My name is Kirsten Mansfield, and my presentation is titled 3-Tesla MRI Outperforms 1.5-Tesla MRI and Diagnosis of Osteochondral Lesions of the Talus in Patients Undergoing Burst Rome Repair. I have nothing to disclose. Osteochondral lesions of the talus are injuries involving the articular cartilage and subculnar bone of the talus and is caused by repetitive microtrauma and traumatic events. It is seen in patients with lateral ankle instability and is associated with significant ankle pain, progressive osteoarthritis, and contributes to increased morbidity after an ankle sprain. Arthrosphy is currently the gold standard for visualizing and diagnosing these lesions, and the role of MRI is disputed. MRI is currently accepted to be useful for preoperative evaluation and surgical planning. However, its diagnostic utility is debated. Prior studies looking at the diagnostic utility of preoperative MRIs and identifying OLTs observed low detection rates, with one study reporting a detection rate of 39%. This suggests that OLTs are difficult to observe in the ankle when using conventional MRI imaging modalities. However, with a widespread shift to using higher field strength imaging, such as 3-Tesla MRIs, it appears that there is potential that the diagnostic efficacy of MRIs may be improved over what was previously observed in studies that were limited to assessing the conventional and older 1.5-Tesla scanners. In turn, the objective of this study is to assess the efficacy of 3-Tesla MRIs and 1.5-Tesla MRIs in diagnosing OLTs in patients undergoing Brostrom-Gallup procedure for lateral ankle instability. To study this topic, we utilize a retrospective cohort design and use a database that included all individuals who underwent a Brostrom-Gallup procedure for lateral ankle instability from February 11, 2015 to January 21st, 2019. Patient charts were then reviewed to determine the field strength of the preoperative MRIs and the efficacy of these imaging modalities and identifying OLTs when compared against diagnostic arthroscopy as a reference standard. The final analysis included those patients who had both a preoperative MRI and diagnostic arthroscopy of the tibial-tailor joint and excluded those who did not meet inclusion criteria and where their MRI magnet strength could not be determined. A total of 40 patients met our inclusion criteria and were included in our final analysis. Of this sample, 19 patients had OLTs and then when looking at their preoperative MRI evaluations, 21 patients had a 3-Tesla MRI where 19 patients had a 1.5-Tesla MRI. When comparing patients who received 3-Tesla preoperative MRI to those who received 1.5-Tesla preoperative MRI, there appeared to be no statistically significant differences with regards to the group's age, their gender, the duration of time between their preoperative MRI to surgery, as well as the size of their injury. Lastly, when comparing the diagnostic test characteristics for 3-Tesla MRI and 1.5-Tesla MRI, it appeared that 3-Tesla MRI had a greater sensitivity, specificity, and overall diagnostic accuracy in correctly identifying the presence of osteochondral lesions or the absence of osteochondral lesions. In conclusion, with a greater sensitivity, specificity, and accuracy, the current study supports that 3-Tesla MRIs outperform 1.5-Tesla MRIs in diagnosing osteochondral lesions of the talus in patients undergoing Brostrom-Gal procedure for lateral ankle instability. Secondly, the current study continues to maintain past findings that MRIs are more specific rather than sensitive tests. This provides further evidence that MRIs are valuable in preoperative planning and identifying patients who would be suitable for further workup. Some limitations of the current study include that our sample is limited to one health system in one time period, such that it may not be representative of the entire population. Secondly, our retrospective analysis only assessed the diagnostic efficacy in identifying osteochondral lesions of the talus. It did not include other pathologies associated with lateral ankle instability and cannot provide evidence for the overall diagnostic efficacy of MRIs in imaging the ankle. Below are our references. And I would like to thank you for taking your time to listen to my presentation. I'd also like to extend my gratitude to Dr. Michael Nardi for his mentorship, guidance, and expertise, as well as acknowledge my fellow research colleagues and the Center for Orthopedic Research and Translational Science. Thank you.

3-Tesla MRI

1.5-Tesla MRI

osteochondral lesions of the talus

Brostrom-Gallup procedure

lateral ankle instability