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Open AccessArticle
Radiological Landmarks for Joint Line Level in Challenging Total Ankle Arthroplasty
by
Simone Ottavio Zielli
Simone Ottavio Zielli 1,2
,
Antonio Mazzotti
Antonio Mazzotti 1,2
,
Elena Artioli
Elena Artioli 1,2,*
,
Alberto Arceri
Alberto Arceri 1,2
,
Federico Sgubbi
Federico Sgubbi 1,2,
Laura Langone
Laura Langone 1,2
,
Pejman Abdi
Pejman Abdi 1,2
and
Cesare Faldini
Cesare Faldini 1,2
1
1st Orthopaedics and Traumatologic Clinic, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy
2
Department of Biomedical and Neuromotor Sciences (DIBINEM), Alma Mater Studiorum University of Bologna, 40123 Bologna, Italy
*
Author to whom correspondence should be addressed.
J. Clin. Med. 2024, 13(15), 4451; https://doi.org/10.3390/jcm13154451 (registering DOI)
Submission received: 7 June 2024
/
Revised: 22 July 2024
/
Accepted: 26 July 2024
/
Published: 29 July 2024
Abstract
Background: Although Total Ankle Arthroplasty (TAA) is primarily performed for post-traumatic ankle arthritis with joint disruption, anatomical landmarks for Joint Line (JL) level are typically preserved. However, severe Post-Traumatic Bone Loss (PTBL) or TAA revision may render some landmarks unidentifiable, challenging JL restoration. Methods: Patients undergoing customized TAA for severe PTBL or revision were enrolled. Custom-made implants, based on 3D CT scans, were designed to address bone defects and provide adequate bone support. Evaluated parameters, measured on bilateral ankle weight-bearing radiographs taken preoperatively and 6–8 months postoperatively, included JL Height Ratio (JLHR) and the distances from JL to the Lateral Malleolus apex (LM-JL), the posterior colliculus of the Medial Malleolus (MM-JL), and the Gissane Calcaneal Sulcus (CS-JL). Reproducibility and variability were assessed, and comparisons were made between radiological parameters measured at TAA and those at the contralateral ankle. Results: Thirteen patients were included. Intra- and interobserver reliability demonstrated excellent values. The least variability was observed in the LM-JL distance. Statistically significant correlations were found between CS-JL and MM-JL distances in the operated limb and between the CS-JL of the operated limb and the contralateral ankle. While TAA parameters did not show statistically significant differences compared with the contralateral ankle, a trend toward proximalization of the JL was noted. Conclusion: This study demonstrated good reproducibility of the analyzed parameters for evaluating JL in TAA among patients with severe PTBL or undergoing revision surgery. However, these parameters cannot be deemed fully reliable. Given their potential weaknesses, it is crucial to identify more reproducible values, preferably ratios.
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MDPI and ACS Style
Zielli, S.O.; Mazzotti, A.; Artioli, E.; Arceri, A.; Sgubbi, F.; Langone, L.; Abdi, P.; Faldini, C.
Radiological Landmarks for Joint Line Level in Challenging Total Ankle Arthroplasty. J. Clin. Med. 2024, 13, 4451.
https://doi.org/10.3390/jcm13154451
AMA Style
Zielli SO, Mazzotti A, Artioli E, Arceri A, Sgubbi F, Langone L, Abdi P, Faldini C.
Radiological Landmarks for Joint Line Level in Challenging Total Ankle Arthroplasty. Journal of Clinical Medicine. 2024; 13(15):4451.
https://doi.org/10.3390/jcm13154451
Chicago/Turabian Style
Zielli, Simone Ottavio, Antonio Mazzotti, Elena Artioli, Alberto Arceri, Federico Sgubbi, Laura Langone, Pejman Abdi, and Cesare Faldini.
2024. "Radiological Landmarks for Joint Line Level in Challenging Total Ankle Arthroplasty" Journal of Clinical Medicine 13, no. 15: 4451.
https://doi.org/10.3390/jcm13154451
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