scholarly journals Is the fibula positioned anteriorly in weight-bearing in individuals with chronic ankle instability? A case control study

2020 ◽  
pp. 1-8
Author(s):  
Ishanka Weerasekara ◽  
Peter G. Osmotherly ◽  
Suzanne Snodgrass ◽  
John Tessier ◽  
Darren A. Rivett
Keyword(s):  
Case Control Study ◽  
Ankle Instability ◽  
Weight Bearing ◽  
Case Control ◽  
Chronic Ankle Instability ◽  
Control Study

scholarly journals Deviations in gait metrics in patients with chronic ankle instability: a case control study

2015 ◽  
Vol 8 (1) ◽  
Author(s):  
Roy Gigi ◽  
Amir Haim ◽  
Elchanan Luger ◽  
Ganit Segal ◽  
Eyal Melamed ◽  
...  
Keyword(s):  
Case Control Study ◽  
Ankle Instability ◽  
Case Control ◽  
Chronic Ankle Instability ◽  
Control Study

scholarly journals Hallux valgus measurements using weight-bearing computed tomography: what changes?

2021 ◽  
Vol 15 (3) ◽  
pp. 259-264
Author(s):  
Samuel Braza ◽  
Nacime Salomão Barbachan Mansur ◽  
Vineel Mallavarapu ◽  
Kepler Alencar Mendes de Carvalho ◽  
Kevin Dibbern ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Hallux Valgus ◽  
Case Control Study ◽  
Weight Bearing ◽  
Metatarsal Head ◽  
Case Control ◽  
Retrospective Case ◽  
Level Of Evidence ◽  
Mean Values ◽  
Control Study

Objective: To assess whether traditional hallux valgus (HV) measurements obtained with conventional radiography (CR) correspond to those obtained with weight-bearing computed tomography (WBCT). Methods: In this retrospective case-control study, 26 HV feet and 20 control feet were analyzed with CR and WBCT. Hallux valgus angle (HVA), intermetatarsal angle (IMA), interphalangeal angle (IPA), distal metatarsal articular angle (DMAA), sesamoid station (SS), and first metatarsal head shape were measured. Chi-square tests were used to compare hallux valgus and control patients. T-tests were used to compare CR and WBCT. P-values less than 0.05 were considered significant. Results: WBCT was capable of discriminating patients with HV from controls, showing higher mean values for HV patients than controls in HVA (35.29 and 9.02, p < 0.001), IMA (16.01 and 10.01, p < 0.001), and DMAA (18.90 and 4.10, p < 0.001). When comparing the two methods, differences were not significant between CR and WBCT measurements in HVA (-0.84, p = 0.79), IMA (-0.93, p = 0.39), IPA (1.53, p = 0.09), or SS (p = 0.40), but were significant for DMAA (13.43, p < .0001). CR analysis yielded varied metatarsal head shapes, while all WBCT shape classifications were round.  Conclusion: Unidimensional HV measurements were similar between WBCT and CR, while more three-dimensional findings were not. CR may be used to assess the axial aspects of HV, but multidimensional aspects of the deformity may not be accurately assessed with plain radiographs. Level of Evidence III; Therapeutic Studies; Retrospective Case-Control Study.

scholarly journals Short and Medium Latency Responses in Participants With Chronic Ankle Instability

2018 ◽  
Vol 53 (7) ◽  
pp. 679-686 ◽  
Author(s):  
Andreia S. P. Sousa ◽  
Isabel Valente ◽  
Ana Pinto ◽  
Tiago Soutelo ◽  
Márcia Silva
Keyword(s):  
Postural Stability ◽  
Case Control Study ◽  
Outcome Measure ◽  
Ankle Instability ◽  
Chronic Ankle Instability ◽  
Injured Limb ◽  
Postural Adjustments ◽  
Postural Responses ◽  
Control Study

Context:  The determinant role of medium latency responses (MLRs) during compensatory postural adjustments in postural stability and the lack of clarity about the mechanisms behind chronic ankle instability (CAI) sustain the hypothesis that these postural responses are impaired in this condition. However, to the best of our knowledge, no authors have assessed MLRs in patients with CAI; most of the research regarding compensatory postural adjustments has been directed at the timing of short latency responses (SLRs). Objective:  To evaluate bilateral compensatory postural responses, including SLRs and MLRs, in response to a unilateral simulated ankle-sprain mechanism in participants with CAI. Design:  Case-control study. Setting:  Laboratory. Patients or Other Participants:  Twenty-four participants with CAI and 20 controls. Intervention(s):  Bilateral electromyography of the peroneus longus (PL), peroneus brevis, tibialis anterior (TA), and soleus (SOL) muscles was collected during a unilateral sudden-inversion perturbation (30°). Main Outcome Measure(s):  Muscle-onset activations and magnitudes of SLRs and MLRs in the support and perturbed positions. Results:  Participants with CAI showed (1) later-onset activation of the TA and SOL in the uninjured limb and bilateral decreases in the magnitude of the TA MLR in the support position, (2) increased magnitude of the PL MLR in the uninjured limb in the support and perturbed positions, and (3) increased magnitude of the PL SLR and MLR in the injured limb in the perturbed position. Conclusions:  Chronic ankle instability was associated with later TA and SOL activation in the uninjured limb and bilaterally decreased magnitude of the TA MLR in the support position.

scholarly journals Three-Dimensional Weightbearing Assessment of the First Ray in Hallux Valgus: A Case-Control Study

2019 ◽  
Vol 4 (4) ◽  
pp. 2473011419S0005
Author(s):  
Francois Lintz ◽  
Alessio Bernasconi ◽  
Celine Fernando ◽  
Matthew Welck ◽  
Cesar de Cesar Netto
Keyword(s):  
Hallux Valgus ◽  
Case Control Study ◽  
Weight Bearing ◽  
Three Dimensional ◽  
Case Control ◽  
Rotational Deformity ◽  
Intermetatarsal Angle ◽  
First Ray ◽  
3D Architecture ◽  
Control Study

Category: Bunion Introduction/Purpose: Coronal plane rotational deformity of the first ray has been implicated with the developmental pathologic process of hallux valgus (HV). Weight Bearing CT (WBCT) is an imaging technology that can support the assessment of this complex three-dimensional (3D) deformity. The objective of the study was to analyze the 3D architecture of the first ray in patients with HV when compared to controls using WBCT images and a 3D biometric algorithm analyzing the deformity in all three planes. We hypothesized that WBCT would confirm the rotational deformity in HV patients, and that the 3D algorithm would demonstrate increased specificity and sensitivity for the pathology when compared to traditional two-dimensional (2D) HV measurements such as the 1-2 intermetatarsal angle. Methods: Retrospective case-control study, ethics committee approved. Twenty-one feet of patients with clinically symptomatic HV and 20 feet of asymptomatic controls were included. Exclusion criteria applied were previous trauma or surgery affecting first ray or forefoot morphology. All patients were assessed using WBCT. First ray 3D coordinates (x, y, z) were harvested including: center-points of the heads and bases of the first and second metatarsals, center-point of the medial and lateral sesamoids, distal condyles of the proximal phalanx (PP) of the first toe, as well as the medial and lateral borders of the first metatarsal head and diaphysis. The 2D measurements (dorsoplantar 1-2 intermetatarsal (IMA) and metatarsophalangeal (MPA) angles) were obtained using digitally reconstructed radiographs (DRR). The Sesamoid Rotation Angle (SRA) was measured in the coronal plane. Using these coordinates, all 2D, 3D axes, distances, angulations and 3D biometric for HV (HV-3DB) could be calculated. Results: Mean ages were respectively 62.2y in the HV group and 48.8y in the control group (p<0.05). In 2D, the mean IMA and MPA for HV/controls were respectively 14.9/9.3 (p<0.001) and 30.1/13.1 (p<0.001). The SRA were respectively 29.1/7.1 (p<0.001). We found an almost perfect positive correlation between P1 rotation and sesamoid rotation, good correlation between IMA, MPA and SRA angles. There was poor correlation between pronation angles of the 1st phalanx and the 1st metatarsal. The 3D biometric algorithm combining IMA, MPA and SRA had a sensitivity of 95% and a specificity of 95.2% for the diagnosis of HV, compared to 90%/85.6% for the IMA and 90%/90.5% for the SRA. Conclusion: This original study confirmed our hypotheses. Weight Bearing CT efficiently analyzed the 3D architecture of the 1st ray in HV patients compared to asymptomatic controls. We concur with previous findings described in the literature concerning increased pronation of the 1st ray in HV. A novel biometric for HV using a specific multidimensional algorithm which combined IMA, HVA and SRA in a single 3D measurement, demonstrated increased sensitivity and specificity compared to the conventional 2D 1-2 intermetatarsal angle for the diagnosis of HV.

scholarly journals Evaluation of a Weightbearing CT Artificial Intelligence-based Automatic Measurement for Hallux Valgus: A Case-Control Study

2020 ◽  
Vol 5 (4) ◽  
pp. 2473011420S0003
Author(s):  
Jonathan Day ◽  
Francois Lintz ◽  
Martinus Richter ◽  
Céline Fernando ◽  
Scott J. Ellis ◽  
...  
Keyword(s):  
Artificial Intelligence ◽  
Hallux Valgus ◽  
Case Control Study ◽  
Weight Bearing ◽  
Intraclass Correlation ◽  
Automatic Measurement ◽  
Case Control ◽  
Foot And Ankle ◽  
Beta Version ◽  
Control Study

Category: Bunion; Other Introduction/Purpose: Cone Beam Weight Bearing CT (WBCT) is gaining traction, particularly in the foot and ankle, due to the ability to perform natural stance weight bearing 3D scans. However, the resulting wealth of 3D data renders daily clinical use time consuming. Therefore, reliable automatic measurements are indispensable in order to make best use of the technology. The aim of this study was to evaluate a beta-version WBCT artificial intelligence (AI) automatic measurement system for the M1-M2 intermetatarsal angle (IMA), which is applicable in the absence of metallic hardware in the foot and ankle. We hypothesized that automatic measurements would correlate well with human measurements, and that software reproducibility would be better and close to perfect compared to manual measurements. Methods: In this retrospective case-control study, 90 feet were included from patients who underwent WBCT scans during routine follow up: 44 feet (90.9% female, mean age 54 years) with symptomatic hallux valgus (HV), 46 controls (76.1% female, mean age 49 years). Patients were excluded if they had history of surgery or trauma involving the first or second metatarsals, hallux rigidus, or presence of metal in their foot/ankle. IMA was measured manually on Digitally Reconstructed Radiographs (DRR IMA) and automatically with AI software producing auto 2D (ground plane projection) and 3D (multiplanar) measurements. Each IMA DRR was measured by two independent raters twice to calculate intraclass correlation coefficients (ICCs). To assess intra- software reliability, AI software measurements were made twice on each dataset. Manual and automatic measurements were compared between HV and control groups. Failures of the AI software to produce a measurement were recorded. Results: Mean values for controls were 8.6° +-1.8° (range, 5°-14°) for the manually measured DRR IMA, 9.3° +-2.8° (range, 3°- 17°) for auto 2D, and 9.2° +-2.6° (range, 3°-16°) for auto 3D IMA measurements. Compared to controls, HV patients demonstrated significantly increased IMA (p<0.0001): 14.2° +-2.7° (range, 8°-21°) for the manually measured DRR IMA, 15.4°+- 4.4° (range, 8°-26°) for auto 2D, and 15.1° +-4.1° (range 8°-28°) for auto 3D IMA measurements. There were strong correlations (r=0.75 and r=0.80) between manual and auto 2D and 3D measurements. Intraobserver and interobserver ICCs for DRR IMA were 0.96 and 0.90, respectively, and the intra-software ICCs for the AI were near 1.0 for both auto 2D and auto 3D IMA. The AI software failed in 32.3% cases. Conclusion: Our results demonstrated strong correlation between a WBCT Artificial Intelligence based automatic measurement for IMA with human measurements, with the ability to distinguish HV from control with close to 100% repeatability. However, the number of failures was still high due to the early stage beta-version of the algorithm tested. While these early results are promising, further developments are warranted in order to improve usability of this tool in daily practice, especially in the presence of metal hardware. [Figure: see text]

scholarly journals Results of the weight-bearing Lunge test on patients with functional hallux limitus: A cross sectional case–control study

2017 ◽  
Vol 28 (2) ◽  
pp. e32-e37
Author(s):  
José Javier Alfaro Santafé ◽  
Antonio Gómez Bernal ◽  
Carla Lanuza Cerzócimo ◽  
Carlos Sempere Bonet ◽  
Aida Barniol Mercade ◽  
...  
Keyword(s):  
Case Control Study ◽  
Weight Bearing ◽  
Case Control ◽  
Cross Sectional ◽  
Hallux Limitus ◽  
Control Study

scholarly journals Clinical Significance of Measurements in Adult Acquired Flatfoot Deformity using Weight Bearing CT: A Matched Case-Control Study

2020 ◽  
Vol 5 (4) ◽  
pp. 2473011420S0033
Author(s):  
Francois Lintz ◽  
Alessio Bernasconi ◽  
Matthieu Lalevée ◽  
Céline Fernando ◽  
Alexej Barg ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Case Control Study ◽  
Weight Bearing ◽  
Roc Curves ◽  
Case Control ◽  
Foot And Ankle ◽  
Adult Acquired Flatfoot Deformity ◽  
Diagnostic Power ◽  
2D And 3D ◽  
Control Study

Category: Hindfoot; Other Introduction/Purpose: Adult Acquired Flatfoot Deformity (AAFD) results in progressive foot collapse through peritalar subluxation. Numerous radiographic and Weight Bearing CT (WBCT) measurements have been described in the literature aiming to gauge the severity of the multiple components of the deformity. However, the real diagnostic power of each measurement is currently unknown. Moreover, novel measurements have recently been described such as 3D biometrics and multidimensional measurements. The objective of this case-control study was to individually assess the diagnostic accuracy of known 2D and 3D WBCT measurements and to compare it with a novel multidimensional measurement. We hypothesized that the latter would demonstrate superior diagnostic power than isolated 2D and 3D measurements. Methods: Retrospective case-control study, including 19 AAFD feet and 19 controls that were matched for age, gender and BMI (9 male, 10 female, mean age 54.4 years in both groups). All patients had standing WBCT imaging as baseline assessment of their foot pathology. 2D measurements assessed included: axial and sagittal talus-first metatarsal angles (TM1A), talonavicular coverage angle (TNCA), forefoot arch angle (FFAA) and middle facet incongruence angle (MF°) and uncoverage percentage (MF%). The 3D Foot and Ankle Offset (FAO) was calculated using semi-automatic software. A novel multiplanar biometric measurement (AAFD- MD) was calculated using a multidimensional mathematical algorithm that pooled multiplanar 2D measurements. Intra and interobserver reliabilities were assessed. Comparisons between variables were done using Student-t test or Wilcoxon rank-sum test. Receiver Operating Characteristic (ROC) curves were calculated to determine diagnostic accuracy, sensitivity and specificity of each measurement. Results: AUC for ROC curves were 1. for MF%, 0.96 for FAO, 0.94 for MF° and 0.92 for AAFD-MD. For MF%, a threshold value equal of greater than 28.1% was found to be diagnostic of AAFD with a sensitivity of 100% and specificity of 100%. FFAA were decreased in AAFD: 6.3° versus 15.2° in controls (p<0.001). Axial and sagittal TM1A were respectively 17.6° and 20.8° in AAFD, while in controls: 7.5° (p<0.001) and 6.3° (p< 0.001). The TNCA was increased in AAFD: 27.9° versus 15.6° in controls (p<0.001). In AAFD, MF° and MF% were respectively 13° and 49.4% compared with 5.3° and 10.6% in controls (p<0.001 for both). The FAO was 7.5% in AAFD and 1.1% in controls (p<0.001). Conclusion: The observed results did not confirm our hypothesis. The multidimensional measurement was not as accurate a diagnostic tool as Middle Facet uncoverage percentage which expresses the amount of subluxation of the MF. In that respect, this could mean that congruency of the middle facet could be the last frontier between asymptomatic Pes Planovalgus and symptomatic AAFD, leading to progressive foot collapse, secondarily affecting the FAO. These results also give insight into the meaning of the FAO, which appears here to be a more general assessment of the Foot and Ankle Complex alignment, rather than a marker for a specific pathology.

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