Purpose
The purpose of this study was to determine whether preoperative computed tomography
(CT) of the ankle joint in full plantar flexion is a reliable and accurate tool to
determine the anterior arthroscopic accessibility of talar osteochondral defects (OCDs).
Methods
Twenty consecutive patients were prospectively studied. All patients had an OCD of
the talar dome and had a preoperative CT scan of the affected ankle in maximum plantar
flexion. Accessibility of the OCD was defined by the distance between the anterior
border of the OCD and the anterior distal tibial rim. This distance was measured on
sagittal CT reconstructions by 2 investigators. The reference standard was the distance
between the same landmarks measured during anterior ankle arthroscopy by an orthopaedic
surgeon blinded to the CT scans. Intraobserver and interobserver reliability of CT,
as well as the correlation and agreement between CT and arthroscopy, were calculated.
Results
The measured distance between the anterior border of the OCD and the anterior distal
tibial rim ranged from −3.1 to 9.1 mm on CT and from −3.0 to 8.5 mm on arthroscopy.
The intraobserver and interobserver reliability of the measurements made on CT scans
(intraclass correlation coefficients >0.99, P < .001), as well as the correlation between CT and arthroscopy, were excellent (r = 0.98, P < .001).
Conclusions
Measurements on CT scans of the ankle in full plantar flexion are a reliable and accurate
preoperative method to determine the in situ arthroscopic location of talar OCDs.
Level of Evidence
Level II, development of diagnostic criteria based on consecutive patients.
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Article info
Publication history
Published online: February 20, 2012
Accepted:
November 22,
2011
Received:
May 14,
2011
Footnotes
The authors report that they have no conflicts of interest in the authorship and publication of this article.
Identification
Copyright
© 2012 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.
