Department of Orthopaedic Surgery, College of Medicine, The Catholic University of Korea, Seoul, South Korea.
Department of Orthopaedic Surgery, Yeungnam University Hospital, Daegu, South Korea.
J Foot Ankle Surg. 2022 Jul-Aug;61(4):836-840. doi: 10.1053/j.jfas.2021.12.001. Epub 2021 Dec 6.
Understanding plain radiograph in association with 3-dimensional (3D) morphology of the ankle is essential for treatment about varus ankle osteoarthritis (OA). The aims of this study were to investigate whether the alignment of the tibial plafond as determined on plain radiograph reflected the alignment of the tibial plafond on computed tomography (CT) in varus ankle OA and whether the alignment of the tibial plafond changed as the OA progressed. The 3D CT and plain radiographs from 101 ankles with varus ankle OA were analyzed and compared with 40 ankles in control group. The tibial plafond was assessed in the coronal and sagittal planes using 3D CT. The medial angle between the vertical line and the tibial plafond was measured on 3 different coronal plane CT images which was anterior, middle and posterior area of the tibial plafond. The medial distal tibial angle on plain radiograph reflected the posterior area of the tibial plafond on CT. The amount of varus angulation on CT was larger in anterior and middle area of the tibial plafond than the posterior area. There was a difference in the degree of varus of the tibial plafond between control group and OA patients; however, there was no difference among patients in different stages of varus ankle OA. Weightbearing plain radiographs underestimate the varus deformity in anterior and middle area of the tibial plafond and there is no significant difference in deformity of the tibial plafond among patients in different stages of varus ankle OA.
了解踝关节的普通 X 线片与 3 维（3D）形态的关联对于治疗内翻型踝关节骨关节炎（OA）至关重要。本研究的目的是探究普通 X 线片上确定的距骨平台的对线是否反映了内翻型踝关节 OA 中 CT 上的距骨平台对线，以及距骨平台对线是否随 OA 的进展而改变。分析了 101 例内翻型踝关节 OA 患者的 3D CT 和普通 X 线片，并与 40 例对照组踝关节进行比较。使用 3D CT 评估距骨平台在冠状面和矢状面的情况。在 3 张不同的冠状面 CT 图像上测量垂直线与距骨平台之间的内侧角，分别为距骨平台的前、中、后区域。普通 X 线片上的胫骨远端内侧角反映了 CT 上距骨平台的后区域。CT 上距骨内翻的角度在前、中距骨平台区域大于后距骨平台区域。对照组和 OA 患者的胫骨平台内翻程度存在差异；然而，在不同内翻型踝关节 OA 阶段的患者之间，胫骨平台的内翻程度没有差异。负重普通 X 线片低估了前、中距骨平台的内翻畸形，并且在不同内翻型踝关节 OA 阶段的患者之间，胫骨平台的畸形没有显著差异。
