The Relationship Between Calcaneofibular Ligament Injury and Ankle Osteoarthritis Progression: A Comprehensive Analysis of Stress Distribution and Osteophyte Formation in the Subtalar Joint

IF 2.4 2区医学 Q2 ORTHOPEDICS

Foot & Ankle International Pub Date : 2024-04-22 DOI:10.1177/10711007241245363

Satoru Sakurai, Tomoyuki Nakasa, Yasunari Ikuta, Shingo Kawabata, Dan Moriwaki, Saori Ishibashi, Asyumaredha Asril Silan, Nobuo Adachi

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引用次数: 0

Abstract

Background:Ankle osteoarthritis (OA) mainly arises from trauma, particularly lateral ligament injuries. Among lateral ligament injuries, ankles with calcaneofibular ligament (CFL) injuries exhibit increased instability and can be a risk factor ankle OA progression. However, the relationship between CFL injury and OA progression remains unclear. Therefore, this study aims to assess the relationship between CFL injuries and ankle OA by investigating stress changes and osteophyte formation in subtalar joint.Methods:We retrospectively reviewed the magnetic resonance imaging (MRI) and plain radiographic evaluations of 100 ankles of 91 patients presenting with chronic ankle instability (CAI), ankle OA, or other ankle conditions. The association between CFL injuries on the oblique view of MRI and the severity of ankle OA (based on Takakura-Tanaka classification) was statistically evaluated. Additionally, 71 ankles were further subjected to CT evaluation to determine the association between the CFL injuries and the Hounsfield unit (HU) ratios of the subtalar joint and medial gutter, and the correlation between the subtalar HU ratios and osteophyte severity were statistically evaluated.Results:CFL injury was observed in 35.9% (14/39) of patients with stage 0, 42.9% (9/21) with stage 1, 50.0% (10/20) with stage 2, 100% (9/9) with stage 3a, and 90.9% (10/11) with stage 3b. CFL-injured ankles exhibited higher HU ratios in the medial gutter and lower ratios in the medial posterior subtalar joint compared to uninjured ankles. A negative correlation was observed between medial osteophyte severity and the medial subtalar joint HU ratio.Conclusion:Our findings suggest that CFL injuries are common in severe ankle OA impairing the compensatory function of the subtalar joint through abnormal stress distribution and osteophyte formation.Level of Evidence:Level III, retrospective cohort study.

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钙腓韧带损伤与踝关节骨关节炎进展之间的关系：胫腓韧带损伤与踝关节骨性关节炎进展的关系：胫腓韧带损伤与踝关节骨性关节炎进展的关系：踝关节骨性关节炎进展与胫腓韧带损伤的关系

背景：踝关节骨关节炎（OA）主要源于创伤，尤其是外侧韧带损伤。在外侧韧带损伤中，小腿腓骨韧带（CFL）损伤的踝关节表现出更大的不稳定性，可能成为踝关节OA恶化的危险因素。然而，小腿腓骨韧带损伤与 OA 进展之间的关系仍不清楚。方法：我们回顾性地检查了91例慢性踝关节不稳定（CAI）、踝关节OA或其他踝关节疾病患者的100只脚踝的磁共振成像（MRI）和X光平片评估结果。对核磁共振成像斜视图上的 CFL 损伤与踝关节 OA 严重程度（基于高仓-田中分类法）之间的关联进行了统计评估。此外，还对 71 只脚踝进行了 CT 评估，以确定 CFL 损伤与踝关节和内侧沟的 Hounsfield 单位（HU）比率之间的关联，并对踝关节 HU 比率与骨质增生严重程度之间的相关性进行了统计评估。结果：35.9%（14/39）的 0 期患者、42.9%（9/21）的 1 期患者、50.0%（10/20）的 2 期患者、100%（9/9）的 3a 期患者和 90.9%（10/11）的 3b 期患者观察到 CFL 损伤。与未受伤的踝关节相比，CFL 受伤踝关节内侧沟的 HU 比率较高，而内侧后距下关节的 HU 比率较低。结论：我们的研究结果表明，CFL损伤在严重踝关节OA中很常见，它通过异常的应力分布和骨质增生的形成损害了踝关节的代偿功能。

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来源期刊

Foot & Ankle International 医学-整形外科

CiteScore

5.60

自引率

22.20%

发文量

144

审稿时长

2 months

期刊介绍： Foot & Ankle International (FAI), in publication since 1980, is the official journal of the American Orthopaedic Foot & Ankle Society (AOFAS). This monthly medical journal emphasizes surgical and medical management as it relates to the foot and ankle with a specific focus on reconstructive, trauma, and sports-related conditions utilizing the latest technological advances. FAI offers original, clinically oriented, peer-reviewed research articles presenting new approaches to foot and ankle pathology and treatment, current case reviews, and technique tips addressing the management of complex problems. This journal is an ideal resource for highly-trained orthopaedic foot and ankle specialists and allied health care providers. The journal’s Founding Editor, Melvin H. Jahss, MD (deceased), served from 1980-1988. He was followed by Kenneth A. Johnson, MD (deceased) from 1988-1993; Lowell D. Lutter, MD (deceased) from 1993-2004; and E. Greer Richardson, MD from 2005-2007. David B. Thordarson, MD, assumed the role of Editor-in-Chief in 2008. The journal focuses on the following areas of interest: • Surgery • Wound care • Bone healing • Pain management • In-office orthotic systems • Diabetes • Sports medicine