might be used to prevent the progression of deformity. Moreover, strengthening the PTT through therapeutic exercise might improve its ability to restore foot alignment.

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