The Use of a 6-DOF Robotic System for the Functional Analysis of Ankle Joint Ligaments

2013 ◽  
Author(s):  
Satoshi Yamakawa ◽  
Takuma Kobayashi ◽  
Kei Kimura ◽  
Daisuke Suzuki ◽  
Kota Watanabe ◽  
...  
Keyword(s):  
Ankle Joint ◽  
Joint Instability ◽  
Experimental Methodology ◽  
Reconstruction Technique ◽  
Ankle Sprains ◽  
Joint Stability ◽  
Calcaneofibular Ligament ◽  
Ankle Ligaments ◽  
Specific Loading ◽  
Tensile Forces

Ankle sprains are common injuries in daily and athletic activities. An epidemiological report indicated that the incidence rate of ankle sprains treated in emergency departments in the USA is more than 2 per 1000 persons a year, and the rate is estimated to be more than double as for ankle sprains in athletic activity [1]. Better understanding of ankle biomechanics is, therefore, important for the improvement of clinical outcome. Many investigators have performed in vitro and in vivo experiments to determine the mechanical roles of ankle structures such as range of motion, contribution of ankle ligaments to joint stability, joint instability due to ligament transection, and so on. In spite of these efforts, tensile forces in ankle ligaments in response to specific loading conditions still remains unclear because of a lack of experimental methodology. Meanwhile, the use of robotic technology for knee joint biomechanics study has been established by Fujie et al [2]. Using the technique, tensile forces in knee cruciate ligaments have been determined by Woo et al [3], Li et al [4], Fujie et al [5], and other groups, while ligament reconstruction technique has been evaluated by many investigators [for example 6–8]. Therefore, the objectives of the present study were to determine the ankle joint instability due to ligament transection and to determine the tensile forces in the anterior tarofibular ligament (ATFL) and calcaneofibular ligament (CFL) in response to anterior-posterior (AP) drawer force to the human cadaveric ankle joints.

The Role of Calcaneofibular Ligament Injury in Ankle Instability: Implications for Surgical Management

2018 ◽  
Vol 47 (2) ◽  
pp. 431-437 ◽  
Author(s):  
Kenneth J. Hunt ◽  
Helder Pereira ◽  
Judas Kelley ◽  
Nicholas Anderson ◽  
Richard Fuld ◽  
...  
Keyword(s):  
Contact Mechanics ◽  
Ankle Joint ◽  
Contact Area ◽  
Ankle Instability ◽  
Peak Torque ◽  
Ligament Injury ◽  
Lateral Ligament ◽  
Anterior Talofibular Ligament ◽  
Ankle Sprains ◽  
Calcaneofibular Ligament

Background: Acute inversion ankle sprains are among the most common musculoskeletal injuries. Higher grade sprains, including anterior talofibular ligament (ATFL) and calcaneofibular ligament (CFL) injury, can be particularly challenging. The precise effect of CFL injury on ankle instability is unclear. Hypothesis: CFL injury will result in decreased stiffness, decreased peak torque, and increased talar and calcaneal motion and will alter ankle contact mechanics when compared with the uninjured ankle and the ATFL-only injured ankle in a cadaveric model. Study Design: Descriptive laboratory study. Methods: Ten matched pairs of cadaver specimens with a pressure sensor in the ankle joint and motion trackers on the fibula, talus, and calcaneus were mounted on a material testing system with 20° of ankle plantarflexion and 15° of internal rotation. Intact specimens were axially loaded to body weight and then underwent inversion along the anatomic axis of the ankle from 0° to 20°. The ATFL and CFL were sequentially sectioned and underwent inversion testing for each condition. Linear mixed models were used to determine significance for stiffness, peak torque, peak pressure, contact area, and inversion angles of the talus and calcaneus relative to the fibula across the 3 conditions. Results: Stiffness and peak torque did not significantly decrease after sectioning of the ATFL but decreased significantly after sectioning of the CFL. Peak pressures in the tibiotalar joint decreased and mean contact area increased significantly after CFL release. Significantly more inversion of the talus and calcaneus as well as calcaneal medial displacement was seen with weightbearing inversion after sectioning of the CFL. Conclusion: The CFL contributes considerably to lateral ankle instability. Higher grade sprains that include CFL injury result in significant decreases in rotation stiffness and peak torque, substantial alteration of contact mechanics at the ankle joint, increased inversion of the talus and calcaneus, and increased medial displacement of the calcaneus. Clinical Relevance: Repair of an injured CFL should be considered during lateral ligament reconstruction, and there may be a role for early repair in high-grade injuries to avoid intermediate and long-term consequences of a loose or incompetent CFL.

The in situ force in the calcaneofibular ligament and the contribution of this ligament to ankle joint stability

2016 ◽  
Vol 40 ◽  
pp. 8-13 ◽  
Author(s):  
Takuma Kobayashi ◽  
Satoshi Yamakawa ◽  
Kota Watanabe ◽  
Kei Kimura ◽  
Daisuke Suzuki ◽  
...  
Keyword(s):  
Ankle Joint ◽  
Joint Stability ◽  
Calcaneofibular Ligament ◽  
In Situ Force

Ligament Function and Joint Stability Elucidated by a New Technique

1982 ◽  
Vol 11 (2) ◽  
pp. 77-81 ◽  
Author(s):  
O Rasmussen ◽  
K Andersen
Keyword(s):  
Ankle Joint ◽  
Strain Gauges ◽  
Anterior Talofibular Ligament ◽  
Joint Stability ◽  
Mobility Patterns ◽  
Partial Rupture ◽  
Calcaneofibular Ligament ◽  
Service Centre ◽  
A New Technique ◽  
Cutting Experiments

For analysing the ligaments of the ankle joint, their function, and the traumatic mechanisms which cause them to rupture, an apparatus was developed which enables graphic registration of rotatory movements in the ankle joint in two planes simultaneously, when a given torque is applied to the talus. In a modified form, this apparatus is applicable also for other joints. A lever with strain gauges and potentiometers is fixed in the talus of an osteoligamentous preparation. The lever is moved manually, and signals from the strain gauges and potentiometers are collected by a microcomputer for later transfer to a computer service centre where the mobility at the chosen torque is calculated and plotted as mobility patterns. The appearance of these patterns depends upon which ligaments are intact. The patterns plotted in any situation are reproducible, provided that the state of the ligaments is unchanged. In cutting experiments it was possible to demonstrate that rupture of the anterior talofibular ligament may occur simultaneously with partial rupture of the posterior talofibular ligament, although the calcaneofibular ligament remains intact. This occurs if the distortion trauma causing the rupture consists of an internal rotation of the talus, not if it consists mainly of a tilting of the talus in the ankle mortise.

Medial Compressible Forefoot Sole Elements Reduce Ankle Inversion in Lateral SSC Jumps

2013 ◽  
Vol 29 (3) ◽  
pp. 346-353 ◽  
Author(s):  
Jana Fleischmann ◽  
Guillaume Mornieux ◽  
Dominic Gehring ◽  
Albert Gollhofer
Keyword(s):  
Ankle Joint ◽  
Muscle Activity ◽  
Frontal Plane ◽  
Triceps Surae ◽  
Ankle Sprains ◽  
Joint Stability ◽  
Lateral Ankle ◽  
Foot Placement ◽  
3 Dimensional ◽  
Ankle Inversion

Sideward movements are associated with high incidences of lateral ankle sprains. Special shoe constructions might be able to reduce these injuries during lateral movements. The purpose of this study was to investigate whether medial compressible forefoot sole elements can reduce ankle inversion in a reactive lateral movement, and to evaluate those elements’ influence on neuromuscular and mechanical adjustments in lower extremities. Foot placement and frontal plane ankle joint kinematics and kinetics were analyzed by 3-dimensional motion analysis. Electromyographic data of triceps surae, peroneus longus, and tibialis anterior were collected. This modified shoe reduced ankle inversion in comparison with a shoe with a standard sole construction. No differences in ankle inversion moments were found. With the modified shoe, foot placement occurred more internally rotated, and muscle activity of the lateral shank muscles was reduced. Hence, lateral ankle joint stability during reactive sideward movements can be improved by these compressible elements, and therefore lower lateral shank muscle activity is required. As those elements limit inversion, the strategy to control inversion angles via a high external foot rotation does not need to be used.

scholarly journals Effect of Kinesio Taping on Ankle Joint Kinematics During Landing on Stable and Unstable Surfaces in Ankle Sprain and Health Persons

2021 ◽  
Vol 10 (3) ◽  
pp. 522-531
Author(s):  
Mohammad Baghbani ◽  
◽  
Mohammadtaghi Amiri-Khorasani ◽  
Abdolhamid Daneshjoo ◽  
◽  
...  
Keyword(s):  
Ankle Joint ◽  
Ankle Sprain ◽  
Repeated Measures ◽  
Plantar Flexion ◽  
Three Dimensional ◽  
Joint Kinematics ◽  
Ankle Sprains ◽  
Ankle Ligaments ◽  
Kinesio Tape ◽  
Kinesio Taping

Background and Aims: Landing is a typical sports motion that can create impact force 2-12 times of body weight, and finally, it’s one of the main reasons for non-contact injuries in ankle ligaments. Specialized. The usual effects of Kinesio tape include increasing proprioception, health direction of joints, reducing pain, and raising pressure on nervous tissue. The study aimed to investigate the effect of Kinesio taping on ankle joint kinematics during landing on stiff and soft surfaces in ankle sprain and healthy persons. Methods: The method of the present study was quasi-experimental with a two-group design in control groups (without ankle sprain) and experimental (with an ankle sprain). A total of 30 male students of the Shahid Bahonar University of Kerman were purposefully and accessibly selected and divided into two groups with (15 students) and without ankle sprains (15 students). Then, they performed both landing operations on stable and unstable surfaces, with and without Kinesio tape. Maximum dorsi and plantar flexion, supination, pronation and maximum ankle angular velocity parameters were recorded by a three-dimensional motion analysis system. Statistical analysis was performed using independent t-test and repeated measures analysis of variance at the significant level of 0.05. Results: There was no significant reduction in plantar flexion of the ankle in healthy and twisted individuals while landing on stable and unstable surfaces with and without Kinesio tape (P≤0.07), but there was a significant reduction in the dorsiflexion in both groups(P≤0.001). On the other hand, there was no significant decrease in pronation (P≤0.66), but there was a significant decrease in foot supination (P≤0.001). Conclusion: Generally, Kinesio tape in recovery ankle movement is offered to persons for ankle sprain. Thus recommendation landing exercises fare with more flexion angle and less knee joint valgus and more dorsiflexion angle at ankle joint and preferable on the unstable surfaces.

The Influence of Profession on Functional Ankle Stability in Musicians

2010 ◽  
Vol 25 (1) ◽  
pp. 22-28 ◽  
Author(s):  
Susanne Rein ◽  
Tobias Fabian ◽  
Hans Zwipp ◽  
Jan Heineck ◽  
Stephan Weindel
Keyword(s):  
Reaction Time ◽  
Ankle Joint ◽  
Postural Balance ◽  
Balance Control ◽  
Ankle Sprains ◽  
Exact Test ◽  
Work Related ◽  
Ankle Stability ◽  
Ankle Joints ◽  
The Right

OBJECTIVE: The aim of this study was to examine the influence of extensive work-related use of the feet on functional ankle stability among musicians. METHODS: Thirty professional organists were compared to professional pianists and controls. All participants completed a questionnaire. Range of motion (ROM), peroneal reaction time, and positional sense tests of the ankle were measured. The postural balance control was investigated with the Biodex Stability System for the stable level 8 and unstable level 2. Statistical analysis was done with the Kruskal-Wallis test, Mann-Whitney test with Bonferroni-Holm correction, and Fisher’s exact test. RESULTS: Nine of 30 organists compared to 5 of 30 pianists and controls reported ankle sprains in their medical history. Pianists had a significant increased flexion of both ankle joints compared to organists (p≤0.01) and increased flexion of the right ankle joint compared to controls (p=0.02). The positional sense test and postural balance control showed no significant differences among groups. The peroneal reaction time of the right peroneus longus muscle was significantly increased in pianists compared to controls (p=0.008). CONCLUSIONS: Organists have shown a high incidence of ankle sprains. Despite their extensive work-related use of the ankle joints, organists have neither increased functional ankle stability nor increased ROM of their ankle joints in comparison to controls. Pianists have increased flexion of the ankle joint, perhaps due to the exclusive motion of extension and flexion while using the pedals. To minimize injuries of the ankle and improve functional ankle stability as well as balance control, proprioceptive exercises of the ankle in daily training programs are recommended.

scholarly journals The ACL of the Ankle Joint: A Cadaveric Evaluation of the Subtalar Intrinsic Ligaments and Optimal Surgical Approach

2020 ◽  
Vol 5 (4) ◽  
pp. 2473011420S0019
Author(s):  
Naven Duggal ◽  
Patrick M. Williamson ◽  
Ara Nazarian
Keyword(s):  
Ankle Joint ◽  
Subtalar Joint ◽  
Cruciate Ligament ◽  
Surgical Approaches ◽  
Ankle Sprains ◽  
Anterior Border ◽  
Lateral Ankle ◽  
Sinus Tarsi ◽  
Sinus Tarsi Approach ◽  
Anterior Cruciate

Category: Ankle; Basic Sciences/Biologics; Sports Introduction/Purpose: The biomechanics of ankle sprains involves a multiplanar-supination motion and not the strict inversion as is often described. During supination, calcaneal inversion occurs at the anatomic subtalar joint. The intrinsic subtalar ligaments include a series of broad thick ligaments situated in the tarsal canal that separate the anterior and posterior compartments. The subtalar intrinsic ligaments are damaged in an estimated 25% to 80% of all lateral ankle sprains. We hypothesize that the intrinsic subtalar ligaments have a multiplanar role in ankle joint stabilization similar to that of the anterior cruciate ligament at the knee. The purpose of this study is to evaluate the efficacy of four surgical approaches to the subtalar ligaments through cadaveric dissection. Methods: Four fresh-frozen cadaveric ankle specimens were utilized. Ability to access the extrinsic lateral ankle ligament (anterior talofibular), the extrinsic subtalar ligaments (calcaneofibular, lateral talocalcaneal) and the intrinsic subtalar ligaments (interosseous talocalcaneal, cervical) was evaluated. The first cadaveric specimen was dissected as a baseline to identify the extrinsic and intrinsic subtalar ligaments. The three remaining cadaveric specimens were utilized to evaluate the efficacy of three standard surgical approaches (a curvilinear incision made over the distal anterior border of lateral malleolus, a posterolateral longitudinal incision, and an extensile sinus tarsi approach) to access both the extrinsic ankle and subtalar ligaments as well as the intrinsic subtalar ligaments. Ability to access all ligaments as well as identification of neurovascular structures at risk during the dissection was recorded for each approach. Results: The curvilinear incision made over the distal anterior border of the lateral malleolus provided access to the anterior talofibular, calcaneofibular ligaments. Branches of the superficial peroneal nerve were noted to be at direct risk. The posterior longitudinal incision provided access to the calcaneofibular, lateral talocalcaneal ligaments. Branches of the sural nerve were noted to be at direct risk with this approach. An extensile posterolateral incision improved access to the anterior talofibular ligament. An extensile sinus tarsi approach provided the most direct access to the interosseous talocalcaneal and cervical ligaments. Visualization of the calcaneofibular and lateral talocalcaneal was also provided with this incision. The saphenous and superficial nerve branches and the sinus tarsi artery were noted to be at risk. Conclusion: We hypothesize that the intrinsic subtalar ligaments have a multiplanar role in ankle joint stabilization similar to that of the anterior cruciate ligament at the knee. Accurate identification and optimal surgical approach to these structures has not been well described in the orthopaedic foot and ankle literature. This cadaveric study provides evidence that an extensile sinus tarsi approach can provide access to the extrinsic ankle and subtalar ligaments as well as the intrinsic ligaments of the subtalar joint.

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