A Determination of Ankle Kinematics Using Fluoroscopy

2000 ◽  
Vol 21 (4) ◽  
pp. 343-350 ◽  
Author(s):  
Richard D. Komistek ◽  
James B. Stiehl ◽  
Frederick F. Buechel ◽  
Eric J. Northcut ◽  
Mary E. Hajner
Keyword(s):  
Range Of Motion ◽  
External Rotation ◽  
Plantar Flexion ◽  
Weight Bearing ◽  
Distal Tibia ◽  
Three Dimensional ◽  
Contact Points ◽  
Ligament Instability ◽  
Video Fluoroscopy

In vivo weight-bearing studies utilizing dynamic video fluoroscopy have been shown to offer an accurate and reproducible method for determining the kinematics of a joint. The purpose of this study was to evaluate translational and rotational motions of the distal tibia relative to the talus in the sagittal and frontal planes. Ten subjects, each having a normal ankle and a total ankle arthroplasty on the opposite side (Buechel-Pappas Total Ankle, Endotec, South Orange, NJ), were studied under in vivo, weight-bearing conditions using video fluoroscopy. All ten subjects were judged to have a successful arthroplasty without demonstrable pain or ligament instability. Under weight-bearing conditions, each subject performed successive motions moving from maximum dorsiflexion to plantarflexion. At maximum dorsiflexion, both the normal and implanted ankles had similar sagittal midline talar contact positions but with plantar flexion, implanted ankles had increased posterior talar contact. Contact points on the distal tibia revealed that the lateral surface contacted at the midline or posterior throughout range-of-motion with minimal translation. The medial distal tibia contacted the talus posterior on plantarflexion and often moved anteriorly with dorsiflexion. This translation described relative external rotation of the distal tibia on plantar flexion and internal rotation on dorsiflexion. The measured distances were larger for the implanted ankles with higher variability. The average range-of-motion was 37.4° for normal ankles and 32.3° for implanted ankles. This study defines the normal kinematic rotational and translational motions of the ankle joint by accurately describing the three dimensional joint orientations. The implanted ankles experienced rotational and translational motions but had contacts more posterior, possibly related to surgical technique or alterations of ligamentous tension.

Kinematics of the Ankle/Foot Complex: Plantarflexion and Dorsiflexion

Foot & Ankle ◽  
1989 ◽  
Vol 9 (4) ◽  
pp. 194-200 ◽  
Author(s):  
Arne Lundberg ◽  
Ian Goldie ◽  
Bo Kalin ◽  
Göran Selvik
Keyword(s):  
Plantar Flexion ◽  
Three Dimensional ◽  
Substantial Contribution ◽  
Neutral Position ◽  
Transverse Axis ◽  
Talocrural Joint ◽  
Foot Kinematics ◽  
Talocalcaneal Joint ◽  
Axis Rotation

In an in vivo investigation of eight healthy volunteers, three dimensional ankle/foot kinematics were analyzed by roentgen stereophotogrammetry in 10° steps of motion from 30° of plantar flexion to 30° of dorsiflexion of the foot. The study included all of the joints between the tibia and the first metatarsal, as well as the talocalcaneal joint, and was performed under full body load. Although the talocrural joint was found to account for most of the rotation around the transverse axis occurring from 30° of plantar flexion to 30° of dorsiflexion, there was a substantial contribution from the joints of the arch. This was seen particularly in the input arc from 30° of plantar flexion to the neutral position, where the dorsiflexion motion of these joints amounted to 10% to 41% of the total transverse axis rotation.

In-vivo three-dimensional motion analysis of the wrist during dart-throwing motion after midcarpal fusion and radioscapholunate fusion

2020 ◽  
Vol 45 (5) ◽  
pp. 501-507
Author(s):  
Lisa Reissner ◽  
Olga Politikou ◽  
Gabriella Fischer ◽  
Maurizio Calcagni
Keyword(s):  
Range Of Motion ◽  
Motion Capture ◽  
Three Dimensional ◽  
Healthy Controls ◽  
Dart Throwing ◽  
Radioscapholunate Fusion ◽  
Infrared Cameras ◽  
Basic Motion ◽  
Throwing Motion

We recorded the dart-throwing motion and basic motion tasks in patients following radioscapholunate fusion and midcarpal fusion with a three-dimensional motion capture system in vivo, using digital infrared cameras to track the movement of reflective skin markers on the hand and forearm. During the dart-throwing motion, 20 healthy volunteers showed a median range of motion of 107°. As expected, patients had significantly reduced wrist range of motion during basic motion tasks and dart-throwing motion compared with the healthy controls, except for ulnar flexion occurring in the dart-throwing motion in patients treated by midcarpal fusion and radial deviation after midcarpal fusion or radioscapholunate fusion. In addition, patients who had undergone radioscapholunate fusion had significantly reduced range of motion during dart-throwing motion compared with patients after midcarpal fusion.

scholarly journals ATFL repair alone versus combined repairs of ATFL and CFL

2017 ◽  
Vol 2 (3) ◽  
pp. 2473011417S0002
Author(s):  
Kenneth Hunt ◽  
Judas Kelley ◽  
Richard Fuld ◽  
Nicholas Anderson ◽  
Todd Baldini
Keyword(s):  
Contact Area ◽  
Peak Pressure ◽  
Plantar Flexion ◽  
Weight Bearing ◽  
Three Dimensional ◽  
Lateral Ligament ◽  
Joint Stability ◽  
Intact Specimen ◽  
Significant Difference ◽  
The Impact

Category: Ankle Introduction/Purpose: The standard for lateral ligament stabilization is direct repair of the ATFL by open or arthroscopic technique. The implications and necessity of repairing the CFL are not well understood. The purpose of this study was to assess the impact of repairing the ATFL alone compared to repairing both the ATFL and CFL, in a biomechanical cadaver model. We hypothesized that repairing the CFL will substantially augment ankle and subtalar joint stability during weight-bearing ankle inversion compared to ATFL repair alone. Methods: Ten matched pairs of fresh frozen human cadaveric ankles were dissected to expose intact ATFL and CFL. Ankles were mounted to an Instron at 20° plantar flexion and 15° of internal rotation. Each ankle was loaded to body weight and then tested from 0 to 20° of inversion for three cycles; stiffness and torque were recorded, peak pressure and contact area were recorded using a calibrated Tekscan sensor system, and rotational displacement of the talus and calcaneus relative to the ankle mortise was recorded using a three-dimensional motion capture system. Ankles then underwent sectioning of ATFL and CFL and were randomly assigned to ATFL only repair using two arthroscopic Broström all-soft anchors, or combined ATFL and CFL repair. Testing was repeated after repair to 20° of inversion, then load-to-failure (LTF). Results: The predominant mode of failure after repair was at the tissue/suture. There were no instances of anchor pullout. There was an 11.7% increase in stiffness in combined repairs, and only a 1.6% increase in ATFL-only repairs. CFL failed at lower torque and rotation than the ATFL in combined repairs. There were strong correlations between intact stiffness and stiffness after repair (r=.74) and ATFL torque in LTF testing (r=.77), across both groups. There was no significant difference in peak pressure or contact area in the tibiotalar joint between the intact ankle and ATFL or combined repair. Conclusion: We found a greater increase in stiffness following combined ATFL and CFL repair compared to ATFL repair alone. This added stability is due to complimentary contributions of the CFL, not augmented LTF strength of the ATFL. Intact specimen stiffness correlated strongly with stiffness after repair and LTF torque, suggesting that a patient’s inherent tissue laxity or inelasticity is likely a meaningful predictor of strength after repair. Restoring the CFL plays a relevant role in lateral ligament repair, however sufficient time for ligament healing should be allowed before substantial inversion stresses are applied.

scholarly journals Gait Biomechanics Following Taping and Bracing in Patients With Chronic Ankle Instability: A Critically Appraised Topic

2020 ◽  
Vol 29 (3) ◽  
pp. 373-376
Author(s):  
Kimmery Migel ◽  
Erik Wikstrom
Keyword(s):  
Range Of Motion ◽  
Ankle Instability ◽  
External Rotation ◽  
Plantar Flexion ◽  
Chronic Ankle Instability ◽  
Ankle Sprains ◽  
Case Control Studies ◽  
Bottom Line ◽  
Gait Biomechanics ◽  
Evidence Grade

Clinical Scenario: Approximately 30% of all first-time patients with LAS develop chronic ankle instability (CAI). CAI-associated impairments are thought to contribute to aberrant gait biomechanics, which increase the risk of subsequent ankle sprains and the development of posttraumatic osteoarthritis. Alternative modalities should be considered to improve gait biomechanics as impairment-based rehabilitation does not impact gait. Taping and bracing have been shown to reduce the risk of recurrent ankle sprains; however, their effects on CAI-associated gait biomechanics remain unknown. Clinical Question: Do ankle taping and bracing modify gait biomechanics in those with CAI? Summary of Key Findings: Three case-control studies assessed taping and bracing applications including kinesiotape, athletic tape, a flexible brace, and a semirigid brace. Kinesiotape decreased excessive inversion in early stance, whereas athletic taping decreased excessive inversion and plantar flexion in the swing phase and limited tibial external rotation in terminal stance. The flexible and semirigid brace increased dorsiflexion range of motion, and the semirigid brace limited plantar flexion range of motion at toe-off. Clinical Bottom Line: Taping and bracing acutely alter gait biomechanics in those with CAI. Strength of Recommendation: There is limited quality evidence (grade B) that taping and bracing can immediately alter gait biomechanics in patients with CAI.

Movement Coordination During Humeral Elevation in Individuals With Newly Acquired Spinal Cord Injury

2020 ◽  
Vol 36 (5) ◽  
pp. 345-350
Author(s):  
Margaret A. Finley ◽  
Elizabeth Euiler ◽  
Shivayogi V. Hiremath ◽  
Joseph Sarver
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Linear Relationship ◽  
Thoracic Kyphosis ◽  
External Rotation ◽  
Weight Bearing ◽  
Elevation Angle ◽  
Three Dimensional ◽  
Movement Coordination ◽  
Cord Injury

Humeral elevation is a critical motion for individuals who use a manual wheelchair given that, in a typical day, wheelchair users reach overhead 5 times more often than able-bodied controls. Kinematic analyses in individuals with chronic spinal cord injury (SCI) have focused on weight-bearing tasks rather than overhead reaching. This technical report presents shoulder movement coordination during overhead reaching in individuals with newly acquired SCI. Eight volunteers with acute SCI and 8 matched, uninjured controls participated. Three-dimensional kinematics were collected during seated, humeral elevation. Scapular and thoracic rotations during humeral elevation were averaged across repetitions. The linear relationship of scapular upward rotation to humeral elevation provided movement coordination analysis. Maximal elevation was reduced in SCI with increased thoracic kyphosis. Medium to large effect sizes were found at each elevation angle, with reduced scapular external rotation, posterior tilt, and increased thoracic kyphosis for those with SCI. The linear relationship occurred later and within a significantly (P = .02) smaller range of humeral elevation in SCI. Altered movement coordination, including a diminished linear association of scapular upward rotation and humeral elevation (scapulohumeral rhythm), is found with reduced maximal elevation and increased thoracic kyphosis during overhead reaching tasks in those with acute SCI.

scholarly journals In Vivo Kinematics of the Tibiotalar and Subtalar Joints in Asymptomatic Subjects: A High-Speed Dual Fluoroscopy Study

2016 ◽  
Vol 138 (9) ◽  
Author(s):  
Koren E. Roach ◽  
Bibo Wang ◽  
Ashley L. Kapron ◽  
Niccolo M. Fiorentino ◽  
Charles L. Saltzman ◽  
...  
Keyword(s):  
Subtalar Joint ◽  
High Speed ◽  
External Rotation ◽  
Translational Motion ◽  
Three Dimensional ◽  
Tibiotalar Joint ◽  
In Vivo Kinematics ◽  
Asymptomatic Subjects ◽  
Capture Techniques

Measurements of joint kinematics are essential to understand the pathomechanics of ankle disease and the effects of treatment. Traditional motion capture techniques do not provide measurements of independent tibiotalar and subtalar joint motion. In this study, high-speed dual fluoroscopy images of ten asymptomatic adults were acquired during treadmill walking at 0.5 m/s and 1.0 m/s and a single-leg, balanced heel-rise. Three-dimensional (3D) CT models of each bone and dual fluoroscopy images were used to quantify in vivo kinematics for the tibiotalar and subtalar joints. Dynamic tibiotalar and subtalar mean joint angles often exhibited opposing trends during captured stance. During both speeds of walking, the tibiotalar joint had significantly greater dorsi/plantarflexion (D/P) angular ROM than the subtalar joint while the subtalar joint demonstrated greater inversion/eversion (In/Ev) and internal/external rotation (IR/ER) than the tibiotalar joint. During balanced heel-rise, only D/P and In/Ev were significantly different between the tibiotalar and subtalar joints. Translational ROM in the anterior/posterior (AP) direction was significantly greater in the subtalar than the tibiotalar joint during walking at 0.5 m/s. Overall, our results support the long-held belief that the tibiotalar joint is primarily responsible for D/P, while the subtalar joint facilitates In/Ev and IR/ER. However, the subtalar joint provided considerable D/P rotation, and the tibiotalar joint rotated about all three axes, which, along with translational motion, suggests that each joint undergoes complex, 3D motion.

Kinematics of the Midtarsal Joint During Standing Leg Rotation

2002 ◽  
Vol 92 (2) ◽  
pp. 77-81 ◽  
Author(s):  
Christopher Nester ◽  
Peter Bowker ◽  
Peter Bowden
Keyword(s):  
Range Of Motion ◽  
Three Dimensional ◽  
In Vivo Studies ◽  
Kinematic Data ◽  
Joint Characteristics ◽  
Infrared Cameras ◽  
Cadaver Studies ◽  
Midtarsal Joint ◽  
Invasive Techniques

Building on previous work that was cadaver based or involved invasive techniques, this study quantifies the kinematics of an approximation of the midtarsal joint with a noninvasive method. Three-dimensional kinematic data describing the motion of the forefoot and heel during transverse plane rotation of the leg were collected from 25 subjects by means of reflective markers and four infrared cameras. The motion between these segments was assumed to be the best possible clinical approximation of the midtarsal joint. The kinematic characteristics of the midtarsal joint were described in terms of the range and direction of motion in each cardinal body plane, the ratio of the range of motion in each plane, and the orientation of the axis of rotation. The characteristics of the midtarsal joint changed during the range of motion; thus, multiple axes of rotation could be calculated and joint characteristics were varied among subjects. The results of this in vivo method were generally consistent with those of cadaver studies and invasive in vivo studies. (J Am Podiatr Med Assoc 92(2): 77-81, 2002)

scholarly journals In vivo three-dimensional motion analysis of the shoulder joint during internal and external rotation

2011 ◽  
Vol 35 (10) ◽  
pp. 1503-1509 ◽  
Author(s):  
Hayato Koishi ◽  
Akira Goto ◽  
Makoto Tanaka ◽  
Yasushi Omori ◽  
Kazuma Futai ◽  
...  
Keyword(s):  
Motion Analysis ◽  
Shoulder Joint ◽  
External Rotation ◽  
Three Dimensional

Reliability of Achilles Tendon Moment Arm Measured In Vivo Using Freehand Three-Dimensional Ultrasound

2017 ◽  
Vol 33 (4) ◽  
pp. 300-304 ◽  
Author(s):  
Steven J. Obst ◽  
Lee Barber ◽  
Ashton Miller ◽  
Rod S. Barrett
Keyword(s):  
Achilles Tendon ◽  
Plantar Flexion ◽  
Three Dimensional ◽  
Correlation Coefficients ◽  
Lateral Malleolus ◽  
Medial Malleolus ◽  
Minimal Detectable Change ◽  
Ultrasound Images ◽  
Moment Arm

This study investigated reliability of freehand three-dimensional ultrasound (3DUS) measurement of in vivo human Achilles tendon (AT) moment arm. Sixteen healthy adults were scanned on 2 separate occasions by a single investigator. 3DUS scans were performed over the free AT, medial malleolus, and lateral malleolus with the ankle passively positioned in maximal dorsiflexion, mid dorsiflexion, neutral, mid plantar flexion and maximal plantar flexion. 3D reconstructions of the AT, medial malleolus, and lateral malleolus were created from manual segmentation of the ultrasound images and used to geometrically determine the AT moment arm using both a straight (straight ATMA) and curved (curved ATMA) tendon line-of-action. Both methods were reliable within- and between-session (intra-class correlation coefficients > 0.92; coefficient of variation < 2.5 %) and revealed that AT moment arm increased by ∼ 7 mm from maximal dorsiflexion (∼ 41mm) to maximal plantar flexion (∼ 48 mm). Failing to account for tendon curvature led to a small overestimation (< 2 mm) of AT moment arm that was most pronounced in ankle plantar flexion, but was less than the minimal detectable change of the method and could be disregarded.

Influence of posterior tibial slope on three-dimensional femorotibial alignment under weightbearing conditions in healthy Japanese elderly people

2021 ◽  
pp. 1-12
Author(s):  
Ryota Katsumi ◽  
Takashi Sato ◽  
Tomoharu Mochizuki ◽  
Satoshi Watanabe ◽  
Osamu Tanifuji ◽  
...  
Keyword(s):  
Sagittal Plane ◽  
External Rotation ◽  
Weight Bearing ◽  
Linear Regression Analysis ◽  
Three Dimensional ◽  
Tibial Slope ◽  
Rotational Alignment ◽  
Posterior Tibial Slope ◽  
Posterior Tibial ◽  
Japanese Elderly

BACKGROUND: Assessment of three-dimensional (3D) femorotibial alignment is essential for successful knee osteoarthritis treatment in the elderly. The complex morphology of the posterior tibial slope (PTS) might have an influence on sagittal and rotational alignment and the positional relationship between the femur and tibia in the anterior–posterior (AP) direction under weight-bearing conditions. OBJECTIVE: This study aimed to clarify the association between the PTS and 3D femorotibial alignment under weight-bearing conditions in healthy Japanese elderly individuals. METHODS: We investigated the 3D femorotibial alignment of 110 lower extremities of 55 healthy individuals (26 women, 29 men, mean age: 70 ± 6 years). Using our previously reported 3D-to-2D image registration technique, we evaluated the 3D hip-knee-ankle angle (3DHKA) in the sagittal plane, rotational alignment, and the distance between the femoral and tibial origins in the AP direction (tibial AP position) as femorotibial alignment parameters under weight-bearing conditions. We assessed the medial and lateral PTS and their angular difference (PTS difference) as PTS parameters. Stepwise multiple linear regression analysis was performed using PTS parameters and other possible confounders (age, sex, height, and weight) as the independent variables and femorotibial alignment parameters as the dependent variable. RESULTS: Weight (𝛽 = 0.393, p < 0.001) and lateral PTS (𝛽 = 0.298, p < 0.001) were the predictors associated with 3DHKA in the sagittal plane. Lateral PTS (𝛽 = 0.304, p = 0.001) was the only predictor associated with the tibial AP position. Sex (𝛽 = −0.282, p = 0.002) and PTS difference (𝛽 = −0.231, p = 0.012) were associated with rotational alignment. CONCLUSIONS: We found that a steeper lateral PTS resulted in a more flexed knee and anterior tibia. The PTS difference was positively correlated with tibial external rotation. Our data could be used as the standard reference for realignment surgery to ensure PTS is appropriately maintained.

Sign in / Sign up

Export Citation Format

Share Document