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Does subtalar instability really exist? A systematic review.

Frederick Michels1, Stefan Clockaerts2, Jan Van Der Bauwhede1

  • 1Orthopaedic Department, AZ Groeninge, President Kennedylaan 4, 8500, Kortrijk, Belgium.

Foot and Ankle Surgery : Official Journal of the European Society of Foot and Ankle Surgeons
|March 5, 2019
PubMed
Summary
This summary is machine-generated.

Subtalar joint instability (STI) can cause chronic hindfoot pain. While diagnosis is challenging, MRI can identify ligament injuries and abnormal motion, aiding clinical assessment.

Keywords:
Ankle instabilityBrodén viewHindfoot instabilityInterosseous talocalcaneal ligamentInversion stressLigament injurySubtalar instabilitySubtalar joint

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Area of Science:

  • Orthopedics
  • Sports Medicine
  • Radiology

Background:

  • Subtalar joint instability (STI) is a potential cause of chronic lateral hindfoot instability.
  • Clinical diagnosis of STI remains a significant challenge.
  • This review assesses the diagnostic consistency and reliability of tools for STI.

Purpose of the Study:

  • To evaluate the clinical entity of subtalar instability.
  • To determine the reliability of diagnostic methods for STI.
  • To critically review existing literature on subtalar instability.

Main Methods:

  • Systematic review of Medline, Web of Sciences, and EMBASE databases.
  • Included studies on subtalar instability, sinus tarsi syndrome, and acute ligament lesions.
  • Assessed diagnostic tests for subtalar instability and ligament injuries.

Main Results:

  • Identified 25 relevant studies (16 on chronic STI, 5 on acute lesions, 4 on STS).
  • Found evidence linking instability complaints to increased subtalar motion or ligament abnormalities.
  • Stress radiographs showed insufficient evidence; MRI effectively assessed ligament abnormalities and motion.

Conclusions:

  • Subtalar joint instability complaints correlate with ligament injuries and abnormal motion.
  • Stress radiographs require cautious interpretation and are not a reference standard.
  • Clinical diagnosis should integrate multiple parameters, including MRI findings.