University of Oulu

Lehtovirta S, Casula V, Haapea M, et al. Assessment of articular cartilage of ankle joint in stable and unstable unilateral weber type-B/SER-type ankle fractures shortly after trauma using T2 relaxation time. Acta Radiologica Open. 2023;12(9). doi:10.1177/20584601231202033

Assessment of articular cartilage of ankle joint in stable and unstable unilateral weber type-B/SER-type ankle fractures shortly after trauma using T2 relaxation time

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Author: Lehtovirta, Sami1,2; Casula, Victor1,2; Haapea, Marianne3;
Organizations: 1Research Unit of Health Sciences and Technology, University of Oulu, Oulu, Finland
2Medical Research Center, Oulu University Hospital, University of Oulu, Oulu, Finland
3Department of Diagnostic Radiology, Oulu University Hospital, Oulu, Finland
4Pihlajalinna Hospital, Oulu, Finland
Format: article
Version: published version
Access: open
Online Access: PDF Full Text (PDF, 1 MB)
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Language: English
Published: SAGE Publications, 2023
Publish Date: 2023-10-06


Background: Early detection of post-traumatic cartilage damage in the ankle joint in magnetic resonance images can be difficult due to disturbances to structures usually appearing over time.

Purpose: To study the articular cartilage of unilateral Weber type-B/SER-type ankle fractures shortly post-trauma using T2 relaxation time.

Material and Methods: Fifty one fractured ankles were gathered from consecutively screened patients, compiled initially for RCT studies, and treated at Oulu University Hospital and classified as stable (n = 28) and unstable fractures (n = 23) based on external-rotation stress test: medial clear space of ≥5 mm was interpreted as unstable. A control group of healthy young individuals (n = 19) was also gathered. All ankles were imaged on average 9 (range: 1 to 25) days after injury on a 3.0T MRI unit for T2 relaxation time assessment, and the cartilage was divided into sub-regions for comparison.

Results: Control group displayed significantly higher T2 values in tibial cartilage compared to stable (six out of nine regions, p-values = .003–.043) and unstable (six out of nine regions, p-values = .001–.037) ankle fractures. No differences were detected in talar cartilage. Also, no differences were observed between stable and unstable fractures in tibial or talar cartilage.

Conclusions: Lower T2 relaxation times of tibial cartilage in fractured ankles suggest intact extra cellular matrix (ECM) of the cartilage. Severity of the ankle fracture, measured by ankle stability, does not seem to increase ECM degradation immediately after trauma.

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Series: Acta radiologica open
ISSN: 2058-4601
ISSN-E: 2058-4601
ISSN-L: 2058-4601
Volume: 12
Issue: 9
Pages: 1 - 10
DOI: 10.1177/20584601231202033
Type of Publication: A1 Journal article – refereed
Field of Science: 217 Medical engineering
3126 Surgery, anesthesiology, intensive care, radiology
Funding: This work was supported by the Northern Ostrobothnia Hospital District (VTR).
Copyright information: © The Author(s) 2023. Creative Commons CC BY: This article is distributed under the terms of the Creative Commons Attribution 4.0 License ( which permits any use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (