Journal article
Weight-Bearing CT Scan After Tibial Pilon Fracture Demonstrates Significant Early Joint-Space Narrowing
Journal of bone and joint surgery. American volume, Vol.102(9), pp.796-803
05/06/2020
DOI: 10.2106/JBJS.19.00816
PMID: 32379120
Abstract
Background: Posttraumatic osteoarthritis (PTOA) is a common and early sequela of tibial pilon fractures resulting in substantial long-term disability. New approaches are needed to objectively and reliably quantify early disease progression in order to critically assess the impact of interventions aimed at preventing or mitigating PTOA. Weight-bearing computed tomography (WBCT) scans provide a means for measuring joint space while the ankle is in a loaded, functional position. We assessed the interrater and intrarater reliability of a standardized, regional method to quantify joint-space loss following tibial pilon fracture compared with the uninjured contralateral ankle. Methods: We prospectively enrolled 20 patients with intra-articular tibial pilon fractures that were surgically treated at 1 of 2 level-I trauma centers. Six months after injury, bilateral ankle WBCT scans were obtained. Joint space was measured by 4 reviewers at 9 discrete regions of the tibiotalar articulation on sagittal images. Measurements were repeated by reviewers 2 weeks later. To characterize the measurement method, interrater correlation coefficient estimates and test-retest reproducibility were calculated. Results: The mean tibiotalar joint space was 21% less in the injured ankles compared with the contralateral uninjured ankles (p < 0.0001). The middle-lateral and middle-central regions of the joint demonstrated the greatest decrease in joint space between injured and uninured ankles. The interrater correlation coefficient of the measurement technique was 0.88, and the test-retest reproducibility was 0.80, indicating good reliability and reproducibility of the method. Conclusions: We developed a simple, standardized, and reliable technique to quantify tibiotalar joint space following tibial pilon fracture on WBCT. Significant loss of joint space is seen 6 months after the injury. This tool can be used to longitudinally quantify loss of joint space following pilon fracture and assess the impact of interventions to reduce PTOA.
Details
- Title: Subtitle
- Weight-Bearing CT Scan After Tibial Pilon Fracture Demonstrates Significant Early Joint-Space Narrowing
- Creators
- Michael C. Willey - University of Iowa Hospitals and ClinicsJocelyn T. Compton - University of Iowa Hospitals and ClinicsJ. Lawrence Marsh - University of Iowa Hospitals and ClinicsConor P. Kleweno - Harborview Medical CenterJulie Agel - Harborview Medical CenterElizabeth J. Scott - University of Iowa Hospitals and ClinicsGabrielle Bui - University of Iowa Hospitals and ClinicsJohn Davison - University of IowaDonald D. Anderson - University of Iowa Hospitals and Clinics
- Resource Type
- Journal article
- Publication Details
- Journal of bone and joint surgery. American volume, Vol.102(9), pp.796-803
- DOI
- 10.2106/JBJS.19.00816
- PMID
- 32379120
- NLM abbreviation
- J Bone Joint Surg Am
- ISSN
- 0021-9355
- eISSN
- 1535-1386
- Publisher
- Journal of Bone and Joint Surgery Incorporated
- Number of pages
- 8
- Language
- English
- Date published
- 05/06/2020
- Academic Unit
- Roy J. Carver Department of Biomedical Engineering; Orthopedics and Rehabilitation; Industrial and Systems Engineering; Injury Prevention Research Center
- Record Identifier
- 9984304689302771
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