Support of the Talus: A Biomechanical Investigation of the Contributions of the Talonavicular and Talocalcaneal Joints, and the Superomedial Calcaneonavicular Ligament

Abstract

The goal of this study was to determine the magnitude of force transmission to the talus by its inferior articulations to provide insight into mechanisms involving acquired deformities of the hindfoot. Cadaver feet were mounted in a loading apparatus that applied axial force through the tibia and fibula as well as tensile loading of the tendons of extrinsic musculature. This also permitted positioning of the tibia in the sagittal plane. Eighteen specimens were tested in three selected positions of the gait cycle. In one series, pressure-sensitive film was inserted into the posterior and anteromedial facets of the talocalcaneal joint as well as into the talonavicular joint. In a second series, film was inserted between the talar head and the superomedial calcaneonavicular ligament. In stance position, the specimens were also tested without posterior tibial tendon (PTT) tension. Contact areas and force transmitted across the articulations were greatest in near toe-off position, in the posterior facet of the talocalcaneal joint. The talonavicular joint, the anteromedial facet of the talocalcaneal joint, and the calcaneonavicular ligament articulation showed sequentially decreasing amounts of contact area and force transmission. Mean pressures were similar across all articulations, except in the posterior facet in near toe-off position. From heel-strike to stance, to near toe-off, a trend to increasing contact area and force was noted. No difference in contact characteristics was found in the calcaneonavicular ligament articulation after PTT release. The contact force of the calcaneonavicular ligament against the talus was found to be much smaller than those of other talar articulations; however, its medially oriented direction must contribute to stabilization of the head of the talus against medial displacement. Loss of PTT tension was not found to alter the contact forces acting at the talar head in this model, which might indicate that it shares its talar stabilizing function with other structures.

The subtalar and talonavicular joints: a way to access the long-term load intake using conventional CT-data

“…For the subtalar joint (especially the posterior articular surfaces), Mulcahy described a bicentric distribution of the main contact zones, located anterolaterally and posteromedially [17]. Essentially, Wagner and Reeck came to the same conclusion [21,30]. In contrast to these results, Seangeorzan's [23] study also showed a bicentric distribution of high pressure zones but they were located in the anteromedial and posterolateral portions of the articular surfaces.…”

“…Previously, several studies have investigated the load on these two joints but mainly focused on static and short-term [14,17,21,23,30]. By means of pressuresensitive film the instantaneous load on the articular surfaces was determined.…”

“…In the talonavicular joint, the works of Beaudoin, Mall/ Koebke, and Reeck [6,14,21] have yielded contradictory results as well. Beaudoin and Mall/Koebke [6,14] described a high pressure zone located in the dorsolateral portion, though Reeck [21] found pressure maxima either located around the edges of the articular surfaces or in a narrow region in the centre.…”

“…Previous studies investigating the load on the subtalar and talonavicular joint mainly based on static conditions which represent the load transfer at time but leave out conclusions about the long-term distribution. By means of pressure-sensitive film the instantaneous load on the articular surfaces was determined [14,21,23,30]. To describe the long-term load intake, CT-OAM can be used on conventional CT-data to get a deeper insight in the changes of the mineralisation distribution in the subtalar and talonavicular joint caused by long-term stress.…”

MRI Cartilage Assessment of the Subtalar and Midtarsal Joints During a Transcontinental Ultramarathon – New Insights into Human Locomotion

“…The talonavicular and subtalar joints are linked anatomically and functionally. Because three functions (weight acceptance, single limb support, and advancement of the limb [36]) are completed in each gait cycle, locally different contact forces [32] and energy dissipation [36] occur within the hindfoot. With initial weight acceptance and single limb support, energy dissipation has a higher effect on the distal articular surface in our data, mostly on the calcaneal aspect of posterior facet of the subtalar joint.…”