Talar tilt

Last revised by Henry Knipe on 2 Feb 2022

Talar tilt is a measurement of the angle between the talus and the distal tibia, used in the assessment of ankle instability and ankle osteoarthritis (OA).

Talar tilt is an important measurement in the assessment of ankle osteoarthritis. It is measured as part of the Kellgren and Lawrence classification of osteoarthritis, as modified for the ankle joint 1. It is also important in preoperative evaluation, as the management of ankle osteoarthritis by total ankle arthroplasty necessitates the correction of that tilt (typically a varus tilt) at surgery 2,3

Talar tilt is measured on either AP or mortise view radiographs of the ankle. Talar tilt is the angle between the articular surface of the talar dome and the articular surface of the tibial plafond 3. The tilt may be either varus or valgus

  • normal values 3
    • <2° on non-stress radiographs
    • <5° on inversion stress radiographs
  • talar tilt ≥2° upgrades Kellgren and Lawrence ankle OA from grade 3a to 3b, which is associated with worse clinical outcomes 1,2

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