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Assessment of coronal plane subtalar joint alignment in peritalar subluxation via weight-bearing multiplanar imaging.
Foot Ankle Int. 2015 Mar; 36(3):302-9.FA

Abstract

BACKGROUND

Patients with adult-acquired flatfoot deformity (AAFD) develop peritalar subluxation, which may stem from valgus inclination of the inferior surface of the talus. We hypothesized that patients with AAFD would have an increased valgus tilt of the subtalar joint in the coronal plane compared to controls when assessed with a novel multiplanar weight-bearing imaging (MP-WB).

METHODS

Eighteen normal and 36 stage II AAFD patients scheduled to undergo operative reconstruction were evaluated by MP-WB through measuring 3 novel angles of the subtalar joint in the coronal view: (1) angle between inferior facet of the talus and the horizontal/floor (inftal-hor), (2) angle between inferior and superior facets of the talus (inftal-suptal), and (3) angle between inferior facet of the talus and superior facet of the calcaneus (inftal-supcal). Intra- and interobserver reliability were evaluated via intraclass correlation coefficients (ICCs). Differences in angles between AAFD patients and controls were evaluated using Wilcoxon rank-sum test.

RESULTS

Intra- and interobserver reliability were excellent for inftal-hor (ICC .942 and .991, respectively) and inftal-suptal (ICC .948 and .989, respectively), and moderate-good for inftal-supcal (ICC .604 and .742, respectively). Inftal-hor and inftal-suptal angles were found to be significantly greater in AAFD patients (P < 0.001) at all 3 locations along the posterior subtalar joint, while inftal-supcal did not demonstrate a significant difference (P = .741). While controls exhibited varus orientation at the anterior aspect of the joint, AAFD patients maintained a valgus orientation throughout.

CONCLUSION

Inftal-hor and inftal-suptal angles provided a reliable means of evaluating the orientation of the subtalar joint axis in AAFD via MP-WB, and showed that the subtalar joint had increased valgus orientation in AAFD compared to controls. This may allow for identification of patients at risk for developing AAFD, and could potentially be used in guiding operative reconstruction.

Authors+Show Affiliations

Department of Foot and Ankle Surgery, Hospital for Special Surgery, New York, NY.Department of Foot and Ankle Surgery, Hospital for Special Surgery, New York, NY.Department of Foot and Ankle Surgery, Hospital for Special Surgery, New York, NY.Department of Orthopedics and Sports Medicine, University of Washington, Seattle, WA.Department of Foot and Ankle Surgery, Hospital for Special Surgery, New York, NY.Department of Foot and Ankle Surgery, Hospital for Special Surgery, New York, NY EllisS@hss.edu.

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

25380775

Citation

Probasco, William, et al. "Assessment of Coronal Plane Subtalar Joint Alignment in Peritalar Subluxation Via Weight-bearing Multiplanar Imaging." Foot & Ankle International, vol. 36, no. 3, 2015, pp. 302-9.
Probasco W, Haleem AM, Yu J, et al. Assessment of coronal plane subtalar joint alignment in peritalar subluxation via weight-bearing multiplanar imaging. Foot Ankle Int. 2015;36(3):302-9.
Probasco, W., Haleem, A. M., Yu, J., Sangeorzan, B. J., Deland, J. T., & Ellis, S. J. (2015). Assessment of coronal plane subtalar joint alignment in peritalar subluxation via weight-bearing multiplanar imaging. Foot & Ankle International, 36(3), 302-9. https://doi.org/10.1177/1071100714557861
Probasco W, et al. Assessment of Coronal Plane Subtalar Joint Alignment in Peritalar Subluxation Via Weight-bearing Multiplanar Imaging. Foot Ankle Int. 2015;36(3):302-9. PubMed PMID: 25380775.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Assessment of coronal plane subtalar joint alignment in peritalar subluxation via weight-bearing multiplanar imaging. AU - Probasco,William, AU - Haleem,Amgad M, AU - Yu,Jeanne, AU - Sangeorzan,Bruce J, AU - Deland,Jonathan T, AU - Ellis,Scott J, Y1 - 2014/11/07/ PY - 2014/11/9/entrez PY - 2014/11/9/pubmed PY - 2015/12/17/medline KW - Mulitplanar Weightbearing Imaging (MP-WB) KW - adult-acquired flatfoot deformity (AAFD) KW - flatfoot KW - inferior talus-horizontal angle (inftal-hor) KW - tibialis posterior tendon insufficiency SP - 302 EP - 9 JF - Foot & ankle international JO - Foot Ankle Int VL - 36 IS - 3 N2 - BACKGROUND: Patients with adult-acquired flatfoot deformity (AAFD) develop peritalar subluxation, which may stem from valgus inclination of the inferior surface of the talus. We hypothesized that patients with AAFD would have an increased valgus tilt of the subtalar joint in the coronal plane compared to controls when assessed with a novel multiplanar weight-bearing imaging (MP-WB). METHODS: Eighteen normal and 36 stage II AAFD patients scheduled to undergo operative reconstruction were evaluated by MP-WB through measuring 3 novel angles of the subtalar joint in the coronal view: (1) angle between inferior facet of the talus and the horizontal/floor (inftal-hor), (2) angle between inferior and superior facets of the talus (inftal-suptal), and (3) angle between inferior facet of the talus and superior facet of the calcaneus (inftal-supcal). Intra- and interobserver reliability were evaluated via intraclass correlation coefficients (ICCs). Differences in angles between AAFD patients and controls were evaluated using Wilcoxon rank-sum test. RESULTS: Intra- and interobserver reliability were excellent for inftal-hor (ICC .942 and .991, respectively) and inftal-suptal (ICC .948 and .989, respectively), and moderate-good for inftal-supcal (ICC .604 and .742, respectively). Inftal-hor and inftal-suptal angles were found to be significantly greater in AAFD patients (P < 0.001) at all 3 locations along the posterior subtalar joint, while inftal-supcal did not demonstrate a significant difference (P = .741). While controls exhibited varus orientation at the anterior aspect of the joint, AAFD patients maintained a valgus orientation throughout. CONCLUSION: Inftal-hor and inftal-suptal angles provided a reliable means of evaluating the orientation of the subtalar joint axis in AAFD via MP-WB, and showed that the subtalar joint had increased valgus orientation in AAFD compared to controls. This may allow for identification of patients at risk for developing AAFD, and could potentially be used in guiding operative reconstruction. SN - 1944-7876 UR - https://www.unboundmedicine.com/medline/citation/25380775/Assessment_of_coronal_plane_subtalar_joint_alignment_in_peritalar_subluxation_via_weight_bearing_multiplanar_imaging_ L2 - http://journals.sagepub.com/doi/full/10.1177/1071100714557861?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -