Influence of Arthrodeses on Kinematics of the Axially Loaded Ankle Complex during Dorsiflexion/Plantarflexion

1995 ◽  
Vol 16 (10) ◽  
pp. 633-636 ◽  
Author(s):  
Beat Hintermann ◽  
Benno M. Nigg
Keyword(s):  
Ankle Joint ◽  
Tibial Rotation ◽  
Testing Apparatus ◽  
Rotational Movement ◽  
Ankle Complex ◽  
Axially Loaded

The purpose of this study was to quantify the effect of selective arthrodesis (stabilization) of the ankle, subtalar, and talonavicular joints on the rotational movement of the tibia and the calcaneus occurring with dorsiflexion/plantarflexion. Six cadaver foot-leg specimens were investigated using an unconstrained testing apparatus. Simulated ankle joint arthrodesis caused a large increase in tibial rotation and calcaneal eversion-inversion. Subtalar and talonavicular stabilization did not cause as large a rotation.

Influence of Ligament Transection on Tibial and Calcaneal Rotation with Loading and Dorsi-Plantarflexion

1995 ◽  
Vol 16 (9) ◽  
pp. 567-571 ◽  
Author(s):  
Beat Hintermann ◽  
Christian Sommer ◽  
Benno M. Nigg
Keyword(s):  
Internal Rotation ◽  
Axial Loading ◽  
Interosseous Ligament ◽  
Testing Apparatus ◽  
Rotational Movement ◽  
Lateral Ligaments ◽  
Ankle Complex ◽  
Axially Loaded

The purpose of this study was to quantify the effect of sequential ligament transection (anterior talofibular, calcaneofibular, posterior talofibular, deltoid, and subtalar interosseous ligaments) on the rotational movement of the tibia and the calcaneus as associated with axial loading and dorsi-plantarflexing the foot. Eight cadaver foot-leg specimens were investigated using a unconstrained testing apparatus. As the ankle complex was axially loaded, almost the same internal rotation of the tibia and the same calcaneus eversion was found with and without the various degrees of lateral and medial ligament release; additional sectioning of the subtalar interosseous ligament tremendously increased the resulting tibial and calcaneal rotation. While tibial and calcaneal rotation from foot dorsi-plantarflexing did not alter significantly with transection of the lateral ligaments, almost no tibial and calcaneal rotation occurred after additional sectioning of the deltoid and subtalar interosseous ligament. These results indicate that, after release of the lateral ligaments, the foot becomes partially mechanically disconnected from the tibia by additional transection of the medial ligaments and even further disconnected after transection of the subtalar interosseous ligament.

In Vitro Kinematics of the Axially Loaded Ankle Complex in Response to Dorsiflexion and Plantarflexion

1995 ◽  
Vol 16 (8) ◽  
pp. 514-518 ◽  
Author(s):  
Beat Hintermann ◽  
Benno M. Nigg
Keyword(s):  
Internal Rotation ◽  
External Rotation ◽  
Axial Loading ◽  
Testing Apparatus ◽  
Ankle Complex ◽  
Axially Loaded

The rotational movements of the tibia and calcaneus that occur with dorsiflexion-plantarflexion and axial loading were studied in cadaver foot-leg specimens using an unconstrained testing apparatus. Independent of the foot flexion position, significant internal rotation of the tibia and eversion of the calcaneus were noted after the ankle complex was axially loaded. Independent of loading, 10° of dorsiflexion resulted in 0.1° of eversion and 2.1° of internal rotation of the tibia. Conversely, 10° of plantarflexion resulted in 1.6° of inversion and 1.3° of external rotation of the tibia. The induced rotational movements of the tibia and the calcaneus differed significantly between the specimens. These results suggest that the foot “axes” did not change by axially loading the ankle complex and they support previous reports that the ankle complex uses different axes for dorsiflexion and plantarflexion.

Design of a Prosthetic Ankle Complex

2021 ◽  
pp. 381-399
Author(s):  
Dheeman Bhuyan ◽  
Kaushik Kumar
Keyword(s):  
Ankle Joint ◽  
Cutting Edge ◽  
Geological Time ◽  
Ankle Prosthesis ◽  
Large Span ◽  
Large Segment ◽  
Passive Damper ◽  
Ankle Complex ◽  
And Behavior ◽  
Physiological Systems

Nature has, over a large span of geological time, engineered near perfect solutions to most problems humans face today. Motion of the limbs is one such area, and the cutting edge in the development of effective prostheses is biomimetics. Limb prostheses have been used by mankind for the better part of known history, and most of the technology currently available in prosthetics is not exclusively new. However, modern prosthetics either are uncomfortable—and the lack of flexion affects the gait of the patient—or too expensive for a large segment of the populace. This chapter seeks to study the mimicry of physiological systems through the design for an ankle prosthesis that includes a passive damper and mimics the shape and behavior of the natural ankle joint.

scholarly journals Musculoskeletal modelling of human ankle complex: Estimation of ankle joint moments

2017 ◽  
Vol 44 ◽  
pp. 75-82 ◽  
Author(s):  
Prashant K. Jamwal ◽  
Shahid Hussain ◽  
Yun Ho Tsoi ◽  
Mergen H. Ghayesh ◽  
Sheng Quan Xie
Keyword(s):  
Ankle Joint ◽  
Joint Moments ◽  
Musculoskeletal Modelling ◽  
Human Ankle ◽  
Ankle Complex

A 5-5 One-Degree-of-Freedom Fully Parallel Mechanism for the Modeling of Passive Motion at the Human Ankle Joint

2007 ◽  
Author(s):  
R. Franci ◽  
V. Parenti-Castelli
Keyword(s):  
Ankle Joint ◽  
Parallel Mechanism ◽  
Degree Of Freedom ◽  
Anatomical Structures ◽  
Passive Motion ◽  
Three Sphere ◽  
Contact Points ◽  
Human Ankle ◽  
Sphere Contact ◽  
Ankle Complex

This paper presents a new equivalent spatial mechanism for the passive motion simulation at the human ankle complex joint. The mechanism is based on the geometry of the main anatomical structures of the ankle complex, such as the shape of the talus and tibio/fibula bones at their interface, and the TiCal and CaFil ligament lengths. In particular, three sphere-to-sphere contact points at the interface have been identified and isometric fibers of both TiCal and CaFil ligaments have been considered to devise the equivalent mechanism. The proposed mechanism is a fully-parallel mechanism of type 5-5 with one degree of freedom. A procedure for the optimal synthesis of the mechanism is given. Simulation results compared with experimental data show the efficiency of the proposed mechanism to replicate the ankle passive motion, and also to reflect at the same time the main anatomical structures of the ankle joint. The new mechanism is believed to be a useful tool for both pre-operation planning and prosthesis design.

Design of a Prosthetic Ankle Complex

2019 ◽  
pp. 101-125
Author(s):  
Dheeman Bhuyan ◽  
Kaushik Kumar
Keyword(s):  
Ankle Joint ◽  
Cutting Edge ◽  
Geological Time ◽  
Ankle Prosthesis ◽  
Large Span ◽  
Large Segment ◽  
Passive Damper ◽  
Ankle Complex ◽  
And Behavior ◽  
Physiological Systems

Nature has, over a large span of geological time, engineered near perfect solutions to most problems humans face today. Motion of the limbs is one such area, and the cutting edge in the development of effective prostheses is biomimetics. Limb prostheses have been used by mankind for the better part of known history, and most of the technology currently available in prosthetics is not exclusively new. However, modern prosthetics either are uncomfortable—and the lack of flexion affects the gait of the patient—or too expensive for a large segment of the populace. This chapter seeks to study the mimicry of physiological systems through the design for an ankle prosthesis that includes a passive damper and mimics the shape and behavior of the natural ankle joint.

scholarly journals Is cocontraction a potential cause of tibial internal rotation restriction in patients with knee endoprostheses?

2019 ◽  
Vol 7 (6_suppl4) ◽  
pp. 2325967119S0024
Author(s):  
Christine Suzanne Haberer ◽  
Stefan Weiss ◽  
Igor Komnik ◽  
Sina David
Keyword(s):  
Knee Joint ◽  
Internal Rotation ◽  
Stance Phase ◽  
Knee Prosthesis ◽  
Womac Score ◽  
Subjective Assessment ◽  
Tibial Rotation ◽  
Rotational Movement ◽  
Before And After ◽  
Climbing Stairs

Aims and Objectives: The ischiocrural muscles play an important role in the rotation of the tibia. The main objective of the study was to examine the extent to which an increased cocontraction of the SEMITEN and BIZFEM in patients with bicondylar (TKA) and unicondylar prostheses (UKA) under the influence of everyday forms of stress restricts the tibial rotation. Materials and Methods: 3-D-motion analysis in patients after TKA or UKA was performed to record joint kinematics before and after knee prosthesis. Inclusion criteria: Age 50-70 years, no other prostheses, BMI <31, no relevant diseases, surgery - period 04/2015 to 04/2016. Out of a total of 550 patients finally 22 patients (w:11/m:11) could be included: TKA (n = 11), UKA (n = 9). To imitate various movement patterns of ADL, a parcour was built with a ramp and a staircase with 3 steps. Kinematic data were recorded with 10 infrared 100 Hz cameras. Muscular activities were measured bilaterally with a wireless EMG system (1000 Hz, myon320, muon, CH). Walking speed was collected through a time-gate system (WEKO, Weitmann & Konrad GmbH & Co. KG, DE). Static analysis was performed by statistical nonparametric assignment (SnPM). The WOMAC score was used for subjective assessment of dysfunctions. Results: In normal walking, there was no difference in tibial rotation compared to the non-operated knee in either the TKA or the UKA group. In SnPM analysis, statistically significantly reduced tibial rotation was shown on the downturn of a ramp in the TKA group at the operated knee. The UKA group showed no significant differences on the ramp to the non-operated knee. Concerning co-contraction of the SEMITEN and BIZFEM in the EMG analysis in the operated knee joint, no deviation from the non-operated knee could be shown. When climbing stairs, the SnPM internal rotation analysis revealed significant differences between the TKA and the UKA group (stance phase). Similar to the group comparement a restricted axial rotational movement compared to an operated to non - operated knee joint in the TKA - group could be show.n Especially during the stairway, the knee internal rotation of the prosthesis was impaired compared to the non-operated knee. On the other hand, when climbing stairs, the internal rotation was mostly significantly reduced during the stance phase. The SnPM analysis showed statistically significant asymmetries in the UKA group during stairway walking. The disturbed internal rotational movement showed the UKA group in the operated knee joint compared to the un-operated knee joint to the same extent as the TKA group only during the run down from the ramp. Conclusion: The assumption that cocontractions between the SEMITEN and the BIZFEM contributes to the impairment of internal rotation can not be confirmed from the data available to us. Other influences must be the cause.

scholarly journals The Effect of Achilles Tendon Loading on Ankle Joint Contact Area and Peak Pressure

2018 ◽  
Vol 3 (3) ◽  
pp. 2473011418S0030
Author(s):  
L. Daniel Latt ◽  
Alfonso Ayala ◽  
Samuel Kim ◽  
Jesus Lopez
Keyword(s):  
Achilles Tendon ◽  
Ankle Joint ◽  
Contact Area ◽  
Axial Load ◽  
Peak Pressure ◽  
The Body ◽  
Neutral Position ◽  
Joint Contact ◽  
Axially Loaded ◽  
The Impact

Category: Ankle Introduction/Purpose: Increased tibiotalar peak pressure (PP) and decreased contact area (CA) following ankle fracture are associated with the development of post-traumatic osteoarthtritis. Lateral talar translation of just 1 mm has been shown to decrease CA by 42%. The impact of talar malalignment in other directions on ankle joint contact pressures (AJCP) are not well understood. The majority of research on AJCP has utilized cadaveric models in which body weight is simulated with an axial load applied through the tibia. This model does not account for Achilles tendon - which transmits the largest tendon force in the body during weight bearing. This study aimed to determine the effects of Achilles tendon loading on tibiotalar CA and PP in an axially loaded cadaver model at different ankle flexion angles. Methods: Ten fresh frozen cadaveric lower extremity specimens transected mid-tibia were dissected free of soft tissues surrounding the ankle, sparing the ligaments. The proximal tibia and fibula were potted in quick drying cement for rigid mounting on a MTS machine. A pressure sensing element (TekScan KScan model 5033) was inserted into the tibiotalar joint and used to measure CA (cm2) and PP (MPa). An axial load of 686 N was applied through the tibia and fibula, followed by a 350 N load via the Achilles tendon to simulate mid-stance conditions. Measurements were taken at neutral position, 15 degrees of dorsiflexion and 15 degrees of plantarflexion, with and without Achilles load. The effects of Achilles load and ankle flexion angle on CA and PP were analyzed using a 2x3 ANOVA. Bonferroni post-hoc adjustments were used for multiple comparisons. Level of statistical significance was set at p < 0.05. Results: ANOVA revealed significant main effects of ankle flexion on contact area and peak pressures (Table 1). Contact area was significantly lower for 15 degrees of plantarflexion than neutral and 15 degrees of dorsiflexion (p < 0.001). In addition, peak pressure was significantly higher for 15 degrees of plantarflexion than neutral and 15 degrees of dorsiflexion. ANOVA also indicated that contact area and peak pressure were significantly higher with Achilles load than without (p < 0.001). No interaction effects were found. Conclusion: The applied Achilles tendon load significantly altered tibiotalar PP in an axially loaded cadaver model. On the other hand, changes in CA with Achilles load were found to be minimal (~1.8%). We also found that the greatest PP and smallest CA occured during plantar flexion. This observation can be explained by a difference in width between the anterior and posterior talus. While the results of this study demonstrate the importance of Achilles tendon load on tibiotalar measurements, further studies investigating the effects of additional factors such as loading techniques are warranted to improve the physiological accuracy of cadaver models.

Single Hemicerclage for Lateral Type B Malleolar Fracture - A Novel, Minimal and Reliable Osteosynthesis

Swiss Surgery ◽  
2003 ◽  
Vol 9 (6) ◽  
pp. 283-288
Author(s):  
Maurer ◽  
Stamenic ◽  
Stouthandel ◽  
Ackermann ◽  
Gonzenbach
Keyword(s):  
Ankle Joint ◽  
Weight Bearing ◽  
Fracture Type ◽  
Type B ◽  
Malleolar Fracture ◽  
Metallic Wire ◽  
Long Term Outcome ◽  
X Ray ◽  
Upper Ankle Joint ◽  
Upper Ankle

Aim of study: To investigate the short- and long-term outcome of patients with isolated lateral malleolar fracture type B treated with a single hemicerclage out of metallic wire or PDS cord. Methods: Over an 8-year period 97 patients were treated with a single hemicerclage for lateral malleolar fracture type B and 89 were amenable to a follow-up after mean 39 months, including interview, clinical examination and X-ray controls. Results: The median operation time was 35 minutes (range 15-85 min). X-ray controls within the first two postoperative days revealed an anatomical restoration of the upper ankle joint in all but one patient. The complication rate was 8%: hematoma (2 patients), wound infection (2), Sudeck's dystrophy (2) and deep vein thrombosis (1). Full weight-bearing was tolerated at median 6.0 weeks (range 2-26 weeks). No secondary displacement, delayed union or consecutive arthrosis of the upper ankle joint was observed. All but one patient had restored symmetric joint mobility. Ninety-seven percent of patients were satisfied or very satisfied with the outcome. Following bone healing, hemicerclage removal was necessary in 19% of osteosyntheses with metallic wire and in none with PDS cord. Conclusion: The single hemicerclage is a novel, simple and reliable osteosynthesis technique for isolated lateral type B malleolar fractures and may be considered as an alternative to the osteosynthesis procedures currently in use.

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