The signal intensity of preoperative magnetic resonance imaging has predictive value for determining the arthroscopic re
- PDF / 1,179,626 Bytes
- 9 Pages / 595.276 x 790.866 pts Page_size
- 101 Downloads / 142 Views
ANKLE
The signal intensity of preoperative magnetic resonance imaging has predictive value for determining the arthroscopic reparability of the anterior talofibular ligament Jungtae Ahn1 · Jung Gyu Choi1 · Bi O Jeong1 Received: 30 April 2020 / Accepted: 3 August 2020 © European Society of Sports Traumatology, Knee Surgery, Arthroscopy (ESSKA) 2020
Abstract Purpose Arthroscopic all-inside anterior talofibular ligament (ATFL) repair is a common surgical technique for chronic ankle instability (CAI), and the condition of the ATFL remnants is associated with its reparability. ATFL reparability can affect the clinical course, but the relationship between magnetic resonance imaging (MRI) findings and the intraoperative ATFL reparability is still unclear. The purpose of this study was to investigate the relationship between ATFL signal intensities according to MRI and intraoperative ATFL reparability. Methods This study included 55 cases of CAI (n = 37) and osteochondral lesion of the talus (n = 18) that underwent MRI followed by subsequent arthroscopy. MRI signal intensity was measured preoperatively to calculate the signal to noise ratio (SNR). During arthroscopy, the presence of an ATFL tear was checked and the ATFL tension was classified as taut, mild laxity, or laxity; ATFL quality was classified as excellent (normal), moderate (abnormal but reparable), or poor (irreparable). It was then analyzed whether there was a relationship between the intraoperative findings and the SNR. Results The mean SNR was 23.4 ± 21.6. The SNR was significantly different according to the presence of an ATFL tear and ATFL tension and quality (all P = 0.001). The SNR was better correlated with ATFL quality (r = 0.708) than the presence of a tear (r = 0.545) or degree of tension (r = 0.653). The diagnostic SNR cutoff point to distinguish a normal ATFL from an abnormal but reparable ATFL was 11.2, and that to distinguish between an irreparable and reparable ATFL, was 32.3. Conclusion The SNR, representing MRI signal intensities, is highly correlated with the intraoperative measures of the ATFL. Therefore, the SNR had predictive value for determining the arthroscopic reparability of the ATFL. Level of evidence Level III. Keywords Anterior talofibular ligament · Chronic ankle instability · Signal intensity · Signal/noise ratio · Magnetic resonance imaging
Introduction Despite the use of multimodal conservative treatment interventions following an acute ankle sprain, 15–20% of patients have persistent symptoms or reduced ankle strength [2, 8, 10]. For patients with chronic ankle instability (CAI) who do not respond to adequate conservative treatment, surgical restoration of mechanical instability is considered, and * Bi O Jeong [email protected] 1
Department of Orthopedic Surgery, College of Medicine, Kyung Hee University, 23 Kyunghee‑daero, Dongdaemun‑gu, Seoul 02447, South Korea
most surgical techniques are associated with satisfactory outcomes [3, 17, 20]. Among these techniques, the modified Broström procedure is considered
Data Loading...
