- Number of Segments Within Musculoskeletal Foot Models Influences Ankle Kinematics and Strains of Ligaments and Muscles. [Journal Article]
- JOJ Orthop Res 2019 Jun 17
- Multi-segment foot models (MFMs) are becoming a common tool in musculoskeletal research on the ankle-foot complex. The purpose of this study was to compare ankle joint kinematics as well as ligament …
Multi-segment foot models (MFMs) are becoming a common tool in musculoskeletal research on the ankle-foot complex. The purpose of this study was to compare ankle joint kinematics as well as ligament and muscle strains that result from MFM with a different number of segments during vertical hopping. Ten participants were recruited and performed double-limb vertical hops. Marker positions and ground reaction forces were collected. Two-segment (2MFM), three-segment (3MFM), and five-segment MFM (5MFM) were used to calculate ankle kinematics and the strains of the anterior talofibular and calcaneofibular ligaments and of the soleus and gastrocnemius muscles. Ranges of motion and peak strains were analyzed with Kruskal-Wallis and post hoc tests, whereas the time-series of the ankle kinematics and ligament and muscle strains were analyzed with statistical parametric mapping. There were significant main effects for MFM in the talocrural joint range of motion and peak strains of ligaments and muscles. In addition, there were significant main effects for MFM in time-series data of the talocrural joint angle as well as for ligament and muscle strains. In all cases, the post hoc analyses showed that the 2MFM consistently overestimated the range of motion and tissue strains compared to the 3MFM and 5MFM, while 3MFM and 5MFM did not differ from each other in the most variables. This study showed that the number of segments in MFM significantly affects the biomechanical estimates of joint kinematics and tissue strains during hopping. Clinical significance: MFM that combine all foot structures beyond the talus into one segment likely overestimate ankle joint biomechanics.
- StatPearls: Ankle Fractures [BOOK]
- BOOKStatPearls Publishing: Treasure Island (FL)
- The ankle joint is a highly complex joint. The ankle joint has multidirectional mobility for its complex role in supporting the weight of the body and fulfilling a myriad of daily functions. It is a …
The ankle joint is a highly complex joint. The ankle joint has multidirectional mobility for its complex role in supporting the weight of the body and fulfilling a myriad of daily functions. It is a combination of bones and ligaments structured around the talus. It includes the tibia, fibula, calcaneus, the tibiofibular ligament, the lateral ligament complex, and the medial ligament complex. The talocrural joint is the place where the distal tibia, distal fibula, and talus articulate. The tibia and fibula are anchored together via the syndesmosis. The syndesmosis consists of the interosseous membrane as well as the transverse, anterior, and posterior tibiofibular ligaments. There are both lateral and medial collateral ligament complexes which help to increase the stability of the ankle joint. The lateral collateral ligament forms from the fibulocalcanear ligament (FCL), the anterior fibulotalar ligament (AFTL), and the posterior fibulotalar ligament (PFTL). The medial collateral ligament consists of the deltoid ligament and the plantar calcaneonavicular ligament. The ankle joint moves in a unique way due to its structure. As the talus is asymmetric, the ankle is not purely a hinge joint. Instead, it acts as a rotary hinging movement. As many structures are involved in the ankle joint, in the context of an acute ankle fracture, it is easiest to think of it as a ring of structures situated around the talus. One break in the ring leads to a stable injury, while two or more breaks in the ring lead to an unstable injury.
- The Ankle-Joint Complex: A Kinesiologic Approach to Lateral Ankle Sprains. [Journal Article]
- JAJ Athl Train 2019; 54(6):589-602
- Copious research exists regarding ankle instability, yet lateral ankle sprains (LASs) persist in being among the most common recurrent musculoskeletal injuries. Key anatomical structures of the ankle…
Copious research exists regarding ankle instability, yet lateral ankle sprains (LASs) persist in being among the most common recurrent musculoskeletal injuries. Key anatomical structures of the ankle include a triform articulating structure that includes the inferior tibiofibular, talocrural, and subtalar joints. Functionally, force absorption and propulsion through the ankle complex are necessary for any task that occurs in weight bearing. For optimal ankle performance and avoidance of injury, an intricate balance between stability and mobility is necessary to ensure that appropriate force transfer occurs during sports and activities of daily living. Consideration for the many structures that may be directly or indirectly involved in LASs will likely translate into advancements in clinical care. In this clinical review, we present the structure, function, and relevant pathologic states of the ankle complex to stimulate a better understanding of the prevention, evaluation, and treatment of LASs.
- Evaluating and Differentiating Ankle Instability. [Journal Article]
- JAJ Athl Train 2019; 54(6):617-627
- Given the prevalence of lateral ankle sprains during physical activity and the high rate of reinjury and chronic ankle instability, clinicians should be cognizant of the need to expand the evaluation…
Given the prevalence of lateral ankle sprains during physical activity and the high rate of reinjury and chronic ankle instability, clinicians should be cognizant of the need to expand the evaluation of ankle instability beyond the acute time point. Physical assessments of the injured ankle should be similar, regardless of whether this is the initial lateral ankle sprain or the patient has experienced multiple sprains. To this point, a thorough injury history of the affected ankle provides important information during the clinical examination. The physical examination should assess the talocrural and subtalar joints, and clinicians should be aware of efficacious diagnostic tools that provide information about the status of injured structures. As patients progress into the subacute and return-to-activity phases after injury, comprehensive assessments of lateral ankle-complex instability will identify any disease and patient-oriented outcome deficits that resemble chronic ankle instability, which should be addressed with appropriate interventions to minimize the risk of developing long-term, recurrent ankle instability.
- Sagittal subtalar and talocrural joint assessment between barefoot and shod walking: A fluoroscopic study. [Journal Article]
- GPGait Posture 2019 May 22; 72:57-61
- CONCLUSIONS: This work demonstrates the ability to directly measure talocrural and subtalar kinematics of shod walking using fluoroscopy. Future work using this methodology can be used to increase understanding of hindfoot kinematics during a variety of non-barefoot activities.
- Comparative anatomy of the mouse and human ankle joint using Micro-CT: Utility of a mouse model to study human ankle sprains. [Journal Article]
- MBMath Biosci Eng 2019 04 10; 16(4):2959-2972
- The use of mouse models as a tool to study ankle sprain requires a basic understanding of the similarities and differences between human and mouse ankle joint anatomy. However, few studies have been …
The use of mouse models as a tool to study ankle sprain requires a basic understanding of the similarities and differences between human and mouse ankle joint anatomy. However, few studies have been conducted that address the merits and drawbacks of these differences in the functioning of joints. Twenty hindfoot specimens were obtained from 10 male C57BL/6J mice and scanned using micro-CT. The foot and ankle skeletal structures were reconstructed in three dimensions. Morphological parameters were then measured using a plane projection method and normalized data were compared with those of human ankles. There was no significant difference in the malleolar width, maximal tibial thickness, tibial arc length, trochlea tali arc length or trochlea tali width of the mouse specimens compared with the human model. However, a groove was observed on the talar dome in the mouse specimens which was not observed in humans, the talar dome being more symmetric. The mouse ankle was to a large extent able to mimic the mechanism of a human ankle and so a mouse model could be appropriate for expanding our understanding of ankle biomechanics in general. However, the structural differences in the talar dome in the mouse and human should not be ignored. Although there are some differences in the mouse and human ankle that cannot be ignored, compared to other animals, the human ankle is more similar to that of the mouse.
- The effect of varus knee deformities on the ankle alignment in patients with knee osteoarthritis. [Journal Article]
- JOJ Orthop Surg Res 2019 May 15; 14(1):134
- CONCLUSIONS: Compensatory ankle changes should be considered before TKA.
- StatPearls: Anatomy, Bony Pelvis and Lower Limb, Foot Talus [BOOK]
- BOOKStatPearls Publishing: Treasure Island (FL)
- The talus is the second largest bone in the hindfoot region of the human body. Responsible for transmitting body weight and forces passing between the lower leg and the foot the talus is a compone…
The talus is the second largest bone in the hindfoot region of the human body. Responsible for transmitting body weight and forces passing between the lower leg and the foot the talus is a component of many multiple joints, including the talocrural (ankle), subtalar, and transverse tarsal joints. While the talus does not have any direct muscular attachments and has a tenuous and limited blood supply, it serves as the site of attachment for many ligaments including the lateral ankle ligaments and medial deltoid ligament complex. Talus fractures comprise about 1% of all foot and ankle fractures. Additionally, nearly 70% of ankle injuries can cause varying degrees of chondral and osteochondral injuries to the talus. The clinician must be aware of the occurrence of both isolated and associated talar injuries and their extent of clinical and potentially long-term implications.
- Effect of a Semirigid Ankle Brace on the In Vivo Kinematics of Patients with Functional Ankle Instability during the Stance Phase of Walking. [Journal Article]
- BRBiomed Res Int 2019; 2019:4398469
- An ankle brace is commonly used by patients after they suffer from initial ankle sprains, reducing the incidents of recurrent sprain or limiting laxity in joints with functional ankle instability (FA…
An ankle brace is commonly used by patients after they suffer from initial ankle sprains, reducing the incidents of recurrent sprain or limiting laxity in joints with functional ankle instability (FAI). However, whether the application of a semirigid ankle brace can improve the abnormal ankle gait kinematics of patients with FAI remains unknown. This study aimed to determine the effect of a semirigid ankle brace on the gait kinematics of ankle joints through 3D-2D fluoroscopy image registration. A total of 8 subjects with FAI (3 males and 5 females, 10 feet) as FAI group and 10 subjects without FAI (6 males and 4 females, 10 feet) as control group were enrolled in this study. Three-dimensional bone models created from computed tomography images were matched to fluoroscopic images to compute the 6 degrees of freedom (DOF) talocrural, subtalar, and ankle joints complex kinematics for control and FAI group with or without brace during the stance phase of walking. FAI patients had significantly less ROMs in inversion/eversion rotation of the talocrural and subtalar joint after wearing semirigid ankle brace. Laxity was observed in most of the displacements of the talocrural and subtalar joints in FAI group. The brace partly altered the ankle joints movement in opposite directions, especially joint rotation, and restricted the talocrural and subtalar joints in the dorsiflexion position during the touch down phase of walking.
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- Supramalleolar osteotomy with medial distraction arthroplasty for ankle osteoarthritis with talar tilt. [Journal Article]
- JOJ Orthop Surg Res 2019 May 06; 14(1):120
- CONCLUSIONS: SMOT is a promising procedure for functional improvement and malalignment correction for varus ankle osteoarthritis, even in patients with increased talar tilt. If SMOT is combined with MDA, there can be an improvement in the correction of the increased talar tilt.