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Spring ligament tear decreases static stability of the ankle joint.
Clin Biomech (Bristol, Avon). 2019 01; 61:79-83.CB

Abstract

BACKGROUND

Spring ligament tear is often found in advanced adult acquired flatfoot deformity and its reconstruction in conjunction with the deltoid ligament has been proposed to restore the tibiotalar and talonavicular joint stability. The aim of the present study is to determine the effect of spring ligament injury and subsequent reconstruction on static joint reactive force using a non-invasive method of measurement.

METHODS

Ten fresh-frozen human cadaveric lower legs were disarticulated at the knee joint. Static joint reactive force of the tibiotalar and talonavicular joint were measured at baseline, after spring ligament injury, and after ligament reconstruction. Reconstruction consisted of a forked semitendinosis allograft with dual limbs to reconstruct the tibionavicular and tibiocalcaneal ligaments.

FINDINGS

The mean baseline joint reactive force of the tibiotalar and talonavicular joints were 37.2 N + 8.1 N and 13.4 N + 4.2 N, respectively. The spring ligament injury model resulted in a significant 29% decrease in tibiotalar joint reactive force. Reconstruction of the tibionavicular limb resulted in a significant increase in tibiotalar and talonavicular joint reactive force compared to those seen in the injury state. Furthermore, the addition of the tibiocalcaneal limb significantly increased tibiotalar joint reactive force compared to those results obtained from the injury state and the tibionavicular limb alone.

INTERPRETATION

This is the first study to demonstrate diminished tibiotalar static joint reactive force in a spring ligament injury model with subsequent joint reactive force restoration using two-limbed reconstruction of the deltoid and spring ligament.

LEVEL OF EVIDENCE

Biomechanical Study.

Authors+Show Affiliations

Department of Orthopaedic Surgery, University of Rochester, Rochester, NY, USA.Department of Orthopaedic Surgery, University of Rochester, Rochester, NY, USA.Department of Mechanical Engineering, Rochester Institute of Technology, Rochester, NY, USA.Department of Orthopaedic Surgery, University of Rochester, Rochester, NY, USA.Department of Orthopaedic Surgery, Helwan Univesity, Cairo, Egypt.Department of Orthopaedic Surgery, University of Rochester, Rochester, NY, USA.Department of Mechanical Engineering, Rochester Institute of Technology, Rochester, NY, USA.Department of Orthopaedic Surgery, University of Rochester, Rochester, NY, USA.Department of Orthopaedic Surgery, University of Rochester, Rochester, NY, USA.Department of Orthopaedic Surgery, University of Rochester, Rochester, NY, USA. Electronic address: Irvin_Oh@urmc.rochester.edu.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

30529505

Citation

Kelly, Meghan, et al. "Spring Ligament Tear Decreases Static Stability of the Ankle Joint." Clinical Biomechanics (Bristol, Avon), vol. 61, 2019, pp. 79-83.
Kelly M, Masqoodi N, Vasconcellos D, et al. Spring ligament tear decreases static stability of the ankle joint. Clin Biomech (Bristol, Avon). 2019;61:79-83.
Kelly, M., Masqoodi, N., Vasconcellos, D., Fowler, X., Osman, W. S., Elfar, J. C., Olles, M. W., Ketz, J. P., Flemister, A. S., & Oh, I. (2019). Spring ligament tear decreases static stability of the ankle joint. Clinical Biomechanics (Bristol, Avon), 61, 79-83. https://doi.org/10.1016/j.clinbiomech.2018.11.011
Kelly M, et al. Spring Ligament Tear Decreases Static Stability of the Ankle Joint. Clin Biomech (Bristol, Avon). 2019;61:79-83. PubMed PMID: 30529505.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Spring ligament tear decreases static stability of the ankle joint. AU - Kelly,Meghan, AU - Masqoodi,Noorullah, AU - Vasconcellos,Daniel, AU - Fowler,Xavier, AU - Osman,Walid S, AU - Elfar,John C, AU - Olles,Mark W, AU - Ketz,John P, AU - Flemister,Adolph S, AU - Oh,Irvin, Y1 - 2018/11/27/ PY - 2017/10/16/received PY - 2018/11/11/revised PY - 2018/11/23/accepted PY - 2018/12/12/pubmed PY - 2020/2/12/medline PY - 2018/12/12/entrez KW - Adult acquired flatfoot deformity KW - Joint reaction force KW - Spring ligament KW - Talonavicular joint KW - Tibiotalar joint SP - 79 EP - 83 JF - Clinical biomechanics (Bristol, Avon) JO - Clin Biomech (Bristol, Avon) VL - 61 N2 - BACKGROUND: Spring ligament tear is often found in advanced adult acquired flatfoot deformity and its reconstruction in conjunction with the deltoid ligament has been proposed to restore the tibiotalar and talonavicular joint stability. The aim of the present study is to determine the effect of spring ligament injury and subsequent reconstruction on static joint reactive force using a non-invasive method of measurement. METHODS: Ten fresh-frozen human cadaveric lower legs were disarticulated at the knee joint. Static joint reactive force of the tibiotalar and talonavicular joint were measured at baseline, after spring ligament injury, and after ligament reconstruction. Reconstruction consisted of a forked semitendinosis allograft with dual limbs to reconstruct the tibionavicular and tibiocalcaneal ligaments. FINDINGS: The mean baseline joint reactive force of the tibiotalar and talonavicular joints were 37.2 N + 8.1 N and 13.4 N + 4.2 N, respectively. The spring ligament injury model resulted in a significant 29% decrease in tibiotalar joint reactive force. Reconstruction of the tibionavicular limb resulted in a significant increase in tibiotalar and talonavicular joint reactive force compared to those seen in the injury state. Furthermore, the addition of the tibiocalcaneal limb significantly increased tibiotalar joint reactive force compared to those results obtained from the injury state and the tibionavicular limb alone. INTERPRETATION: This is the first study to demonstrate diminished tibiotalar static joint reactive force in a spring ligament injury model with subsequent joint reactive force restoration using two-limbed reconstruction of the deltoid and spring ligament. LEVEL OF EVIDENCE: Biomechanical Study. SN - 1879-1271 UR - https://www.unboundmedicine.com/medline/citation/30529505/Spring_ligament_tear_decreases_static_stability_of_the_ankle_joint_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0268-0033(18)30978-1 DB - PRIME DP - Unbound Medicine ER -