The intrinsic subtalar ligaments have a consistent presence, location and morphology

Michels, Frederick; Matricali, Giovanni; Vereecke, Evie; Dewilde, Miloud; Vanrietvelde, Frederik; Stockmans, Filip

doi:10.1016/j.fas.2020.03.002

Cited by 23 publications

(25 citation statements)

References 39 publications

(73 reference statements)

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“…Interosseous TC ligament in the control group had a mean thickness of 1.30 mm and a mean width of 1.41 mm. Thickness of ITCL in our study was within the reported range of 1.1 to 3.0 mm in previous cadaveric studies, whereas width of ITCL was far narrower than the reported range of 5.6 to 11.0 mm 10,11,39,40 . The narrow ITCL width in this study might be explained by the fact that only the main fibers of ITCL that were clearly visualized on MRI were measured.…”

Section: Discussionsupporting

confidence: 73%

“…Thickness of ITCL in our study was within the reported range of 1.1 to 3.0 mm in previous cadaveric studies, whereas width of ITCL was far narrower than the reported range of 5.6 to 11.0 mm. 10,11,39,40 The narrow ITCL width in this study might be explained by the fact that only the main fibers of ITCL that were clearly visualized on MRI were measured. Previous studies using 3D isotropic MRI showed relatively similar results to our study, ranging from 2.68 to 2.85 mm.…”

Section: Discussionmentioning

confidence: 86%

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Comparative Analysis of Subtalar Ligaments Between Patients With Talocalcaneal Coalition and Control Subjects Using 3-Dimensional Magnetic Resonance Imaging

Kang¹,

Moon²,

Jung

et al. 2022

J Comput Assist Tomogr

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The purpose of this study was to find the differences in the subtalar ligaments between patients with talocalcaneal (TC) coalition and control subjects using 3-dimensional isotropic magnetic resonance imaging.Methods: Magnetic resonance imaging of 27 ankles with TC coalition and 27 age-and sex-matched controls were retrospectively reviewed. Absence of cervical ligament, anterior capsular ligament (ACL), interosseous TC ligament (ITCL), and partial or complete absence of 3 roots of the inferior extensor retinaculum was analyzed. Thickness and width of ACL and ITCL were measured when possible.Results: Absence of ACL and ITCL was significantly more frequent in TC coalition patients than in controls (59.2% vs 7.4%, P < 0.0001; 44.4% vs 7.4%, P = 0.004). Absence of cervical ligament and 3 roots of the inferior extensor retinaculum did not differ between the 2 groups. Thickness and width of ACL were significantly smaller in TC coalition patients than in control subjects (0.81 ± 0.23 vs 1.27 ± 0.41 mm, P < 0.0001; 5.26 ± 1.17 vs 7.07 ± 1.46 mm, P = 0.001). Thickness and width of ITCL did not differ between the 2 groups. In the TC coalition group, the absence of ACL and ITCL did not differ according to coalition type, patient demographics, and magnetic resonance imaging units. Conclusions:Anterior capsular ligament and ITCL are frequently absent in TC coalition patients. Even when present, the ACL is attenuated in TC coalition patients compared with controls.

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Section: Discussionsupporting

confidence: 73%

Section: Discussionmentioning

confidence: 86%

Comparative Analysis of Subtalar Ligaments Between Patients With Talocalcaneal Coalition and Control Subjects Using 3-Dimensional Magnetic Resonance Imaging

Kang¹,

Moon²,

Jung

et al. 2022

J Comput Assist Tomogr

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“…In the present study, among the ligamentous structures of the subtalar joint, only the footprint area of the ITCL showed significantly higher values in the Degeneration (+) group compared to the Degeneration (-) group for the subtalar joint facet. Previous studies have suggested that the CL, ITCL, and ACaL in the subtalar joint are each important for stability of the subtalar joint [12,15,16]. In addition, the main function of the ITCL has been considered to be connection of the talus and calcaneus and maintenance of the subtalar joint axis [26,27].…”

Section: Discussionmentioning

confidence: 99%

“…The ligaments involved in the braking of the subtalar joint include the calcaneofibular ligament [12,13], cervical ligament (CL) [14,15], interosseous talocalcaneal ligament (ITCL) [15][16][17], and anterior capsular ligament (ACaL) [15][16][17]. The calcaneofibular ligament is reportedly important in braking the subtalar joint, but the CL, ITCL, and ACaL have not been adequately studied.…”

Section: Introductionmentioning

confidence: 99%

Relationship between Joint and Ligament Structures of the Subtalar Joint and Degeneration of the Subtalar Articular Facet

Togashi¹,

Edama²,

Shagawa³

et al. 2023

Preprint

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This study aimed to clarify the relationship between the joint and ligament structures of the subtalar joint and degeneration of the subtalar articular facet. We examined 50 feet from 25 Japanese cadavers. The number of articular facets, joint congruence, and intersecting angle were measured for the joint structure of the subtalar joint, and the footprint areas of the ligament attachments of the cervical ligament, interosseous talocalcaneal ligament (ITCL), and anterior capsular ligament were measured for the ligament structure. Also, subtalar joint facets were classified into Degeneration (+) and (-) groups according to degeneration of the talus and calcaneus. No significant relationship was identified between the joint structure of the subtalar joint and degeneration of the subtalar articular facet. In contrast, footprint area of the ITCL was significantly higher in the Degeneration (+) group than in the Degeneration (-) group for the subtalar joint facet. These results suggest that the joint structure of the subtalar joint may not affect degeneration of the subtalar articular facet. Degeneration of the subtalar articular facet may be related to the size of the ITCL.

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“…Despite decades of research since its first diagnostic description, 2 subtalar joint instability remains a clinical enigma within the concept of hindfoot instability 9 . This could be attributed to the complex anatomy, 37,38 triplanar motion, 39 and clinical presentation, 9 which is difficult to discern from ankle instability due to overlapping symptomology 40 . For this reason, diagnostic imaging holds an important potential to characterize subtalar joint instability.…”

Section: Discussionmentioning

confidence: 99%

Interaction of loading and ligament injuries in subtalar joint instability quantified by 3D weightbearing computed tomography

Burssens

Krähenbühl

Lenz

et al. 2021

Journal Orthopaedic Research

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Despite decades of research since its first description, subtalar joint instability remains a diagnostic enigma within the concept of hindfoot instability. This could be attributed to current imaging techniques, which are impeded by two‐dimensional measurements. Therefore, we used weightbearing computed tomography imaging to quantify three‐dimensional displacement associated with subtalar joint instability. Three‐dimensional models were generated in seven paired cadaver specimens to compute talocalcaneal displacement after different patterns of axial load (85 kg) combined with torque in internal and external rotation (10 Nm). Sequential imaging was repeated in the subtalar joint containing intact ligaments to determine reference displacement. Afterward, the interosseus talocalcaneal ligament (ITCL) or calcaneofibular ligament (CFL) was sectioned, then the ITCL with CFL and after the ITCL, CFL with the deltoid ligament (DL). The highest translation could be detected in the dorsal direction and the highest rotation occurred in the internal direction when external torque was applied to the foot without load. These displacements differed significantly from the condition containing intact ligaments, with a mean difference of 1.6 mm (95% CI, 1.3 to 1.9) for dorsal translation and a mean of 12.4° (95% CI, 10.1 to 14.8) for internal rotation. Clinical relevance: Our study provides a novel and noninvasive analysis to quantify subtalar joint instability based on three‐dimensional WBCT imaging. This approach overcomes former studies using trans‐osseous fixation to determine three‐dimensional subtalar joint displacement and implements an imaging device and software modalities that are readily available. Based on our findings, we recommend applying torque in external rotation to the foot to optimize the detection of subtalar joint instability.

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The intrinsic subtalar ligaments have a consistent presence, location and morphology

Cited by 23 publications

References 39 publications

Comparative Analysis of Subtalar Ligaments Between Patients With Talocalcaneal Coalition and Control Subjects Using 3-Dimensional Magnetic Resonance Imaging

Comparative Analysis of Subtalar Ligaments Between Patients With Talocalcaneal Coalition and Control Subjects Using 3-Dimensional Magnetic Resonance Imaging

Relationship between Joint and Ligament Structures of the Subtalar Joint and Degeneration of the Subtalar Articular Facet

Interaction of loading and ligament injuries in subtalar joint instability quantified by 3D weightbearing computed tomography

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