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Magnetic Resonance Imaging Clinics of... Nov 2022Many surgical procedures and operations are used to treat ankle and foot disorders. Radiography is the first-line imaging for postoperative surveillance and evaluation... (Review)
Review
Many surgical procedures and operations are used to treat ankle and foot disorders. Radiography is the first-line imaging for postoperative surveillance and evaluation of pain and dysfunction. Computed tomography scans and MR imaging are used for further evaluation. MR imaging is the most accurate test for soft tissues assessments. MR imaging protocol adjustments include basic and advanced metal artifact reduction. We chose a surgical approach to select the common types of procedures and discuss the normal and abnormal postoperative MR imaging appearances, highlighting potential complications. This article reviews commonly used surgical techniques and their normal and abnormal MR imaging appearances.
Topics: Ankle; Ankle Injuries; Ankle Joint; Foot Diseases; Humans; Magnetic Resonance Imaging
PubMed: 36243515
DOI: 10.1016/j.mric.2022.05.006 -
Foot and Ankle Clinics Sep 2023Ultrasound is a high-resolution, real-time imaging modality that is frequently used for image-guided procedures. Due to the highly complex anatomy of the foot and ankle,... (Review)
Review
Ultrasound is a high-resolution, real-time imaging modality that is frequently used for image-guided procedures. Due to the highly complex anatomy of the foot and ankle, ultrasound should be considered a first-line imaging modality for injections and procedures in this region.
Topics: Humans; Ankle; Ankle Joint; Ultrasonography; Injections, Intra-Articular
PubMed: 37536823
DOI: 10.1016/j.fcl.2023.04.005 -
Skeletal Radiology Jan 2020The distal tibiofibular joint is a fibrous joint that plays a crucial role in the stability of the ankle joint. It is stabilized by three main ligaments: the anterior... (Review)
Review
The distal tibiofibular joint is a fibrous joint that plays a crucial role in the stability of the ankle joint. It is stabilized by three main ligaments: the anterior inferior tibiofibular ligament, the posterior inferior tibiofibular ligament, and the interosseous tibiofibular ligament, which are well delineated on magnetic resonance imaging. Pathology of the distal tibiofibular joint is mostly related to trauma and the longer-term complications of trauma, such as soft tissue impingement, heterotopic ossification, and synostosis. This review article outlines the MRI anatomy and pathology of this joint.
Topics: Ankle Injuries; Ankle Joint; Arthrography; Chronic Disease; Humans; Ligaments, Articular; Magnetic Resonance Imaging; Patient Positioning
PubMed: 31289899
DOI: 10.1007/s00256-019-03260-7 -
Foot and Ankle Clinics Jun 2023Not all ankle sprains are the same and not all ankles behave the same way after an injury. Although we do not know the mechanisms behind an injury producing an unstable... (Review)
Review
Not all ankle sprains are the same and not all ankles behave the same way after an injury. Although we do not know the mechanisms behind an injury producing an unstable joint, we do know ankle sprains are highly underestimated. While some of the presumed lateral ligament lesions might eventually heal and produce minor symptoms, a substantial number of patients will not have the same outcome. The presence of associated injuries, such as additional medial chronic ankle instability, chronic syndesmotic instability, has been long discussed as a possible reason behind this. To explain multidirectional chronic ankle instability, this article aims to present the literature surrounding the condition and its importance nowadays.
Topics: Humans; Ankle; Ankle Joint; Joint Instability; Sprains and Strains; Ankle Injuries
PubMed: 37137631
DOI: 10.1016/j.fcl.2023.01.012 -
Physical Medicine and Rehabilitation... Nov 2021Ablation therapies in the foot and ankle are accessible adjuncts to surgery and comprehensive pain management in recalcitrant pain syndromes. Techniques are best applied... (Review)
Review
Ablation therapies in the foot and ankle are accessible adjuncts to surgery and comprehensive pain management in recalcitrant pain syndromes. Techniques are best applied to individual patient anatomy with strong advantages in a working knowledge of neuromuscular real-time imaging with ultrasound. Interventionists face the unique challenge in this region of preserving balance and proprioception as well as intrinsic muscle function, while optimizing pain relief. A decision-making approach emphasizing selectivity by using regional and target-specific ablations is optimal. This article reviews basic technique, approaches, potential complications, and ultrasound anatomy for a practical introduction to ablation options in the foot and ankle.
Topics: Ankle; Ankle Joint; Humans; Pain Management; Proprioception; Ultrasonography
PubMed: 34593145
DOI: 10.1016/j.pmr.2021.05.014 -
Clinics in Podiatric Medicine and... Jul 2023Arthroscopic reduction of tibiotalar osteophytes results in good to excellent results in the vast majority of patients. Pain is primarily due to synovial hypertrophy and... (Review)
Review
Arthroscopic reduction of tibiotalar osteophytes results in good to excellent results in the vast majority of patients. Pain is primarily due to synovial hypertrophy and anterior tibiotalar entrapment associated with the osteophytes. Osteophytes may be due to repetitive trauma such as sports, or associated with subtle or overt ankle instability. A minimally invasive approach results in rapid recovery and less risk than open interventions. In cases where anterior osteophytes have coexisting ankle instability and in many cases ancillary procedures such as ankle stabilization are performed.
Topics: Humans; Ankle; Osteophyte; Ankle Joint; Arthroscopy; Joint Instability
PubMed: 37236678
DOI: 10.1016/j.cpm.2022.12.001 -
Clinics in Podiatric Medicine and... Oct 2023Ankle fusion is a well-studied, classical procedure for conditions affecting the ankle joint, and has a long history with predictable results. Although there are many... (Review)
Review
Ankle fusion is a well-studied, classical procedure for conditions affecting the ankle joint, and has a long history with predictable results. Although there are many different approaches available, a few options are commonly used. The two main focuses of modern literature are on anterior plating versus traditional screw fixation, and on arthroscopic versus open techniques for fusion. This article discusses recent literature and then presents cases and techniques that are commonly used today. This includes arthroscopic ankle arthrodesis, traditional transfibular approach, anterior plating, and the indications and application of external fixation. Standard recovery and complications are discussed.
Topics: Humans; Ankle Joint; Ankle; Arthrodesis; Bone Screws; Fracture Fixation, Internal
PubMed: 37716745
DOI: 10.1016/j.cpm.2023.05.010 -
Clinics in Podiatric Medicine and... Apr 2022Total ankle replacement (TAR) continues to increase in popularity as a motion-preserving option to ankle arthrodesis. TAR is indicated for primary, posttraumatic and... (Review)
Review
Total ankle replacement (TAR) continues to increase in popularity as a motion-preserving option to ankle arthrodesis. TAR is indicated for primary, posttraumatic and inflammatory arthropathies as an alternative procedure to tibiotalar arthrodesis. Proper patient selection is paramount to a successful outcome in TAR. Contraindications to TAR include the presence of neuropathy, active infection, severe peripheral arterial disease, inadequate bone stock, and severe uncorrectable coronal plane deformity. This article is a brief overview of techniques and PEARLS on how to address a well-aligned ankle joint, varus deformity as well as valgus deformities as well as the authors' experience with single versus staging coronal plane deformities.
Topics: Ankle; Ankle Joint; Arthritis; Arthroplasty, Replacement, Ankle; Humans; Range of Motion, Articular
PubMed: 35365326
DOI: 10.1016/j.cpm.2021.11.012 -
Foot and Ankle Surgery : Official... Apr 2022There is limited literature on axial rotation of the ankle or variations in anatomy of the talus. We aim to evaluate the rotational profile of the distal tibia and its...
BACKGROUND
There is limited literature on axial rotation of the ankle or variations in anatomy of the talus. We aim to evaluate the rotational profile of the distal tibia and its relationship to talus morphology, radiographic foot-type, and tibiotalar tilt in arthritic ankles.
METHODS
Preoperative imaging was reviewed in 173 consecutive patients with ankle arthritis. CT measurements were used to calculate tibial torsion and the talar neck-body angle (TNBA). Tibiotalar tilt and foot-type were measured on weightbearing plain radiographs.
RESULTS
Measurements indicated mean external tibial torsion of 29.2±9.1˚ and TNBA of 35.2±7.5˚ medial. Tibiotalar tilt ranged from 48˚ varus to 23.5˚ valgus. A moderate association between increasing external tibial torsion and decreasing TNBA was found (ρ=-0.576, p<.0001). Weak relationships were found between external tibial torsion and varus tibiotalar tilt (ρ=-0.239, p=.014) and plantarflexion of the talo-first metatarsal angle (ρ=-0.218, p<.025).
CONCLUSION
We observed a statistically significant correlation between tibial torsion and morphology of the talus, tibiotalar tilt, and first ray plantarflexion. This previously unreported association may provide information regarding the development of foot and ankle deformity and pathology.
LEVEL OF EVIDENCE
Level III.
Topics: Ankle; Ankle Joint; Arthritis; Humans; Talus; Weight-Bearing
PubMed: 33888396
DOI: 10.1016/j.fas.2021.04.007 -
Clinics in Podiatric Medicine and... Jul 2023The arthroscopic approach provides a manageable postoperative course in terms of wound healing, pain control, and bone healing when compared with an open procedure. In... (Review)
Review
The arthroscopic approach provides a manageable postoperative course in terms of wound healing, pain control, and bone healing when compared with an open procedure. In particular, posterior arthroscopic subtalar joint arthrodesis (PASTA) allows a reproducible and viable alternative to standard lateral-portal subtalar joint (STJ) arthrodesis without violating sinus or canalis tarsi neurovascular structures. Additionally, those patients who have undergone previous total ankle arthroplasty, arthrodesis, or talonavicular joint arthrodesis may be better served with PASTA over open arthrodesis if STJ fusion becomes necessary. This article describes the unique PASTA surgical procedure and its helpful tips and pearls.
Topics: Humans; Subtalar Joint; Arthroscopy; Arthrodesis; Ankle; Ankle Joint
PubMed: 37236684
DOI: 10.1016/j.cpm.2023.02.002