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Published on: January 24, 2018
Evaluation of Subtalar Joint's Compensatory Function in Varus Ankle Osteoarthritis Using Globally Optimal Iterative
Hiroaki Kurokawa1, Shinichi Kosugi1, Takuya Fujinuma2
1Nara Medical University, Nara, Japan.
Background:
A previous study on 2-dimensional evaluation of the subtalar joint functioning in varus ankle osteoarthritis concluded that varus deformity was compensated for by the subtalar joint during early stages but not in the advanced stages. Although compensatory function is expected both along the axial and coronal planes, compensatory function in all 3 dimensions (3D) remains unevaluated. This study evaluated the 3D-compensatory function of a varus subtalar joint using Globally Optimal Iterative Closest Points (Go-ICP), a 3D-shape registration algorithm, after 3D-bone shape reconstruction using computed tomography.
Methods:
This study included 22 ankles: 4 stage 2 ankles, 5 stage 3a ankles, 6 stage 3b ankles, and 4 stage 4 ankles, categorized according to the Takakura-Tanaka classification. As the control group, 3 ankles without prior ankle injuries and disorders and 4 stage 2 ankles were included. One control ankle was used as a reference. Relative values compared with the reference ankle were evaluated in each group using Go-ICP. Each axis was set so that dorsiflexion, valgus, and abduction were positive on the X axis, Y axis, and Z axis, respectively.
Results:
Rotation angles of the talus (Rotation T) and calcaneus (Rotation C) on the Y axis in the control and stage 3b were -7.6, -28, -2.1, and -13 degrees, respectively, indicating significant differences. Value of Rotation T-Rotation C (Rotation T-C) represents compensatory function of the subtalar joint. In all ankles, there was a correlation between Rotation T and Rotation T-C on the Y axis and Z axis (P < .01, r = 0.84; P < .01, r = -0.84, respectively). There was a correlation between Rotation T values on the on Y and Z axes (P = .01, r = 0.53).
Conclusion:
In varus ankle osteoarthritis, the talus had varus deformity with adduction. Compensatory function in the coronal plane persisted, even in the advanced stages; however, it was not sufficiently maintained in stage 3b. Furthermore, compensatory function in the axial plane was relatively sustained.
Level Of Evidence:
Level III, retrospective comparative study.
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