Is medial or lateral localization of osteochondral lesions of talus related to foot angles?

Objectives: This study aims to examine the relationship between foot angles and the presence and localization of osteochondral lesions of the talus (OLTs).

Patients and methods: Between January 2014 and January 2019, a total of 152 patients with a diagnosis of medial OTLs (95 males, 57 females; mean age: 28.8±6.4 years; range, 18 to 40 years), 51 patients with a diagnosis of lateral OTLs (36 males, 15 females; mean age: 27.1±6.2 years; range, 18 to 39 years), and 114 patients without known foot-ankle trauma as the control group (56 males, 58 females; mean age: 29.0±6.1 years; range, 18 to 40 years) were included. Magnetic resonance imaging and radiographs of each group were analyzed retrospectively. Lateral talocalcaneal angle (LTCA), calcaneal inclination angle (CIA), Böhler angle (BA), and Gissane angle (GA) were measured on the images and the values were compared among the groups.

Results: The CIA had a significant relationship with the localization (p<0.001). It was higher in patients with OLTs and had an effect on localization. The mean CIA was 26.6º±3.9º in the medial OLTs group, 23.0º±3.5º in the lateral OLTs group, and 18.5º±3.6º in the control group. There was a significant difference in the LTCA between the control and OLTs groups (p<0.001). The LTCA was higher in patients with OLTs, but had no effect on localization. The mean LTCA was 41.1º±4.2º for medial OLTs, 41.3º±4.2º for lateral OLTs, and 35.7º±6.8º for the controls. No significant relationship was found for BA and GA among the three groups.

Conclusion: Factors affecting the localization of OLTs are still not fully understood. However, foot morphology seems to play a role in determining medial or lateral localization. The LTCA is not related to the localization of OLTs; however, an increased LTCA may be related to the occurrence of OLTS. Increased CIA may be related to both OLTS localization and OLTs occurrence.