Journal article
Metal artifact reduction MRI for total ankle replacement sagittal balance evaluation
Foot and ankle surgery, Vol.25(6), pp.739-747
12/2019
DOI: 10.1016/j.fas.2018.09.005
PMID: 30385108
Abstract
•Restoration of ankle anatomical relationship is crucial for total ankle replacement.•Study’s purpose was to compare TAR sagittal balance on MARS MRI and WB radiographs.•We had excellent intra- and inter-observer agreement on MRI and radiographic readings.•Sagittal balance measurements had substantial correlation on MRI and radiographs.•MARS MRI may be helpful for the evaluation of TAR sagittal balance.
Restoration of anatomical relationship between talus and tibia is crucial for longevity of total ankle replacement (TAR). Weight-bearing (WB) radiographs are the standard for evaluating the sagittal balance alignment, but are prone to rotational misalignment and altered measurements. Metal artifact reduction sequence (MARS) MRI allows visualization of periprosthetic landmarks and alignment of the image plane to the true sagittal axis of the implant. The purpose of this study was to compare TAR sagittal balance measurements on MARS MRI and WB radiographs.
Twenty-three subjects with TAR [10 men/13 women, age 60 (41–73) years; 13 (3–24) months post-op] underwent MARS MRI and standard lateral WB radiographs. Standardized MARS MR images were aligned to the sagittal talar component axis. Three observers performed sagittal balance alignment measurements twice in an independent, random and blinded fashion. Lateral Talar Station (LTS), tibial axis-to-talus (T-T) ratio and normalized tibial axis-to-lateral-process (T-L) distance were measured. Concordance correlation coefficients (CCC) and intraclass correlation coefficients (ICC) were used for statistical analysis. In addition, mixed effects linear models were employed to assess overall concordance of the two image types.
The intraobserver agreement was excellent for radiographic (CCC=0.96) and MRI (CCC=0.90–0.97) measurements. Interobserver agreements were good-to-excellent with overall slightly higher agreements for MRI (ICC=0.78–0.94) than radiography (ICC=0.78–0.90) measurements. The T-T ratios of radiographs and MRI showed a high degree of concordance, whereas LTS was significantly lower on MRI when compared with radiographs, and T-L distance showed notable disagreement between the two imaging types.
Sagittal balance measurements performed on standardized weight-bearing radiographs and standardized MARS MRI demonstrate substantial correlation and similarity. Given its high intra and interobserver agreement, MARS MRI may be helpful for the evaluation of TAR sagittal balance.
Level of evidence: Level II - Prospective Comparative Study.
Details
- Title: Subtitle
- Metal artifact reduction MRI for total ankle replacement sagittal balance evaluation
- Creators
- Cesar de Cesar Netto - Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, 601 North Caroline Street, Baltimore, MD 21287, USALew C Schon - Department of Orthopaedic Surgery, Medstar Union Memorial Hospital, 201 E University Pkwy, Baltimore, MD 21218, USALucas Furtado da Fonseca - Department of Orthopaedic Surgery, Medstar Union Memorial Hospital, 201 E University Pkwy, Baltimore, MD 21218, USAApisan Chinanuvathana - Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, 601 North Caroline Street, Baltimore, MD 21287, USASteven E Stern - Bond Business School, Bond University, Gold Coast, QLD 4229, AustraliaJan Fritz - Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, 601 North Caroline Street, Baltimore, MD 21287, USA
- Resource Type
- Journal article
- Publication Details
- Foot and ankle surgery, Vol.25(6), pp.739-747
- Publisher
- Elsevier Ltd
- DOI
- 10.1016/j.fas.2018.09.005
- PMID
- 30385108
- ISSN
- 1268-7731
- eISSN
- 1460-9584
- Grant note
- name: Siemens Healthcare USA
- Language
- English
- Date published
- 12/2019
- Academic Unit
- Orthopedics and Rehabilitation
- Record Identifier
- 9984040328702771
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