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

Mueller, Fabian; Hoechel, Sebastian; Klaws, Joerg; Wirz, Dieter; Müller‐Gerbl, Magdalena

doi:10.1007/s00276-013-1205-2

Cited by 5 publications

(5 citation statements)

References 29 publications

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“…However, it has been found that an increase in hindfoot valgus and a decrease in forefoot valgus may exacerbate the shear stress in the middle third of the navicular bone as posterior valgus is increased ( Arndt et al, 2007 ; Becker et al, 2018 ). The findings of the present study are consistent with those reported by Mueller et al (2014) . In the three-dimensional model of the talus and the two-dimensional images of the coronal surface of the navicular bone, high-density zones were observed in the posterior articular surface of the talus and in the talonavicular surface.…”

Section: Discussionsupporting

confidence: 94%

Characterization of Changes in Subchondral Bone Tissue Density of the Ankle Joint in Taekwondo Players

Liu

Zhang

2022

Front. Bioeng. Biotechnol.

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Background: It has been found that ankle joint impingement can cause articular cartilage injury, and the change of subchondral bone density and distribution under long-term stress loading can reflect the stress interaction of the articular surface and the difference in bone remodeling degree and predict the location of cartilage injury.Objective: To investigate the bone density distribution pattern of ankle joint subchondral bone under mechanical stress loading of Taekwondo, the volume proportion of bone tissue with different bone densities, and the distribution characteristics of bone remodeling position.Study design: A controlled laboratory study.Methods: Computed tomography data were collected from the feet of 10 normal subjects (control group) and 10 high-level Taekwondo athletes. First, the distribution pattern of the high-density area of the articular surface was determined by computed tomography osteoabsorptiometry and the nine-grid anatomical region localization method. Second, the percentage of bone volume (%BTV) and the distribution trend of bone tissue were measured.Result: In the present study, it was found that there were high-density areas in the 1st, 2nd, 3rd, 4th, 6th, 7th, and 9th regions of the distal tibia of Taekwondo athletes, and the distribution track was consistent with the high-density areas of the talar dome surface (1st, 2nd, 3rd, 4th, 6th, 7th, and 9th regions). In Taekwondo athletes, the percentage of bone tissue volume in the distal tibia and talus with high and moderate bone density was significantly higher than that in the control group (p < 0.05).Conclusion: The impact stress, ground reaction force, intra-articular stress, lower limb movement technology, lower limb muscle, and tendon stress caused by Taekwondo lead to special pressure distribution patterns and bone tissue remodeling in the ankle.

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Section: Discussionsupporting

confidence: 94%

Characterization of Changes in Subchondral Bone Tissue Density of the Ankle Joint in Taekwondo Players

Liu

Zhang

2022

Front. Bioeng. Biotechnol.

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“…CT‐OAM has been used to show mineralization distribution in multiple joints, such as the shoulder, knee, subtalar joint, mid foot, and cervical vertebral endplates . Density distribution and mineralization of the subchondral bone plate are associated and can be seen as a mirror of the long‐term load intake of a joint . However, changes of subchondral bone plate density distribution regarding to its mineralization before and after supramalleolar osteotomies have not been investigated as of yet.…”

Section: Discussionmentioning

confidence: 99%

“…Joint preserving surgery, such as supramalleolar osteotomies, has produced encouraging results in reducing pain and improving subjective and objective function in asymmetric ankle degeneration . Changes in density distribution of the subchondral bone plate are thought to be adaptations to altered joint biomechanics and may reflect the long‐term load intake of a joint . Increasing evidence suggests that changes in subchondral bone mineralization are associated with progressive OA .…”

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confidence: 99%

Changes of density distribution of the subchondral bone plate after supramalleolar osteotomy for valgus ankle osteoarthritis

et al. 2014

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CT-osteoabsorptiometry (CT-OAM) has been used to visualize subchondral bone plate density distribution regarding to its mineralization. The purpose of this study was to display and analyze the density distribution of the subchondral bone plate before and after supramalleolar realignment osteotomies. We retrospectively analysed pre-and postoperative CT images of nine consecutive patients with post-traumatic unilateral valgus ankle OA. The distribution charts of CT-OAM scans were quantitatively analyzed for subchondral bone plate density distribution. VAS for pain and the Tegner activity scale were used to assess clinical outcome. At a mean follow-up of 20 AE 5.6 months (range 13-27), we observed a significant pre-to postoperative decrease of the mean high-density area ratio in tibia (lateral and posterior area) (p 0.05) and the talus (lateral area) (p 0.05). Pairwise comparison between the pre-and postoperative mineralization at the articular surface showed a significant decrease of the high-density area ratio for the tibia and the talus. The VAS decreased from 6.2 AE 0.9 pre-to 2.8 AE 0.9 postoperatively (p ¼ 0.027), and the Tegner score inclined from 4.5 AE 1.1 preoperatively to 5.3 AE 0.7 after surgery (p ¼ 0.082). The tibial and talar subchondral bone plate density, regarding to its mineralization, decreased after supramalleolar medial closing wedge osteotomy in patients with valgus ankle OA. The results of this study suggest that realignment surgery may decrease peak bone density areas corresponding to the alignment correction and contribute to a homogenization of the subchondral bone plate mineralization. ß

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“…Furthermore, tibial forces are known to load eccentrically on the calcaneus, leading to torque and shear stresses in the joint. Forces are not distributed homogenously throughout the articular surface of the subtalar joint ( Mueller et al 2014 ). In cases in which the stabilizing muscles were atrophied after the intervention, shear stresses may have exceeded their normal extent and led to cartilage impairment.…”

Section: Discussionmentioning

confidence: 99%

Muscular forces affect the glycosaminoglycan content of joint cartilage

et al. 2014

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Background and purpose Unloading alters the thickness of joint cartilage. It is unknown, however, to what extent unloading leads to a loss of glycosaminoglycans (GAGs) in the cartilage tissue. We hypothesized that muscle forces, in addition to axial loading, are necessary to maintain the joint cartilage GAG content of the knee and the upper and lower ankle.Patients and methods The HEPHAISTOS orthosis was worn unilaterally by 11 men (mean age 31 (23–50) years old) for 56 days. The orthosis reduces activation and force production of the calf muscles while it permits full gravitational loading of the lower leg. MRI measurements of the knee and ankle were taken before the intervention, during the intervention (on day 49), and 14 days after the end of the intervention. Cartilage segmentation was conducted semiautomatically for the knee joint (4 segments) and for the upper (tibio-talar) and lower (subtalar) ankle joints (2 segments each). Linear mixed-effects (LME) models were used for statistical analysis.Results 8 volunteers completed the MRI experiment. In the lower ankle joint, differences in ΔT1 were found between the end of the intervention and 14 days after (p = 0.004), indicating a decrease in GAG content after reloading. There were no statistically significant differences in ΔT1 values in the knee and upper ankle joints.Interpretation Our findings suggest that in addition to gravitational load, muscular forces affect cartilage composition depending on the local distribution of forces in the joints affected by muscle contraction.

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

Cited by 5 publications

References 29 publications

Characterization of Changes in Subchondral Bone Tissue Density of the Ankle Joint in Taekwondo Players

Characterization of Changes in Subchondral Bone Tissue Density of the Ankle Joint in Taekwondo Players

Changes of density distribution of the subchondral bone plate after supramalleolar osteotomy for valgus ankle osteoarthritis

Muscular forces affect the glycosaminoglycan content of joint cartilage

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