Difference in orientation of the talar articular facets between healthy ankle joints and ankle joints with chronic instability

Kleipool, Roeland P.; Stufkens, Sjoerd A. S.; Dahmen, Jari; Vuurberg, Gwendolyn; Streekstra, Geert J.; Dobbe, Johannes G. G.; Blankevoort, Leendert; Knupp, Markus

doi:10.1002/jor.25068

“…Shape approximation is one of the useful methods to study bone morphology and design ankle implants. Although several studies have measured the morphology of the talar trochlea [ 7 – 12 ], only a few studies [ 13 – 16 ] approximated the shape of the talar trochlea from the perspective of TAR implant design. Note that the majority of studies analyzed the shape of the talus in CT images considering that the thickness of the articular cartilage layer of the talar trochlea was shown in the previous literature [ 17 ] to be small and vary slightly, averaging 1.35 ± 0.22 mm in males and 1.11 ± 0.28 in females.…”

Section: Introductionmentioning

confidence: 99%

Shape Approximation and Size Difference of the Upper Part of the Talus: Implication for Implant Design of the Talar Component for Total Ankle Replacement

Yu

¹

,

Zhao

²

,

Wang

³

et al. 2022

BioMed Research International

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The implant design of the talar component for total ankle replacement (TAR) should match the surface morphology of the talus so that the replaced ankle can restore the natural motion of the tibiotalar joint and may reduce postoperative complications. The purpose of this study was to introduce a new 3D fitting method (the two-sphere fitting method of the talar trochlea with three fitting resection planes) to approximate the shape of the upper part of the talus for the Chinese population. 90 models of the tali from CT images of healthy volunteers were used in this study. Geometrical fitting and morphological measurements were performed for the surface morphology of the upper part of the talus. The accuracy of the two-sphere fitting method of the talar trochlea was assessed by a comparison of previously reported data. Parameters of the fitting geometries with different sizes were recorded and compared. Results showed that compared with previously reported one-sphere, cylinder, and bitruncated cone fitting methods, the two-sphere fitting method presented the smallest maximum distance difference, indicating that talar trochlea can be approximated well as two spheres. The radius of the medial fitting sphere R M was 20.69 ± 2.19 mm which was significantly smaller than the radius of the lateral fitting sphere R L of 21.32 ± 1.88 mm. After grouping all data by the average radius of fitting spheres, the result showed that different sizes of the upper part of the talus presented significantly different parameters except the orientation of the lateral cutting plane, indicating that the orientation of the lateral cutting plane may keep consistent for all upper part of the talus and have no relationship with the size. The linear regression analyses demonstrated a weak correlation ( R 2 < 0.5 ) between the majority of parameters and the average radius of the fitting spheres. Therefore, different sizes of the upper part of the talus presented unique morphological features, and the design of different sizes of talar components for TAR should consider the size-specific characteristics of the talus. The parameters measured in this study provided a further understanding of the talus and can guide the design of different sizes of the talar components of the TAR implant.

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“… 10 The LHA test is a reliable (ICC, 0.88) and widely used indicator of rearfoot alignment abnormalities in the standing position. 31 In a cohort study by Kleipool et al, 12 participants with CAI had a slightly valgus-directed subtalar joint. Previous studies have reported a higher incidence of ankle sprains for female athletes with a greater calcaneal eversion.…”

Section: Discussionmentioning

confidence: 99%

Relationship of Chronic Ankle Instability With Foot Alignment and Dynamic Postural Stability in Adolescent Competitive Athletes

Maeda,

Ikuta,

Tsutsumi

et al. 2023

Orthopaedic Journal of Sports Medicine

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Background: Competitive adolescent athletes should be aware of the early signs of chronic ankle instability (CAI) and the connection between the condition and performance. Purpose: To investigate whether CAI is related to foot alignment and morphology as well as dynamic postural stability after a jump landing among adolescent competitive athletes with and without a history of a lateral ankle sprain and CAI. Study Design: Cross-sectional study; Level of evidence, 3. Methods: Between July 2020 and August 2021, adolescent competitive athletes (N = 85; n = 49 boys; n = 36 girls) were classified into 3 groups using Cumberland Ankle Instability Tool (CAIT) scores: healthy athletes (n = 55), coper athletes (n = 19), and athletes with CAI (n = 11). Results of foot alignment assessments involving the leg-heel angle (LHA) and navicular height, intrinsic foot muscle morphology, dynamic postural stability index (DPSI), and other parameters were compared among the 3 groups. The relationship between the CAIT score and the LHA and dynamic postural stability and instability were examined using multiple linear regression. Results: Compared with the healthy group, the CAI group had a significantly greater LHA (8.73°± 3.22° vs 6.09°± 3.26°; P < .05), higher DPSI (0.336 ± 0.046 vs 0.298 ± 0.035), and higher vertical stability index (0.303 ± 0.048 vs 0.264 ± 0.037; P < .05 for all). Multiple regression analysis showed that the LHA (β = −0.228; P = .033) and DPSI (β = −0.240; P = .025) were significantly associated with the CAIT score . Conclusion: Valgus rearfoot alignment and poorer dynamic postural control were associated with CAI among adolescent athletes.

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“…A Sprain can lead to the relaxation or rupture of ligaments around the ankle, resulting in a change in the mechanical properties of the ankle or subtalar joint and uneven force distribution around the subtalar joint, and further lead to instability of the ankle or subtalar joint [ 1 – 3 ]. Injuries to the subtalar joint are difficult to detect because of the similarities in the mechanism and clinical manifestations of ankle and subtalar joint injuries [ 1 , 4 – 7 ]. At present, researchers are still uncertain about the factors that cause instability of the subtalar joint.…”

Section: Discussionmentioning

confidence: 99%

“…However, because of similar mechanisms of injury and clinical manifestations (both may develop symptoms such as ecchymosis, hematoma, or tenderness on the lateral foot), the involvement of subtalar joint is often neglected [ 1 , 4 , 5 ]. Undetected subtalar joint injuries may result in chronic subtalar instability (CSI) and further cause mechanical and functional instability in the hindfoot, ultimately leading to pain, dysfunction, joint deformity, and PTOA [ 2 , 4 , 6 , 7 ]. The consequences not only increase the financial burden of families but also seriously affect patient quality of life.…”

Section: Introductionmentioning

confidence: 99%

Mouse model of subtalar post-traumatic osteoarthritis caused by subtalar joint instability

Wang

¹

,

Liu

²

,

Chen

³

et al. 2022

J Orthop Surg Res

2

0

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Background Common ankle sprains are often accompanied by injury to the subtalar joint, which eventually leads to subtalar joint instability. Because the clinical manifestations for subtalar joint instability are similar to ankle joint injuries, these are often overlooked. This study aimed to establish an animal model of subtalar joint instability to study post-traumatic osteoarthritis of the subtalar joint caused by long-term subtalar joint instability and to provide a reference for future clinical research on chronic subtalar joint instability. Methods In all, 24 C57BL/6 male mice were randomly divided into three groups: Sham, cervical ligament (CL) transection and CL + calcaneofibular ligament (CFL) transection groups. One week after surgical operation, all mice were trained to run in the mouse rotation fatigue machine every day. During this period, a balance beam test was used to evaluate the motor level and coordination ability of the mice before the operation and three days, one week, four weeks, eight weeks, and twelve weeks after operation. Further, post-traumatic osteoarthritis of the subtalar joint was quantified via micro-CT and histological staining. Results The mice in the partial ligament transection group took significantly longer than those in the Sham group to pass through the balance beam and showed an increased number of hindfoot slips. Micro-CT analysis showed that the subtalar bone volume fraction in the CL + CFL transection group and CL transection group was 5.8% and 2.8% higher than that in the Sham group, respectively. Histological staining showed obvious signs of post-traumatic osteoarthritis (PTOA) in the subtalar joint of the ligament transection group. Conclusions The transection of CL and CL + CFL can cause instability of the subtalar joint in mice, resulting in a decrease in motor coordination, and long-term instability of the subtalar joint in mice can cause PTOA of the subtalar joint, which is manifested as destruction and loss of articular cartilage.

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Difference in orientation of the talar articular facets between healthy ankle joints and ankle joints with chronic instability

Cited by 10 publications

References 30 publications

Shape Approximation and Size Difference of the Upper Part of the Talus: Implication for Implant Design of the Talar Component for Total Ankle Replacement

Shape Approximation and Size Difference of the Upper Part of the Talus: Implication for Implant Design of the Talar Component for Total Ankle Replacement

Relationship of Chronic Ankle Instability With Foot Alignment and Dynamic Postural Stability in Adolescent Competitive Athletes

Mouse model of subtalar post-traumatic osteoarthritis caused by subtalar joint instability

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