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Knee Surgery, Sports Traumatology, Arthroscopy

Published in:

28-09-2023 | Computed Tomography | ANKLE

Increased subtalar rotational motion in patients with symptomatic ankle instability under load and stress conditions

Authors: María Reyes Fernández-Marín, David González-Martín, Mario Herrera-Pérez, Félix Paulano-Godino, Jesús Vilá-Rico, Sergio Tejero

Published in: Knee Surgery, Sports Traumatology, Arthroscopy | Issue 11/2023

Abstract

Purpose

Differentiating subtalar and ankle instability in the clinical setting is challenging. This study aims to analyze the rotational laxity of the subtalar joint bilaterally in patients with asymptomatic and symptomatic ankle instability under simulated load and stress-induced position of the subtalar joint.

Methods

A case–control study was conducted using an adjustable load device (ALD). Patients with chronic ankle instability and healthy volunteers were included. Each subject underwent a CT scan under mechanical stress and simulated weight-bearing conditions, maintaining maximum eversion and inversion hindfoot positions. The images were obtained in a single model, allowing calculations of the motion vector as well as the helical axis. The helical axis was defined by a rotation angle and a translation distance.

Results

A total of 72 feet were included in the study. Thirty-one patients with unilateral symptoms and five healthy controls were selected, defining two groups: symptomatic (n = 31) and asymptomatic (n = 41). An absolute difference of 4.6º (95%CI 2–11.1) rotation angle was found on the helical axis of the symptomatic vs. asymptomatic group (p = 0.001). No significant differences were detected in the translation distance (n.s.) between the groups. Additionally, a significant positive correlation was found between the rotation angle and translation distance through the helical axis in the asymptomatic group (r = 0.397, p = 0.027).

Conclusion

Patients with chronic ankle instability suspected of having subtalar joint instability showed a wider subtalar range of laxity in terms of rotation about the helical axis. Furthermore, differences in kinematics between symptomatic and asymptomatic hindfeet was demonstrated when both feet were compared.

Level of evidence

III.

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Title: Increased subtalar rotational motion in patients with symptomatic ankle instability under load and stress conditions
Authors: María Reyes Fernández-Marín
David González-Martín
Mario Herrera-Pérez
Félix Paulano-Godino
Jesús Vilá-Rico
Sergio Tejero
Publication date: 28-09-2023
Publisher: Springer Berlin Heidelberg
Keywords: Computed Tomography
Computed Tomography
Published in: Knee Surgery, Sports Traumatology, Arthroscopy / Issue 11/2023
Print ISSN: 0942-2056
Electronic ISSN: 1433-7347
DOI: https://doi.org/10.1007/s00167-023-07553-2

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Increased subtalar rotational motion in patients with symptomatic ankle instability under load and stress conditions

Abstract

Purpose

Methods

Results

Conclusion

Level of evidence

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

Level of evidence

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