Multi-level multi-domain statistical shape model of the subtalar, talonavicular, and calcaneocuboid joints

Abstract

Traditionally, two-dimensional conventional radiographs have been the primary tool to measure the complex morphology of the foot and ankle. However, the subtalar, talonavicular, and calcaneocuboid joints are challenging to assess due to their bone morphology and locations within the ankle. Weightbearing computed tomography is a novel high-resolution volumetric imaging mechanism that allows detailed generation of 3D bone reconstructions. This study aimed to develop a multi-domain statistical shape model to assess morphologic and alignment variation of the subtalar, talonavicular, and calcaneocuboid joints across an asymptomatic population and calculate 3D joint measurements in a consistent weightbearing position. Specific joint measurements included joint space distance, congruence, and coverage. Noteworthy anatomical variation predominantly included the talus and calcaneus, specifically an inverse relationship regarding talar dome heightening and calcaneal shortening. While there was minimal navicular and cuboid shape variation, there were alignment variations within these joints; the most notable is the rotational aspect about the anterior-posterior axis. This study also found that multi-domain modeling may be able to predict joint space distance measurements within a population. Additionally, variation across a population of these four bones may be driven far more by morphology than by alignment variation based on all three joint measurements. These data are beneficial in furthering our understanding of joint-level morphology and alignment variants to guide advancements in ankle joint pathological care and operative treatments.

Reassessing the Role of Foot Power in Human Gait

“…However, we observed a large inter-participant variation with different participants performing positive or negative work across the foot and ankle that could not be explained by the small variations in speed or acceleration. We speculate that this could be because of variation in the morphology of the foot among participants 29 , because of neuromuscular control strategies that divide the work between the lower limb joints differently 30 , or step to step variations as only one step was captured. Due to the participant-specific nature of our results, we suggest avoiding “covering law” statements 31 that discuss overall foot behavior in terms of group averages.…”