CME OnDemand: 2022 AOFAS Annual Meeting-Distribution of Bone Mineral Density in the Ankle Joint: Correlation with Hindfoot Alignment

Distribution of Bone Mineral Density in the Ankle Joint: Correlation with Hindfoot Alignment

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This study aimed to assess the spatial distribution of bone mineral density (BMD) in the ankle joint in patients with normal, varus, and valgus alignment. The hypothesis was that BMD is sensitive to alignment and should be correlated with surface landmarks, providing a method for alignment quantification. The study design was retrospective comparative, with a study population of 54 adults and 81 ankles divided into three groups - normal alignment, varus alignment, and valgus alignment. The WBCT datasets were used for analysis, and the primary outcome measure was the medial/lateral HU ratio. <br /><br />The results showed that in valgus cases, the bone was generally more lateral than in normal and varus cases, while in varus cases, the bone was generally more medial. The bone in normal cases was denser compared to varus and valgus cases, but the difference was not significant. The study suggested that WBCT analysis of BMD is useful for preoperative planning in osteoarthritis cases, specifically for ankle arthrodesis or TAR. <br /><br />The study acknowledged the limitation of hardware influence on the results, particularly stress shielding. The presentation concluded that the data supports the use of WBCT in analyzing BMD and its usefulness in preoperative planning for ankle procedures. It also emphasized the importance of alignment, BMD, pressure, instability, and joint space in understanding ankle joint health.

Asset Subtitle

Francois Lintz, MD MSc FEBOT, Matthew J. Welck, MD, FRCS (Orth), Kristian Buedts, MD, Céline Fernando, Cesar De Cesar Netto, MD, PhD, Alessio Bernasconi, MD PhD FEBOT

Keywords

bone mineral density

ankle joint

normal alignment

varus alignment

valgus alignment

spatial distribution

alignment quantification

retrospective comparative

WBCT datasets

medial/lateral HU ratio