Sy JW, Lopez AJ, Lausé GE, Deal JB, Lustik MB, Ryan PM. Correlation of stress radiographs to injuries associated with lateral ankle instability. World J Orthop 2021; 12(9): 710-719 [PMID: 34631454 DOI: 10.5312/wjo.v12.i9.710]
Corresponding Author of This Article
Gregory E Lausé, MD, MS, Doctor, Department of Orthopaedic Surgery, Tripler Army Medical Center, 1 Jarrett White Rd, Honolulu, HI 96859, United States. gregory.e.lause.mil@mail.mil
Research Domain of This Article
Orthopedics
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Orthop. Sep 18, 2021; 12(9): 710-719 Published online Sep 18, 2021. doi: 10.5312/wjo.v12.i9.710
Correlation of stress radiographs to injuries associated with lateral ankle instability
Joshua W Sy, Andrew J Lopez, Gregory E Lausé, J Banks Deal, Michael B Lustik, Paul M Ryan
Joshua W Sy, Andrew J Lopez, Gregory E Lausé, J Banks Deal, Paul M Ryan, Department of Orthopaedic Surgery, Tripler Army Medical Center, Honolulu, HI 96859, United States
Michael B Lustik, Department of Statistics, Tripler Army Medical Center, Honolulu, HI 96859, United States
Author contributions: Sy JW performed the research; Lausé GE designed the research and contributed to the manuscript and analysis; Lopez AJ performed the research; Deal JB designed the research; Lustik MB performed the statistics review; Ryan PM supervised the report, finalized data analysis and wrote the manuscript.
Institutional review board statement: This study was reviewed by the Tripler Army Medical Center Institutional Review Board and found to be exempt from IRB review IAW 32 Code of Federal Regulation 219.104(d), category (4)(iii).
Informed consent statement: Patients were not required to give informed consent to the study because the analysis used anonymous clinical data.
Conflict-of-interest statement: None of the authors have a conflict of interest with the submitted study.
Data sharing statement: Please contact the corresponding author if access to the de-identified data is requested.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Gregory E Lausé, MD, MS, Doctor, Department of Orthopaedic Surgery, Tripler Army Medical Center, 1 Jarrett White Rd, Honolulu, HI 96859, United States. gregory.e.lause.mil@mail.mil
Received: February 17, 2021 Peer-review started: February 17, 2021 First decision: May 3, 2021 Revised: May 17, 2021 Accepted: August 20, 2021 Article in press: August 20, 2021 Published online: September 18, 2021
Abstract
BACKGROUND
Stress radiographs have demonstrated superior efficacy in the evaluation of ankle instability.
AIM
To determine if there is a degree of instability evidenced by stress radiographs that is associated with pathology concomitant with ankle ligamentous instability.
METHODS
A retrospective review of 87 consecutive patients aged 18-74 who had stress radiographs performed at a single institution between 2014 and 2020 was performed. These manual radiographic stress views were then correlated with magnetic resonance imaging and operative findings.
RESULTS
A statistically significant association was determined for the mean and median stress radiographic values and the presence of peroneal pathology (P = 0.008 for tendonitis and P = 0.020 for peroneal tendon tears). A significant inverse relationship was found between the presence of an osteochondral defect and increasing degrees of instability (P = 0.043).
CONCLUSION
Although valuable in the clinical evaluation of ankle instability, stress radiographs are not an independent predictor of conditions associated with ankle instability.
Core Tip: Ankle Stress Radiographs were predictive of intraoperative findings. Specifically, they may assist the surgeon in clinical decision making regarding osteochondral lesions of the talus and peroneal tendon pathology.
