Arthroscopic defect size measurement in osteochondral lesions of the talus underestimates the exact defect size and size measurement with arthro-MRI (MR-A) and high-resolution flat-panel CT-arthro imaging (FPCT-A).


Journal

Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA
ISSN: 1433-7347
Titre abrégé: Knee Surg Sports Traumatol Arthrosc
Pays: Germany
ID NLM: 9314730

Informations de publication

Date de publication:
Feb 2023
Historique:
received: 18 07 2022
accepted: 15 11 2022
pubmed: 29 11 2022
medline: 8 2 2023
entrez: 28 11 2022
Statut: ppublish

Résumé

The size of osteochondral lesions of the talus (OLTs) is highly relevant for their treatment. In addition to intraoperative measurement of defect size, preoperative planning by means of magnetic resonance imaging (MRI) or computed tomography (CT) is crucial. Four defects of different sizes and depths were created on the talar joint surface in 14 cadaver feet. All defects were evaluated, both arthroscopically and via arthrotomy with a probe. Arthro-MRI (MR-A) and high-resolution flat-panel CT arthro scans (FPCT-A) were acquired. Length, width, and depth were measured for every defect and the defect volume was calculated. To determine the exact defect size, each talar defect was filled with plastic pellets to form a cast and the casts were scanned using FPCT to create a 3D multiplanar reconstruction data set. Finally, the surgically measured values were compared with the radiological values and the exact defect size. Overall, the surgically measured values (both arthroscopic and open) underestimated the exact defect size (p < 0.05). Arthroscopically determined defect length and width showed the largest deviation (p < 0.05) and underestimated the size in comparison with MR-A and FPCT-A. The FPCT-A measurements demonstrated higher correlation with both the arthroscopic and open surgical measurements than did the MR-A measurements (p < 0.05). The exact defect size is underestimated on intraoperative measurement, in both arthroscopic and open approaches. Arthroscopic defect size measurement underestimates defect size in comparison with MR-A and FPCT-A. FPCT-A was shown to be a reliable imaging technique that allows free image reconstruction in every plane and could be considered as the new reference standard for preoperative evaluation of defect size in OLT.

Identifiants

pubmed: 36441219
doi: 10.1007/s00167-022-07241-7
pii: 10.1007/s00167-022-07241-7
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

716-723

Informations de copyright

© 2022. The Author(s) under exclusive licence to European Society of Sports Traumatology, Knee Surgery, Arthroscopy (ESSKA).

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Auteurs

Sarah Ettinger (S)

Department of Orthopedic Surgery, Hannover Medical School at Diakovere Annastift, Anna-Von-Borries-Street 1-7, 30625, Hannover, Germany.

Lena Sonnow (L)

Institute of Radiology, Hannover Medical School, Hannover, Germany.

Christian Plaass (C)

Department of Orthopedic Surgery, Hannover Medical School at Diakovere Annastift, Anna-Von-Borries-Street 1-7, 30625, Hannover, Germany.

Alexandra Rahn (A)

Department of Orthopedic Surgery, Hannover Medical School at Diakovere Annastift, Anna-Von-Borries-Street 1-7, 30625, Hannover, Germany.

Christina Stukenborg-Colsman (C)

Department of Orthopedic Surgery, Hannover Medical School at Diakovere Annastift, Anna-Von-Borries-Street 1-7, 30625, Hannover, Germany.

Christian von Falck (C)

Institute of Radiology, Hannover Medical School, Hannover, Germany.

Gesa Poehler (G)

Institute of Radiology, Hannover Medical School, Hannover, Germany.

Christoph Becher (C)

International Center for Orthopedics, ATOS Clinic Heidelberg, Bismarckstr. 9-15, 69115, Heidelberg, Germany. becher@atos.de.

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