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Talolisthesis in end stage ankle arthrosis
Jeffrey C Christensen1, John M Schuberth2, Eric G Powell3
1Attending Surgeon, Department of Orthopedics Swedish Medical Center, Seattle, WA. 3131 Nassau Street, Suite 101, Everett WA 98201.
Summary
Sagittal displacement, measured by tibiotalar ratio (TTR), is common in end-stage ankle arthritis. Abnormal TTR is influenced by distal tibial angles and talar tilt, indicating joint morphology changes.
Area of Science:
- Orthopedic Surgery
- Radiology
- Biomechanical Analysis
Background:
- End-stage ankle arthritis frequently involves sagittal displacement, quantified by the tibiotalar ratio (TTR).
- The prevalence, patterns, and predictors of talolisthesis in this patient group remain largely uncharacterized.
Purpose of the Study:
- To investigate the incidence and distribution of sagittal talar displacement in end-stage ankle arthritis.
- To identify predictive factors associated with abnormal tibiotalar alignment.
Main Methods:
- Radiographic analysis of 470 end-stage ankle arthritis cases and 49 normal controls.
- Measurement of tibiotalar ratio (TTR), anterior and lateral distal tibial angles, and talar tilt.
- Multivariate linear regression to identify predictors of abnormal TTR.
Main Results:
- Mean TTR was similar between arthritis (34.8±9.12) and normal (34.1±2.62) groups.
- Twenty-eight percent of arthritic ankles showed anterior displacement, 28% posterior talolisthesis, and 44% normal alignment.
- Anterior distal tibial angle and talar tilt were significant predictors of abnormal TTR (p<0.0001 and p=0.0007, respectively).
Conclusions:
- Sagittal displacement is a frequent finding in end-stage ankle arthritis.
- Ligamentous laxity and altered joint morphology, specifically distal tibial angles and talar tilt, significantly impact tibiotalar alignment.
