Foot & Ankle International - September 2020 - 1115

Day et al
dose, and weightbearing positioning are all advantages of
WBCT over standard CT and plain radiographs. These
advantages may be of use clinically in reconstruction, malunion, and certain postoperative malreductions. This study
has significant potential to impact the preferred imaging of
subtalar arthritis, correlate contact stress with subtalar PTOA
development, and provide a novel framework to measure
PTOA severity earlier in the disease process. However, we
recognize that decreased cost and wider availability of
WBCT units will be necessary for this technique to become a
part of routine clinical practice.

Conclusion
The results of this study demonstrate that WBCT can be
utilized to sensitively and reliably assess the subtalar JSW
as a measure of PTOA and help us to better understand how
joint space changes affect patient clinical outcomes. By
improving the early assessment of JSW through improved
visualization of the subtalar joint, we may better understand
the effects of surgical treatment in the prevention of PTOA
and the natural progression of PTOA after IACF, accelerating scientific progress and advancing clinical care.
Declaration of Conflicting Interests
The author(s) declared no potential conflicts of interest with
respect to the research, authorship, and/or publication of this article. ICMJE forms for all authors are available online.

Funding
The author(s) disclosed receipt of the following financial support
for the research, authorship, and/or publication of this article:
Research reported in this publication was supported by the
National Institute of Arthritis and Musculoskeletal and Skin
Diseases of the National Institutes of Health under award number
P50AR055533.

ORCID iDs
Molly A. Day, MD, ATC, https://orcid.org/0000-0001-5205-7947
Kevin Dibbern, PhD,
https://orcid.org/0000-0002-8061-4453

References
1. Barg A, Bailey T, Richter M, et al. Weightbearing computed
tomography of the foot and ankle: emerging technology topical review. Foot Ankle Int. 2018;39(3):376-386.
2. Buck RJ, Wyman BT, Le Graverand MP, et al. Does the use
of ordered values of subregional change in cartilage thickness
improve the detection of disease progression in longitudinal
studies of osteoarthritis? Arthritis Rheum. 2009;61(7):917-24.
3. Carrino JA, Al Muhit A, Zbijewski W, et al. Dedicated
cone-beam CT system for extremity imaging. Radiology.
2014;270(3):816-824.
4. Coleman MC, Goetz JE, Brouillette MJ, et al. Targeting
mitochondrial responses to intra-articular fracture to

1115
prevent posttraumatic osteoarthritis. Sci Transl Med.
2018;10(427):eaan5372.
5. Colin F, Horn Lang T, Zwicky L, Hintermann B, Knupp M.
Subtalar joint configuration on weightbearing CT scan. Foot
Ankle Int. 2014;35(10):1057-1062.
6. Gossec L, Jordan J, Mazzuca S, et al. Comparative evaluation
of three semi-quantitative radiographic grading techniques
for knee osteoarthritis in terms of validity and reproducibility
in 1759 x-rays: report of the OARSI-OMERACT task force.
Osteoarthritis Cartilage. 2008;16(7):742-748.
7. Hays RD, Morales LS. The RAND-36 measure of healthrelated quality of life. Ann Med. 2001;350-357.
8. Kellgren JH, Lawrence JS. Radiological assessment of osteoarthrosis. Ann Rheum Dis. 1957;16:494-502.
9. Krahenbuhl N, Tschuck M, Bolliger L, Hintermann B,
Knupp M. Orientation of the subtalar joint: measurement
and reliability using weightbearing CT scans. Foot Ankle Int.
2016;37(1):109-114.
10. Lepojärvi S, Niinimäki J, Pakarinen H, et al. Rotational

dynamics of the talus in a normal tibiotalar joint as shown by
weight-bearing computed tomography. J Bone Joint Surg Am.
2016;98(7):568-575.
11. Lonza GC, Gardner-Morse MG, Vacek PM, et al.

Radiographic-based measurement of tibiofemoral joint space
width and magnetic resonance imaging derived articular
cartilage thickness are not related in subjects at risk for post
traumatic arthritis of the knee. J Orthop Res. 2019;37(5):10521058.
12. Ludlow J, Ivanovic M. Weightbearing CBCT, MDCT, and
2D imaging dosimetry of the foot and ankle. Int J Diagn
Imaging. 2014;1(2):1-9.
13. Marsh M, Souza RB, Wyman BT, et al. Differences between
x-ray and MRI-determined knee cartilage thickness in weightbearing and non-weightbearing conditions. Osteoarthritis
Cartilage. 2013;21(12):1876-1885.
14. Mayich DJ, Pinsker E, Mayich MS, et al. An analysis of the
use of the Kellgren and Lawrence grading system to evaluate peritalar arthritis following total ankle arthroplasty. Foot
Ankle Int. 2013;34(11):1508-1515.
15. Menz HB, Munteanu SE, Landorf KB, et al. Radiographic
classification of osteoarthritis in commonly affected joints of
the foot. Osteoarthritis Cartilage. 2007;15:1333-1338.
16. Nosewicz TL, Knupp M, Bolliger L, et al. The reliability and
validity of radiographic measurements for determining the
three-dimensional position of the talus in varus and valgus
osteoarthritic ankles. Skeletal Radiol. 2012;41(12):15671573.
17. Praemer A, Furner S, Rice D. The Burden of Musculoskeletal
Diseases in the United States: Prevalence, Societal and
Economic Costs. American Academy of Orthopaedic Surgeons,
1999:27-33.
18. Radnay CS, Clare MP, Sanders RW. Subtalar fusion after
displaced intra-articular calcaneal fracture: does initial operative treatment matter? Surgical technique. J Bone Joint Surg
Am. 2010;92(suppl 1 pt 1):32-43.
19. Richter M, Lintz F, de Cesar Netto C, et al. Results of more
than 11,000 scans with weightbearing CT-impact on costs,
radiation exposure, and procedure time. Foot Ankle Surg.
Published online June 18, 2019. doi:10.1016/j.fas.2019.05.019

https://www.orcid.org/0000-0001-5205-7947 https://www.orcid.org/0000-0002-8061-4453

Foot & Ankle International - September 2020

Table of Contents for the Digital Edition of Foot & Ankle International - September 2020