Semin Musculoskelet Radiol 2012; 16(03): 175-176
DOI: 10.1055/s-0032-1321689
Preface
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Imaging of the Postoperative Ankle and Foot

James M. Linklater
1   Castlereagh Sports Imaging, St. Leonards, Sydney, NSW, Australia
› Author Affiliations
Further Information

Publication History

Publication Date:
31 July 2012 (online)

The last 20 years have seen many advances in the surgical management of pathology in the foot and ankle, resulting in improved patient outcomes in many areas. Imaging plays an important role in the presurgical staging of foot and ankle pathology and in facilitating preoperative planning. Radiologists involved in these preoperative assessments should be aware of the key imaging features that help determine surgical management so they can provide imaging and imaging reports that are clinically relevant. There will inevitably be some patients whose surgical outcomes are suboptimal. Knowledge of the common causes of these scenarios is vital for the musculoskeletal radiologist involved in planning the imaging assessment of these patients and reporting on their examinations. This issue of Seminars in Musculoskeletal Radiology focuses on some of the common surgical procedures performed in the foot and ankle and some of the clinically significant complications that may be seen.

Dr. Trattnig and his colleagues discuss some of the surgical treatments for talar dome osteochondral lesions, their postoperative morphological MRI assessment, and assessment with quantitative MR techniques that can provide an insight into the maturation of the cartilage repair tissue including glycosaminoglycan content and distribution and collagen fiber organization.

Arthrofibrosis can occasionally complicate surgery in the foot and ankle, resulting in painful limitation of motion of the affected joint. There has been very little coverage of this topic in the imaging literature. I thought it would be appropriate to review the etiology, pathogenesis, and imaging findings of arthrofibrosis in the ankle and foot. I am grateful for the contribution of Dr. Fessa, my coauthor.

Dr. Buchan and colleagues review the uncommon but potentially disabling condition of postoperative avascular necrosis (AVN) of bone in the foot and ankle. They discuss imaging strategies for the diagnosis of AVN in the postoperative setting, the differential diagnosis, and the role of imaging in monitoring the temporal evolution and potential complications of AVN including articular collapse and fragmentation.

Total ankle replacement (TAR) is becoming an increasingly utilized alternative to fusion in the treatment of end-stage ankle arthritis. Dr. Cadden discusses the role of imaging in surgical planning, emphasizing the importance of overall foot alignment. We are at a relatively early stage in developing an understanding of the causes of ankle pain following TAR. Dr. Cadden discusses the role of imaging in the assessment of such patients.

Posterior tibial tendon dysfunction and flat foot deformity is a common and disabling condition for which there are several surgical options. Dr. Dimmick and colleagues review the pathology and staging of posterior tibial tendon dysfunction. They outline the relevant details of the commonly performed surgical treatments and the imaging findings that may be seen in cases where there have been complications.

Drs. Brodsky and Toppins review peroneal tendon pathologies including peroneal tendon tears and tendon subluxation. They outline the techniques in the surgical management of these conditions and emphasize the importance of an awareness of these techniques in imaging postoperative peroneal tendons. They discuss strategies for optimizing imaging techniques in the postoperative setting and relevant imaging findings.

Postoperative infection of the bone, joint, or soft tissues is a common and serious problem after foot and ankle surgery that can be diagnostically challenging. Dr. Chan and colleagues review the various imaging modalities and emphasize the importance of placing these tests in the context of clinical assessment and laboratory investigations.

Neurological complications following foot and ankle surgery are not uncommon. Delayed presentation with loss of sensation or pain due to regional nerve damage and resultant muscle weakness is typical. Dr. Chhabra and colleagues review the basic anatomy of peripheral nerves, relevant neural anatomy in the foot and ankle, the pathophysiology of iatrogenic surgery-related nerve injury, and they review imaging strategies in peripheral nerve imaging and the imaging findings in postoperative neurological complications.

I would like to thank the editors for giving me the opportunity to serve as guest editor. In addition, I would like to extend my appreciation to all the authors for their excellent contributions to this issue.