scholarly journals Gait Kinematics of Patients with Lateral Collateral Ligament Injuries of Ankle

2020 ◽  
Author(s):  
Bin Zheng ◽  
Xin Liu ◽  
Dezheng Zhang ◽  
Qinwei Guo ◽  
Zhongshi Zhang
Keyword(s):  
Stance Phase ◽  
Lateral Collateral Ligament ◽  
Measurement Model ◽  
Swing Phase ◽  
Foot And Ankle ◽  
Ligament Injuries ◽  
Collateral Ligament ◽  
Control Subjects ◽  
Computer Aided ◽  
Aided Diagnosis

Abstract Background Lateral collateral ligament (LCL) injuries of ankle are a common problem in sports medicine. The purpose of this study is to evaluate the walking kinematics in patients with LCL injuries of ankle for examining how ankle ligament injuries affect foot and ankle motion. The results will serve in precision assessment and computer-aided diagnosis. Methods Kinematics of walking were assessed by the Heidelberg Foot Measurement Model (HFMM) in 6 adults (3 patients, 3 control subjects). We hypothesized that patients with ligament injury will: present a shorter stance phase, but longer swing phase; be observed with an increasing number of shank and foot adjustments during the stance phase; reduce velocity of foot during the early swing phase with an increasing variation. Velocity profiles and micro-adjustment of knee, ankle, and foot were calculated during different gait phases and compared between two different subject groups by independent-sample t-test with 95% confidence intervals and standard error of measurements. Results In the gait cycle, 1 st rocker phase was 2.09% shorter (p < 0.001) and 2 nd rocker phase was 1.54% longer (p = 0.009) in patients than in controls. Compared to control subjects, the patients showed 89.1 mm shorter stride length (p<0.001), 0.10s slower stride (p<0.001) and 1.57 more complex micro-adjustments in 2 nd rocker phase than in other rocker/swing phases during natural walking (p=0.017). The mean velocity of knee (6.05 mm/10 -2 s vs. 4.74 mm/10 -2 s), ankle (0.85 mm/10 -2 s vs. 0.52 mm/10 -2 s), midfoot (0.79 mm/10 -2 s vs. 0.48 mm/10 -2 s) and forefoot (1.72 mm/10 -2 s vs. 0.97 mm/10 -2 s) in 2 nd rocker was significantly higher in patients (p<0.001). Conclusion Our findings revealed the human motion compensatory mechanism. Patients with ligament injuries need more musculoskeletal adjustments to keeping body balance than control subjects. Precise descriptions of the kinematics are crucial for clinical assessment before and after surgical management. These results will also provide a foundation for computer-aided diagnosis in the future. Key Terms ankle ligaments, gait analysis, Heidelberg Foot Measurement Model, foot and ankle kinematics, phase/rocker, physical therapy/rehabilitation.

scholarly journals Synthesizing Foot and Ankle Kinematic Characteristics for Lateral Collateral Ligament Injuries Detection

IEEE Access ◽  
2020 ◽  
Vol 8 ◽  
pp. 188429-188440 ◽  
Author(s):  
Xin Liu ◽  
Chen Zhao ◽  
Bin Zheng ◽  
Qinwei Guo ◽  
Zhongshi Zhang ◽  
...  
Keyword(s):  
Lateral Collateral Ligament ◽  
Foot And Ankle ◽  
Ligament Injuries ◽  
Collateral Ligament ◽  
Kinematic Characteristics

scholarly journals Kinematic Alignment in Cruciate Retaining Implants Improves the Biomechanical Function in Total Knee Arthroplasty during Gait and Deep Knee Bend

2019 ◽  
Vol 33 (03) ◽  
pp. 284-293 ◽  
Author(s):  
Kyoung-Tak Kang ◽  
Yong-Gon Koh ◽  
Ji Hoon Nam ◽  
Sae Kwang Kwon ◽  
Kwan Kyu Park
Keyword(s):  
Stance Phase ◽  
Lateral Collateral Ligament ◽  
Contact Stresses ◽  
Kinematic Alignment ◽  
Collateral Ligament ◽  
Cruciate Retaining ◽  
Lateral Contact ◽  
Lateral Collateral Ligaments ◽  
Total Knee ◽  
Maximum Contact

AbstractKinematic alignment (KA), which co-aligns the rotational axes of the components with three kinematic axes of the knee by aligning the components to the prearthritic joint lines, has been a recently introduced surgical technique. However, whether KA and cruciate retaining (CR) implants provide better biomechanical function during activities than mechanical alignment (MA) in posterior stabilized (PS) implants is unclear. We evaluated the biomechanical functions during the stance phase gait and deep knee bend, with a computer simulation and measured forces in the medial and lateral collateral ligaments and medial and lateral contact stresses in the polyethylene insert and patellar button. The forces on the medial collateral ligament in KA were lower than those in MA in both CR and PS TKA in the stance phase gait and deep knee bend conditions, whereas those on the lateral collateral ligament did not show any difference between the two surgical alignment techniques in the stance phase gait condition. The maximum contact stresses on the medial PE inserts in KA were lower than those in MA in both CR and PS TKA in the stance phase gait and deep knee bend conditions. However, the maximum contact stresses on the lateral PE inserts and the patellar button did not differ between MA and KA. The biomechanical function was superior in KA TKA than in MA TKA, and KA was more effective in CR TKA. This comparison could be used as a reference by surgeons to reduce the failure rates by using KA TKA instead of MA TKA.

Elbow Lateral Collateral Ligament Injuries

2013 ◽  
Vol 38 (1) ◽  
pp. 184-201 ◽  
Author(s):  
Lee M. Reichel ◽  
Graham S. Milam ◽  
Sean E. Sitton ◽  
Michael C. Curry ◽  
Thomas L. Mehlhoff
Keyword(s):  
Lateral Collateral Ligament ◽  
Ligament Injuries ◽  
Collateral Ligament

scholarly journals Multi-Segment Foot and Ankle Gait Kinematics Following Total Ankle Arthroplasty

2020 ◽  
Vol 5 (4) ◽  
pp. 2473011420S0048
Author(s):  
Dylan Wiese ◽  
Jessica M. Fritz ◽  
Karl Canseco ◽  
Carolyn M. Meinerz ◽  
Katherine Konop ◽  
...  
Keyword(s):  
Stance Phase ◽  
Swing Phase ◽  
Total Ankle Arthroplasty ◽  
Foot And Ankle ◽  
Ankle Arthritis ◽  
Control Data ◽  
Kinematic Data ◽  
Ankle Arthroplasty ◽  
Gait Kinematics

Category: Ankle Arthritis; Ankle. Introduction/Purpose: Ankle arthritis is a painful disease resulting in limited function, mobility, and quality of life.1 Total ankle arthroplasty (TAA) a widely accepted treatment to reduce pain while maintaining joint motion.2,3 There are two common types of implants: fixed bearing (FB) and mobile bearing (MB). Comparisons of these implants have shown similar patient and clinical outcomes;4 however, post-operative gait kinematics from a multi-segment foot and ankle model have not been compared. This study assessed multi-segmental foot and ankle gait kinematics between persons following TAA with MB and FB implants and compared them to control data of adult ambulators without lower extremity pathology. Methods: This was a prospective analysis of persons who had previously underwent TAA with a MB (n=6; average follow-up period of 2.5 years) implant. After consenting to the IRB-approved study, participants were fitted with reflective markers for the Milwaukee Foot Model (MFM).5 Participants walked barefoot along a 30-foot walkway at a comfortable, self-selected pace for a minimum of ten trials while twelve infrared motion capture cameras recorded data. Kinematic data from the MB group and historical data from a FB population who underwent the same protocol with the MFM (n=7; average follow-up period of 2 years) were compared to control data (n=37). Welch’s two-tailed t-tests were used to calculate statistical significance at an alpha level of 0.05. Deviation from control data was compared between both implant groups. Results: In the MB group, sagittal motion of the hindfoot, forefoot, and hallux were significantly different from control for the majority of stance. The only significant MB group swing phase differences were early swing sagittal kinematics in the tibia, forefoot, and hallux segments. The FB data differed significantly for the majority of stance phase for sagittal tibia motion, all hindfoot planes, sagittal and coronal forefoot motion, and all hallux planes. The FB group kinematics also significantly differed throughout most of swing phase across all planes and segments, except coronal hindfoot motion. All FB kinematic data deviated further from control than the MB data except stance phase coronal tibia and transverse forefoot motion, where the data overlapped (Figure 1). Conclusion: Multi-segment foot and ankle gait kinematics following TAA showed the MB implant better restores healthy ambulatory motion than the FB implant. Abnormal stance phase kinematics lead to altered joint loading. This can accelerate adjacent joint arthritis, which has been seen following ankle arthrodesis.6 Both populations showed diminished forefoot plantarflexion throughout gait, compensating for decreased hindfoot dorsiflexion. Because the joints are not heavily loaded during swing phase, the primary concerns of alterations are regarding ground clearance and foot position prior to the next step. The MB implant better restores normal gait, minimizing compensations and likely decreasing arthritis-inducing stress on adjacent joints.

Reconstruction of the Lateral Collateral Ligament of the Knee With Patellar Tendon Allograft

1998 ◽  
Vol 26 (5) ◽  
pp. 656-662 ◽  
Author(s):  
Harrison A. Latimer ◽  
James E. Tibone ◽  
Neal S. ElAttrache ◽  
Patrick J. McMahon
Keyword(s):  
Posterior Cruciate Ligament ◽  
Patellar Tendon ◽  
External Rotation ◽  
Cruciate Ligament ◽  
Lateral Collateral Ligament ◽  
Surgical Reconstruction ◽  
Ligament Injuries ◽  
Collateral Ligament ◽  
Lachman Test ◽  
Test Result

This is a retrospective study of 10 patients with combined cruciate ligament and posterolateral instability who underwent surgical reconstruction between 1991 and 1994. All knees had at least 20° increased external rotation at 30° of knee flexion and from 1 to 3 varus instability. Five knees with posterior cruciate ligament ruptures had at least a 2 Lachman test result. (One knee had both anterior and posterior cruciate ligament injuries.) In all cases the lateral collateral ligament was reconstructed with a bone-patellar tendon-bone allograft secured with interference screws. Fixation tunnels were placed in the fibular head and at the isometric point on the femur. The cruciate ligaments were reconstructed with autograft or allograft material. The average follow-up was 28 months. Excessive external rotation at 30° of flexion was corrected in all but one knee. Six patients had no varus laxity, and four patients had 1 varus laxity at 30° of flexion. The posterior drawer test result decreased, on average, to 1 , and the Lachman test result decreased to between 0 and 1 . The average Tegner score was 4.6, with five patients returning to their preinjury level of activity and four returning to one level lower. These results indicate that this is a promising new procedure for patients with instability resulting from lateral ligament injuries of the knee.

The Use of Orthotics in Foot and Ankle Problems in Cerebral Palsy

Foot & Ankle ◽  
1984 ◽  
Vol 4 (4) ◽  
pp. 195-200 ◽  
Author(s):  
Robert K. Rosenthal
Keyword(s):  
Cerebral Palsy ◽  
Gait Analysis ◽  
Stance Phase ◽  
Specific Problem ◽  
Swing Phase ◽  
Foot Orthoses ◽  
Foot And Ankle ◽  
Ankle Foot Orthosis ◽  
Control Dynamic ◽  
Foot Orthosis

The molded polypropylene orthosis offers many advantages in the treatment of foot and ankle problems in cerebral palsy. Numerous balancing, stance phase, and swing phase difficulties are treated with an ankle-foot orthosis with appropriate molding to correct each specific problem. Various foot orthoses can also be used to control dynamic muscle imbalances. Gait analysis has confirmed the merits of these orthoses.

scholarly journals Ankle-Injury Patients Perform More Microadjustments during Walking: Evidence from Velocity Profiles in Gait Analysis

2022 ◽  
Vol 2022 ◽  
pp. 1-10
Author(s):  
Xin Liu ◽  
Bin Zheng ◽  
Qinwei Guo ◽  
Yuanyuan Yu ◽  
Zhongshi Zhang ◽  
...  
Keyword(s):  
Gait Cycle ◽  
Lateral Collateral Ligament ◽  
Movement Control ◽  
Measurement Model ◽  
Velocity Profiles ◽  
Ligament Injury ◽  
Control Subjects ◽  
Gait Characteristics ◽  
And Control ◽  
Ankle And Foot

Introduction. We evaluated the velocity profiles of patients with lateral collateral ligament (LCL) injuries of the ankle with a goal of understanding the control mechanism involved in walking. Methods. We tracked motions of patients’ legs and feet in 30 gait cycles recorded from patients with LCL injuries of the ankle and compared them to 50 gait cycles taken from normal control subjects. Seventeen markers were placed on the foot following the Heidelberg foot measurement model. Velocity profiles and microadjustments of the knee, ankle, and foot were calculated during different gait phases and compared between the patient and control groups. Results. Patients had a smaller first rocker percentage and larger second rocker percentage in the gait cycle compared to controls. Patients also displayed shorter stride length and slower strides and performed more microadjustments in the second rocker phase than in other rocker/swing phases. Patients’ mean velocities of the knee, ankle, and foot in the second rocker phase were also significantly higher than that in control subjects. Discussion. Evidence from velocity profiles suggested that patients with ligament injury necessitated more musculoskeletal microadjustments to maintain body balance, but these may also be due to secondary injury. Precise descriptions of the spatiotemporal gait characteristics are therefore crucial for our understanding of movement control during locomotion.

scholarly journals Risk Factors for Concomitant Collateral Ligament Injuries in Children and Adolescents With Anterior Cruciate Ligament Tears

2018 ◽  
Vol 6 (11) ◽  
pp. 232596711881038 ◽  
Author(s):  
R. Jay Lee ◽  
Adam Margalit ◽  
Afamefuna Nduaguba ◽  
Melissa A. Gunderson ◽  
Theodore J. Ganley
Keyword(s):  
Risk Factors ◽  
Anterior Cruciate Ligament ◽  
Children And Adolescents ◽  
Cruciate Ligament ◽  
Lateral Collateral Ligament ◽  
Injury Mechanism ◽  
Older Age ◽  
Ligament Injuries ◽  
Collateral Ligament ◽  
Anterior Cruciate

Background: Risk factors for concomitant ligament injuries (CLIs) of the lateral collateral ligament (LCL) and medial collateral ligament (MCL) in children and adolescents with anterior cruciate ligament (ACL) tears are unknown. Purpose: To determine whether body mass index (BMI), sex, age, and injury mechanism are associated with CLIs in children and adolescents with ACL tears and whether CLIs are associated with meniscal and chondral injuries and a delay to surgery. Study Design: Cohort study; Level of evidence, 3. Methods: We reviewed the records of patients aged ≤18 years with ACL tears from 2009 through 2013 for sex, age, height, weight, CLI, injury mechanism, intra-articular injury, and time to surgery. Patients were assigned to groups according to the presence of a CLI (CLI group) compared with the presence of an isolated ACL tear (ACL group). BMI was categorized as underweight, normal weight, or overweight/obese. The older group was defined as age ≥14 years for girls and ≥16 years for boys. Logistic regression, Mann-Whitney U tests, and chi-square tests were performed (alpha = 0.05). Results: We included 509 patients (267 girls) with a mean age of 15 years (range, 6-18 years) at the time of injury. There were 396 patients (78%) in the ACL group and 113 patients (22%) in the CLI group (90 with MCL, 11 with LCL, and 12 with both MCL and LCL injuries). Groups had similar proportions of overweight/obese patients ( P = .619) and girls ( P = .104). Older age (odds ratio [OR], 2.0 [95% CI, 1.3-3.3]) and contact injuries (OR, 2.2 [95% CI, 1.4-3.4]) were associated with CLIs. The CLI group had a higher proportion of chondral injuries ( P = .001) but not meniscal injuries ( P = .295) and presented to surgery earlier than the ACL group ( P = .002). Conclusion: Older age and contact injuries were associated with CLIs in children and adolescents with ACL tears, whereas BMI category and sex were not. CLIs were associated with a higher proportion of chondral injuries but not meniscal injuries and were not associated with a delay to surgery.

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