Subtalar Arthrography in Recurrent Instability of the Ankle

Sugimoto, Kazuya; Takakura, Yoshinori; Samoto, Norihiro; Nakayama, S.; Tanaka, Yasuhito

doi:10.1097/00003086-200201000-00020

Cited by 32 publications

(23 citation statements)

References 20 publications

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“…It is unclear if an abnormal arthrographic finding represents a tear in the capsule of the MTPJ or if it represents a normal variant. It is known from collective arthrographic experience with other joints in the body that anatomic variances and/or synovial outpouchings exist and this may confuse the diagnostic workup (7)(8)(9)(10)(11)(12)(13)(14)(15)(16). Such variances in second MTPJ arthrography have yet to be established.…”

mentioning

confidence: 99%

Second metatarsophalangeal joint arthrography: A cadaveric correlation study

Blitz

Ford

Christensen

2004

The Journal of Foot and Ankle Surgery

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mentioning

confidence: 99%

Second metatarsophalangeal joint arthrography: A cadaveric correlation study

Blitz

Ford

Christensen

2004

The Journal of Foot and Ankle Surgery

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“…of patientsFollow-up (years)ClassTechniqueScoreGood+excellentMesser et al [35]20002234.5ARMod. Broström/GouldKarlsson90.9Paterson et al [43]2000262ARSemitendinosisNA81Krips et al [31]200018530AR3 techniquesKarlsson/Good/Tegner70–85Krips et al [30]200125 vs 2912.3AR vs NARAR vs EvansGood92 vs 69Nimon et al [39]2001919.7NAREvansKarlsson/Good/AOFAS57Krips et al [29]200241 vs 365.4AR vs NARAR vs EvansGood/Tegner88 vs 58Krips et al [28]200254 vs 4520AR vs NARAR vs EvansKarlsson/Good69.6 vs 33.3Sugimoto et al [48]2002132.2NARPatellar tendonGood100Järvelä et al [23]200217 vs 153.1ARKarlsson vs AITFLKarlsson93 vs 94Korkala et al [27]2002251.7NAREvansGood80Cheng and Tho [11]2002153NARChrisman-SnooksKaikkonen93Jarde et al [22]2002465.7NARCastaingAOFAS82Solakoglu et al [46]2003141.7NARCovilleChrisman-Snooks100Takahashi et al [49]2003…”

Section: Discussionmentioning

confidence: 99%

Hemi-Castaing ligamentoplasty for the treatment of chronic lateral ankle instability: a retrospective assessment of outcome

Schepers

Vogels

Lieshout

2011

International Orthopaedics (SICOT)

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PurposeIn the treatment of chronic ankle instability, most non-anatomical reconstructions use the peroneus brevis tendon. This, however, sacrifices the natural ankle stabilising properties of the peroneus brevis muscle. The aim of this study was to evaluate the functional outcome of patients treated with a hemi-Castaing procedure, which uses only half the peroneus brevis tendon.MethodsWe performed a retrospective cohort study of patients who underwent hemi-Castaing ligamentoplasty for chronic lateral ankle instability between 1993 and 2010, with a minimum of one year follow-up. Patients were sent a postal questionnaire comprising five validated outcome measures: Olerud-Molander Ankle Score (OMAS), Karlsson Ankle Functional Score (KAFS), Tegner Activity Level Score (pre-injury, prior to surgery, at follow-up), visual analog scale on pain (VAS) and the Short Form 36 (SF-36).ResultsTwenty patients completed the questionnaire on functional outcome. The OMAS showed good to excellent outcome in 80% and the KAFS in 65%, the Tegner Score improved from surgery but did not reach pre-injury levels, the VAS on pain was 1 of 10 and the SF-36 returned to normal compared with the average population.ConclusionsEven though most patients were satisfied with the results, outcome at long-term follow-up was less favourable compared with the literature on anatomical reconstructions. In accordance with the literature, we therefore conclude that the initial surgical treatment of chronic lateral ankle instability should be an anatomical repair with augmentation (i.e. the Broström-Gould technique) and the non-anatomical repair should be reserved for unsuccessful cases after anatomical repair or in cases where no adequate ligament remnants are available for reconstruction.

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“…These authors reported the posterior subtalar joint communicates with the ankle in 10% of the population [13]. A study using subtalar arthrography in recurrent ankle instability showed communication between the ankle and subtalar joints in 25% of patients with chronic anterior talofibular ligament disruption [12]. These investigators believed this communication was characteristic of rupture of the capsule of the joints or of the septum dividing them.…”

Section: Discussionmentioning

confidence: 99%

Accuracy of Posterior Subtalar Joint Injection Without Fluoroscopy

Kirk¹,

Campbell²,

Guyton³

et al. 2008

Clinical Orthopaedics &Amp; Related Research

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Injection into the posterior subtalar joint has not been validated for accuracy using radiographic end points. We asked whether needle placement into a normal posterior subtalar joint could be performed accurately and selectively by experienced surgeons without fluoroscopic guidance. Three fellowship-trained orthopaedic foot and ankle surgeons each injected the posterior subtalar joint of 20 cadaveric specimens using an anterolateral approach. Fluoroscopic images were obtained by an independent investigator and blinded. A separate fellowship-trained foot and ankle surgeon interpreted the images. Of 60 injections, 58 were accurate and two were extraarticular based on interpretation by an independent foot and ankle surgeon. Extravasation into the ankle occurred in 14 samples and into the peroneal sheath in two samples. Experienced surgeons can place intraarticular injections into a radiographically normal posterior subtalar joint without fluoroscopy with a high degree of accuracy. However, extravasation into the ankle or peroneal tendon sheath occurred in an unpredictable fashion, suggesting selectivity of injection placement is relatively limited without the use of fluoroscopy. Fluoroscopy may not be necessary for injections used solely for therapeutic purposes. However, if the injection is intended for diagnostic purposes or to assist in surgical decision-making or if the joint is abnormal, we recommend fluoroscopy to ensure the subtalar joint is the only anatomic structure impacted by the injection.

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Subtalar Arthrography in Recurrent Instability of the Ankle

Cited by 32 publications

References 20 publications

Second metatarsophalangeal joint arthrography: A cadaveric correlation study

Second metatarsophalangeal joint arthrography: A cadaveric correlation study

Hemi-Castaing ligamentoplasty for the treatment of chronic lateral ankle instability: a retrospective assessment of outcome

Accuracy of Posterior Subtalar Joint Injection Without Fluoroscopy

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