Currently used imaging options cannot accurately predict subtalar joint instability
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To give a systematic overview of current diagnostic imaging options and surgical treatment for chronic subtalar joint instability.
A systematic literature search across the following sources was performed: PubMed, ScienceDirect, and SpringerLink. Twenty-three imaging studies and 19 outcome studies were included. The Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS 2) tool was used to assess the methodologic quality of the imaging articles, while the modified Coleman Score was used to assess the methodologic quality of the outcome studies.
Conventional radiographs were most frequently used to assess chronic subtalar joint instability. Talar tilt, anterior talar translation, and subtalar tilt were the three most commonly used measurement methods. Surgery often included calcaneofibular ligament reconstruction.
Current imaging options do not reliably predict subtalar joint instability. Distinction between chronic lateral ankle instability and subtalar joint instability remains challenging. Recognition of subtalar joint instability as an identifiable and treatable cause of ankle pain requires vigilant clinical investigation.
Level of evidence
Systematic Review of Level III and Level IV Studies, Level IV.
KeywordsSubtalar joint Subtalar instability Hindfoot instability Imaging Outcome
NK: literature search, data extraction, and manuscript writing. MWW: literature search, data extraction, and manuscript writing. NPD: drawing of figures and manuscript writing. MKM: providing clinical cases (X-rays/MRI) and manuscript writing. BH: manuscript writing. CLS: manuscript writing. AB: literature search, data extraction, and manuscript writing.
Nicola Krähenbühl is currently receiving a grant from the Swiss National Science Foundation (SNF; grant number P2BSP3_174979) and Swiss Orthopaedics.
Compliance with ethical standards
Conflict of interest
Maxwell W. Weinberg, Nathan P. Davidson, Megan K. Mills, Beat Hintermann, Charles L. Saltzman, and Alexej Barg have no conflicts to declare.
This article does not contain any studies with human participants or animal experiments performed by any of the authrors.
- 4.Coleman BD, Khan KM, Maffulli N, Cook JL, Wark JD (2000) Studies of surgical outcome after patellar tendinopathy: clinical significance of methodological deficiencies and guidelines for future studies. Victorian Institute of Sport Tendon Study Group. Scand J Med Sci Sports 10(1):2–11PubMedCrossRefGoogle Scholar
- 26.Meyer JM, Garcia J, Hoffmeyer P, Fritschy D (1988) The subtalar sprain. A roentgenographic study. Clin Orthop Relat Res (226):169–173Google Scholar
- 41.Sugimoto K, Takakura Y, Samoto N, Nakayama S, Tanaka Y (2002) Subtalar arthrography in recurrent instability of the ankle. Clin Orthop Relat Res (394):169–176Google Scholar