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Currently used imaging options cannot accurately predict subtalar joint instability

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Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

To give a systematic overview of current diagnostic imaging options and surgical treatment for chronic subtalar joint instability.

Methods

A systematic literature search across the following sources was performed: PubMed, ScienceDirect, and SpringerLink. Twenty-three imaging studies and 19 outcome studies were included. The Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS 2) tool was used to assess the methodologic quality of the imaging articles, while the modified Coleman Score was used to assess the methodologic quality of the outcome studies.

Results

Conventional radiographs were most frequently used to assess chronic subtalar joint instability. Talar tilt, anterior talar translation, and subtalar tilt were the three most commonly used measurement methods. Surgery often included calcaneofibular ligament reconstruction.

Conclusion

Current imaging options do not reliably predict subtalar joint instability. Distinction between chronic lateral ankle instability and subtalar joint instability remains challenging. Recognition of subtalar joint instability as an identifiable and treatable cause of ankle pain requires vigilant clinical investigation.

Level of evidence

Systematic Review of Level III and Level IV Studies, Level IV.

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Funding

Nicola Krähenbühl is currently receiving a grant from the Swiss National Science Foundation (SNF; grant number P2BSP3_174979) and Swiss Orthopaedics.

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Authors and Affiliations

  1. Department of Orthopaedics, University of Utah, 590 Wakara Way, Salt Lake City, UT, 84108, USA

    Nicola Krähenbühl, Maxwell W. Weinberg, Nathan P. Davidson, Charles L. Saltzman & Alexej Barg

  2. Department of Radiology and Imaging Sciences, University of Utah, 30 N. 1900 E. #1A071, Salt Lake City, UT, 84132, USA

    Megan K. Mills

  3. Department of Orthopaedics, Kantonsspital Baselland, Rheinstrasse 26, 4410, Liestal, Switzerland

    Beat Hintermann

Authors
  1. Nicola Krähenbühl
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  2. Maxwell W. Weinberg
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  3. Nathan P. Davidson
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  4. Megan K. Mills
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  6. Charles L. Saltzman
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  7. Alexej Barg
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Contributions

NK: literature search, data extraction, and manuscript writing. MWW: literature search, data extraction, and manuscript writing. NPD: drawing of figures and manuscript writing. MKM: providing clinical cases (X-rays/MRI) and manuscript writing. BH: manuscript writing. CLS: manuscript writing. AB: literature search, data extraction, and manuscript writing.

Corresponding author

Correspondence to Alexej Barg.

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Conflict of interest

Maxwell W. Weinberg, Nathan P. Davidson, Megan K. Mills, Beat Hintermann, Charles L. Saltzman, and Alexej Barg have no conflicts to declare.

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This article does not contain any studies with human participants or animal experiments performed by any of the authrors.

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Krähenbühl, N., Weinberg, M.W., Davidson, N.P. et al. Currently used imaging options cannot accurately predict subtalar joint instability. Knee Surg Sports Traumatol Arthrosc 27, 2818–2830 (2019). https://doi.org/10.1007/s00167-018-5232-8

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  • DOI: https://doi.org/10.1007/s00167-018-5232-8

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