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Relationship Between Chronic Lateral Ankle Instability and Hindfoot Varus Using Weight-Bearing Cone Beam Computed Tomography.

Publication ,  Journal Article
Lintz, F; Bernasconi, A; Baschet, L; Fernando, C; Mehdi, N; Weight Bearing CT International Study Group; de Cesar Netto, C
Published in: Foot Ankle Int
October 2019

BACKGROUND: Varus hindfoot deformity may increase the risk of chronic lateral ankle instability (CLAI). Our aim was to analyze hindfoot alignment (HFA) in patients with CLAI using weight-bearing cone beam computed tomography (WBCT) to assess this risk. METHODS: This retrospective, comparative analysis was carried out using an existing WBCT database (Talas, CurveBeam LLC), including data sets for 370 consecutive feet (189 patients) obtained between July 2016 and October 2018 at a single institution. The software provided semiautomated measurement of HFA, given as foot ankle offset (FAO). Univariate analysis was conducted to compare feet with and without CLAI against sex, age, body mass index, and FAO. Significant variables were included in a multivariable logistic model with random effects to take into account correlation between feet of the same patient. RESULTS: Forty-three feet had CLAI (34 patients). FAO (P = .0009) was significant for CLAI by univariate analysis. Mean FAO was -2.2% ± 5.5% (varus) and + 2.6% ± 4.7% (valgus) with and without CLAI history, respectively. Multivariable logistic regression adjusted for sex and age demonstrated a 35% increased odds ratio (OR) of CLAI per 1% reduction in FAO value (varus) (adjusted OR=0.64, 95% confidence interval [CI]: 0.49-0.84; P = .001) and no significant effect of sex (adjusted OR=0.52; P = .617) or age (adjusted OR=0.94; P = .165) after adjustment for FAO. CONCLUSION: A positive relationship was found between varus HFA and the risk to have CLAI. Systematic recording of FAO measurements from WBCT images along with clinical data regarding CLAI history proved successful at quantifying the risk of CLAI. LEVEL OF EVIDENCE: Level III, retrospective cohort study.

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Published In

Foot Ankle Int

DOI

EISSN

1944-7876

Publication Date

October 2019

Volume

40

Issue

10

Start / End Page

1175 / 1181

Location

United States

Related Subject Headings

  • Young Adult
  • Weight-Bearing
  • Retrospective Studies
  • Orthopedics
  • Middle Aged
  • Male
  • Joint Instability
  • Humans
  • Female
  • Cone-Beam Computed Tomography
 

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Lintz, F., Bernasconi, A., Baschet, L., Fernando, C., Mehdi, N., Weight Bearing CT International Study Group, & de Cesar Netto, C. (2019). Relationship Between Chronic Lateral Ankle Instability and Hindfoot Varus Using Weight-Bearing Cone Beam Computed Tomography. Foot Ankle Int, 40(10), 1175–1181. https://doi.org/10.1177/1071100719858309
Lintz, François, Alessio Bernasconi, Louise Baschet, Céline Fernando, Nazim Mehdi, Weight Bearing CT International Study Group, and Cesar de Cesar Netto. “Relationship Between Chronic Lateral Ankle Instability and Hindfoot Varus Using Weight-Bearing Cone Beam Computed Tomography.Foot Ankle Int 40, no. 10 (October 2019): 1175–81. https://doi.org/10.1177/1071100719858309.
Lintz F, Bernasconi A, Baschet L, Fernando C, Mehdi N, Weight Bearing CT International Study Group, et al. Relationship Between Chronic Lateral Ankle Instability and Hindfoot Varus Using Weight-Bearing Cone Beam Computed Tomography. Foot Ankle Int. 2019 Oct;40(10):1175–81.
Lintz, François, et al. “Relationship Between Chronic Lateral Ankle Instability and Hindfoot Varus Using Weight-Bearing Cone Beam Computed Tomography.Foot Ankle Int, vol. 40, no. 10, Oct. 2019, pp. 1175–81. Pubmed, doi:10.1177/1071100719858309.
Lintz F, Bernasconi A, Baschet L, Fernando C, Mehdi N, Weight Bearing CT International Study Group, de Cesar Netto C. Relationship Between Chronic Lateral Ankle Instability and Hindfoot Varus Using Weight-Bearing Cone Beam Computed Tomography. Foot Ankle Int. 2019 Oct;40(10):1175–1181.
Journal cover image

Published In

Foot Ankle Int

DOI

EISSN

1944-7876

Publication Date

October 2019

Volume

40

Issue

10

Start / End Page

1175 / 1181

Location

United States

Related Subject Headings

  • Young Adult
  • Weight-Bearing
  • Retrospective Studies
  • Orthopedics
  • Middle Aged
  • Male
  • Joint Instability
  • Humans
  • Female
  • Cone-Beam Computed Tomography