Evaluation of the osseous morphology at ATFL attachments and its anatomic ligamentous features in chronic ankle instability using MRI.

IF 2 3区医学 Q2 ORTHOPEDICS

Foot and Ankle Surgery Pub Date : 2025-09-18 DOI:10.1016/j.fas.2025.09.009

Ahmet Oztermeli, Ozgun Karakus

{"title":"Evaluation of the osseous morphology at ATFL attachments and its anatomic ligamentous features in chronic ankle instability using MRI.","authors":"Ahmet Oztermeli, Ozgun Karakus","doi":"10.1016/j.fas.2025.09.009","DOIUrl":null,"url":null,"abstract":"Objective: This study aimed to evaluate the relationship between chronic ankle instability (CAI) and both the anatomical characteristics of the anterior talofibular ligament (ATFL) and the bony morphometry of its attachment sites on the fibula and talus using MRI.Methods: A total of 94 patients were included in this retrospective study (44 with CAI, 50 controls). Morphometric parameters including ATFL length, width, thickness, and the ATFL/PTFL angle were measured, along with sagittal and coronal widths of the fibula and talus at ATFL attachment levels.Results: The ATFL was significantly longer, thinner, and narrower in the CAI group compared to controls (p < 0.001). The ATFL/PTFL angle was also significantly greater in the CAI group (p = 0.007). However, no statistically significant differences were observed in the sagittal or coronal widths of the talus and fibula. ROC analysis revealed that ATFL length had the highest diagnostic performance (AUC = 0.881). Logistic regression identified increased ATFL/PTFL angle and decreased ATFL width and thickness as independent predictors of instability.Conclusion: While the ligamentous characteristics of the ATFL, particularly its length and angulation, are strongly associated with CAI, the morphometric features of its bony attachment sites do not appear to contribute significantly. The ATFL/PTFL angle may be considered a reliable, indirect MRI marker in the assessment of CAI and should be considered in routine evaluations.","PeriodicalId":48743,"journal":{"name":"Foot and Ankle Surgery","volume":" ","pages":""},"PeriodicalIF":2.0000,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Foot and Ankle Surgery","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.fas.2025.09.009","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"ORTHOPEDICS","Score":null,"Total":0}

引用次数: 0

Abstract

Objective: This study aimed to evaluate the relationship between chronic ankle instability (CAI) and both the anatomical characteristics of the anterior talofibular ligament (ATFL) and the bony morphometry of its attachment sites on the fibula and talus using MRI.

Methods: A total of 94 patients were included in this retrospective study (44 with CAI, 50 controls). Morphometric parameters including ATFL length, width, thickness, and the ATFL/PTFL angle were measured, along with sagittal and coronal widths of the fibula and talus at ATFL attachment levels.

Results: The ATFL was significantly longer, thinner, and narrower in the CAI group compared to controls (p < 0.001). The ATFL/PTFL angle was also significantly greater in the CAI group (p = 0.007). However, no statistically significant differences were observed in the sagittal or coronal widths of the talus and fibula. ROC analysis revealed that ATFL length had the highest diagnostic performance (AUC = 0.881). Logistic regression identified increased ATFL/PTFL angle and decreased ATFL width and thickness as independent predictors of instability.

Conclusion: While the ligamentous characteristics of the ATFL, particularly its length and angulation, are strongly associated with CAI, the morphometric features of its bony attachment sites do not appear to contribute significantly. The ATFL/PTFL angle may be considered a reliable, indirect MRI marker in the assessment of CAI and should be considered in routine evaluations.

查看原文本刊更多论文

用MRI评价慢性踝关节不稳定ATFL附着物的骨形态及其解剖韧带特征。

目的：探讨慢性踝关节不稳定（CAI）与距腓骨前韧带（ATFL）的解剖特征及其在腓骨和距骨上附着部位的骨形态的关系。方法：回顾性研究94例患者，其中CAI组44例，对照组50例。测量ATFL长度、宽度、厚度、ATFL/PTFL角度等形态学参数，以及ATFL附着水平下腓骨和距骨的矢状面和冠状面宽度。结果：与对照组相比，CAI组的ATFL明显更长、更薄、更窄（p ）。结论：虽然ATFL的韧带特征，特别是其长度和成角，与CAI密切相关，但其骨附着部位的形态特征似乎没有显著影响。ATFL/PTFL角度可被认为是评估CAI的可靠、间接的MRI标记，应在常规评估中予以考虑。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Foot and Ankle Surgery ORTHOPEDICS-

CiteScore

4.60

自引率

16.00%

发文量

202

期刊介绍： Foot and Ankle Surgery is essential reading for everyone interested in the foot and ankle and its disorders. The approach is broad and includes all aspects of the subject from basic science to clinical management. Problems of both children and adults are included, as is trauma and chronic disease. Foot and Ankle Surgery is the official journal of European Foot and Ankle Society. The aims of this journal are to promote the art and science of ankle and foot surgery, to publish peer-reviewed research articles, to provide regular reviews by acknowledged experts on common problems, and to provide a forum for discussion with letters to the Editors. Reviews of books are also published. Papers are invited for possible publication in Foot and Ankle Surgery on the understanding that the material has not been published elsewhere or accepted for publication in another journal and does not infringe prior copyright.