| Title: |
Clinical Diagnostic Study of Syndesmotic Instability using 3-Dimensional Weight-bearing CT Distance Mapping Algorithm |
| Authors: |
Pozzessere, Enrico; Huanuco Casas, Erik; Luo, Emily; Talaski, Grayson; Grün, Wolfram; Vermorel, Pierre-Henri; O'Neill, Conor; Dibbern, Kevin; Lintz, Francois; De Cesar Netto, Cesar |
| Source: |
Foot & Ankle Orthopaedics ; volume 10, issue 4 ; ISSN 2473-0114 2473-0114 |
| Publisher Information: |
SAGE Publications |
| Publication Year: |
2025 |
| Description: |
Research Type: Level 3 - Retrospective cohort study, Case-control study, Meta-analysis of Level 3 studies Introduction/Purpose: Evaluating syndesmotic stability in both acute and chronic settings is inherently challenging. Failure to diagnose syndesmotic ankle injuries can lead to end-stage ankle osteoarthritis in up to 30% of cases. While advanced imaging modalities, such as magnetic resonance imaging (MRI), have historically been the gold standard for evaluating distal tibiofibular complex injuries, this study investigates the application of a three-dimensional (3D) cone beam weight-bearing computed tomography (WBCT) distance mapping algorithm for detecting syndesmotic instability under physiological loading conditions. We hypothesized that this algorithm would aid surgeons in accurately diagnosing syndesmotic instability in a clinical setting. Methods: A retrospective, single-institution study was conducted on patients with unilateral ankle instability and no history of contralateral ankle injury. All patients underwent surgical intervention for lateral ankle instability. Preoperative assessment included cone-beam WBCT to evaluate syndesmotic morphology under physiological loading conditions. Semiautomatic segmentation of CT scans was performed using Disior Bonelogic (Disior, Paragon28, Englewood, CO, USA), with syndesmotic distance measurements computed via MATLAB. A three-dimensional (3D) distance mapping algorithm was employed to quantify syndesmotic incisura and lateral gutter distances (overall, minimum, maximum, 50% anterior, 50% posterior), which were subsequently compared with uninjured syndesmotic ankles. The diagnostic accuracy of distance mapping in detecting syndesmotic instability was assessed relative to arthroscopic findings using receiver operating characteristic (ROC) curve analysis and area under the curve (AUC). Paired statistical analyses were conducted to identify significant differences between ankles with syndesmotic injuries and contralateral controls. Statistical significance was set ... |
| Document Type: |
article in journal/newspaper |
| Language: |
English |
| DOI: |
10.1177/2473011425s00166 |
| DOI: |
10.1177/2473011425S00166 |
| Availability: |
https://doi.org/10.1177/2473011425s00166; https://journals.sagepub.com/doi/pdf/10.1177/2473011425S00166 |
| Rights: |
https://creativecommons.org/licenses/by-nc/4.0/ ; https://journals.sagepub.com/page/policies/text-and-data-mining-license |
| Accession Number: |
edsbas.4DC1DB32 |
| Database: |
BASE |