scholarly journals Determination of the Optimal Syndesmosis Fixation Angle Using Mortise View of The Ankle Joint

2021 ◽  
Author(s):  
Oğuzhan Tanoğlu ◽  
İzzet Özay Subaşı ◽  
Mehmet Burak Gökgöz
Keyword(s):  
Ankle Joint ◽  
Articular Surface ◽  
Three Dimensional ◽  
Vertical Plane ◽  
Functional Results ◽  
Practical Method ◽  
Medial Malleolus ◽  
Significant Difference ◽  
Horizontal View ◽  
Mortise View

Background: Syndesmosis is an important soft tissue component supporting the ankle stability and commonly injured accompanying with ankle fractures. The accurate reduction and fixation of syndesmosis is essential to obtain better functional results. Therefore, we aimed to find a practical method using the mortise view of ankle to determine the optimal syndesmosis fixation angle intraoperatively. Methods: We randomly selected 200 adults (100 women and 100 men) between 18 - 60 years of age. Three-dimensional anatomical models of tibia and fibula were created using Materialise MIMICS 21. We created a best fit plane on articular surface of medial malleolus and a ninety degrees vertical plane to medial malleolus plane. We determined two splines on cortical borders of tibia and fibula distant from the most superior point of ankle joint in horizontal view. We created two spheres that fit to the predefined splines. The optimal syndesmosis fixation angle was determined measuring the angle between the line connecting the center points of spheres, and the ninety degrees vertical plane to medial malleolus plane. Results: We observed no statistically significant difference between gender groups in terms of optimal syndesmosis fixation angles. The mean age of our study population was 47.1 {plus minus} 10.5. The optimal syndesmosis fixation angle according to mortise view was found as 21 {plus minus} 4.3 degrees. Conclusions: We determined the optimal syndesmosis fixation angle as 21 {plus minus} 4.3 degrees in accordance with the mortise view of ankle. The surgeon could evaluate the whole articular surface of ankle joint with the medial and lateral syndesmotic space in mortise view accurately and at the same position syndesmosis fixation could be performed at 21 {plus minus} 4.3 degrees.

scholarly journals Factors Related to the Occurrence of Osteochondral Lesions of the Talus by 3-dimensional Bone Morphology of the Ankle

2018 ◽  
Vol 3 (3) ◽  
pp. 2473011418S0048
Author(s):  
Atsushi Teramoto ◽  
Hiroaki Shoji ◽  
Hideji Kura ◽  
Yuzuru Sakakibara ◽  
Tomoaki Kamiya ◽  
...  
Keyword(s):  
Ankle Joint ◽  
Articular Surface ◽  
Three Dimensional ◽  
Opening Angle ◽  
Control Group ◽  
Osteochondral Lesions ◽  
Medial Malleolus ◽  
Bone Morphology ◽  
Joint Models ◽  
The Mean

Category: Ankle Introduction/Purpose: Repeated microtrauma is thought to play a major role in the occurrence of osteochondral lesions of the talus (OLTs), but much remains unknown. Two-dimensional assessments of the relationship between ankle bone morphology and OLTs are occasionally seen. The purpose of this study was to evaluate the bone morphology of the ankle in OLT 3-dimensionally using three-dimensional computed tomography (3DCT), and to investigate the factors related to the occurrence of OLTs. Methods: The subjects were 19 patients (19 ankles) who underwent surgery for medial OLTs (OLT group). They included 13 men and 6 women. A healthy group without ankle disease served as a control group with the same number of 19 ankles. Three-dimensional ankle joint models were made based on DICOM data obtained with CT images. In the 3D model, the medial malleolus articular surface and the tibial plafond surface, the medial surface of the trochlea of the talus, and the lateral surface of the trochlea of the talus were defined. The tibial axis-medial malleolus (TMM) angle, the medial malleolus surface area (MMA), the medial malleolus volume (MMV), and the anterior opening angle of the talus were measured 3-dimensionally and compared in the OLT and control groups. Results: The mean TMM angle was significantly larger in the OLT group (34.2 ± 4.4°) than in the control group (29.2 ± 4.8°; p = 0.002). The mean MMA was significantly smaller in the OLT group (219.8 ± 42.4 mm2) than in the control group (280.5 ± 38.2 mm2; p < 0.001). The mean MMV was significantly smaller in the OLT group (2119.9 ± 562.5 mm3) than in the control group (2646.4 ± 631.4 mm3; p = 0.01). The mean anterior opening angle of the talus was significantly larger in the OLT group (15.4 ± 3.9°) than in the control group (10.2 ± 3.6°; p < 0.001). Conclusion: It was shown with 3DCT measurements that, in medial OLT patients, the medial malleolus opens distally, the MMA and MMV are small, and the talus anterior opening angle was significantly larger than in controls. This study suggests the possibility that the 3D bone morphology of both the mortise and tenon of the ankle joint are closely related to the occurrence of OLTs.

scholarly journals Unstable Fractures Osteosynthesis of Malleoli and Posterior Edge of the Tibia Using Posterolateral Surgical Approach

2021 ◽  
Vol 27 (3) ◽  
pp. 29-42
Author(s):  
Igor’ G. Belen’kii ◽  
Boris A. Maiorov ◽  
Aleksandr Yu. Kochish ◽  
Gennadii D. Sergeev ◽  
Viktor E. Savello ◽  
...  
Keyword(s):  
Ankle Joint ◽  
Surgical Approach ◽  
Early Mobilization ◽  
Functional Results ◽  
Medial Malleolus ◽  
Posterior Edge ◽  
Short Term ◽  
Results Of Treatment ◽  
Mid Term Results ◽  
Unstable Fractures

The malleoli fractures in combination with the fractures of posterior edge of the tibia are considered unstable injuries and present particular difficulties in surgical treatment. The aim of the study was to evaluate short-term and mid-term results of osteosynthesis on account of unstable fractures of malleoli and posterior edge of the tibia using posterolateral surgical approach. Materials and Methods. The analysis of short-term and mid-term results of the treatment of 29 patients with malleoli fractures types 44-B3 and 44-C1.3, C2.3 and C3.3 (according to the AO classification) with the involvement of the Volkman`s posterior tibia fragment was performed in traumatology departments of three hospitals during the period from January 2019 to September 2020. In all 29 cases the fracture of the posterior edge of the tibia was classified as type 1 according to the classification of N. Haraguchi et al. All patients underwent osteosynthesis of the posterior edge of the tibia and the lateral malleolus via posterolateral surgical approach. Combined fracture of the medial malleolus was fixed via classical medial approach. 5 patients (17.2%) with continued instability of the distal tibiofibular syndesmosis underwent fixation with positional screw. Functional results, as well as the range of motions in the ankle joint were evaluated with the use of AOFAS and Neer scales 3, 6 and 12 months after surgery. Results. Statistically significant improvement in functional outcomes over time was noted when evaluated on the AOFAS scale (p0.05) and on the Neer scale (p0.01). 12 months after the surgery these points were 83.213.4 and 87.816.8 respectively. Complications were noted in 5 patients (17.24%). Deep periimplant infection was registered just in one case, another patient had marginal necrosis of the operative wound. Three patients had clinically significant post-traumatic deforming arthritis of the ankle joint. Conclusion. Posterolateral surgical approach has advantages when performing osteosynthesis in patients of the studied profile and enables anatomical reduction and stable fixation of fragments of the Volkman`s posterior edge of the tibia, which provides the possibility of early mobilization of the ankle joint and has positive effect on the results of treatment.

scholarly journals Kinematics of a Pyrocarbon Ankle Spacer for the Treatment of Arthritic Disease

2019 ◽  
Vol 4 (4) ◽  
pp. 2473011419S0041
Author(s):  
Daniel R. Sturnick ◽  
Charles L. Saltzman ◽  
Albert H. Burstein ◽  
Matthew A. Hamilton ◽  
Jonathan T. Deland
Keyword(s):  
Ankle Joint ◽  
Structural Integrity ◽  
Articular Surface ◽  
Treatment Options ◽  
Joint Kinematics ◽  
Ankle Arthritis ◽  
Lower Limb Injury ◽  
Ankle Kinematics ◽  
Significant Difference

Category: Ankle, Ankle Arthritis Introduction/Purpose: Treatment options for ankle arthritis in younger patients are currently limited. Since the longevity of modern total ankle replacements is not sufficient for this patient population, ankle arthrodesis is typically utilized when joint preserving treatment is not a viable option. A new procedure using a pyrocarbon ankle spacer has been developed as a potential alternative, allowing for talar articular resurfacing for pain relief with minimal bone resection. The objective of this study was to assess whether this pyrocarbon ankle spacer could provide normal ankle kinematics as the native ankle joint using cadaveric gait simulation. Methods: Five mid-tibia cadaveric specimens without deformity and no history of lower limb injury or surgery were utilized. The stance phase of gait was simulated for each specimen using a six degree-of-freedom robotic device. A force plate was moved relative to stationary specimen through an inverse tibial kinematic path calculated from in vivo data while extrinsic tendons were actuated using physiologic loads (Figure 1A). Magnitudes of load were scaled to that of 25% bodyweight. Ankle kinematics were measured from reflective markers attached to the tibia and talus via surgical pins. The pyrocarbon ankle spacer (Exactech, Gainesville, FL, USA) was implanted in a nest formed 3-4 mm in depth on the talar articular surface using a custom burring technique (Figure 1B). Ankle spacer kinematics were compared to 95% confidence intervals of native, intact ankle joint kinematics to assess agreement. Results: Outcomes revealed no significant difference in ankle joint kinematics between the native, intact condition and post- pyrocarbon spacer implantation (Figure 1C). This result was consistent for the sagittal, coronal and axial planes of motion. Conclusion: The results of this study demonstrate that a pyrocarbon spacer permits normal ankle kinematics. Further, the device was observed to be stable in the joint throughout simulations. While the testing was performed at 25% bodyweight for analyses on all specimens, load magnitudes were also increased up to 75% on a subset of specimens and the structural integrity of the device remained pristine. With these findings, we concluded that the pyrocarbon spacer device offers promising potential as a treatment option for ankle arthritis.

scholarly journals The outcome of a single percutaneous cannulated screw fixation in posterior malleolus fracture accompanied by medial or lateral malleolus fracture

2018 ◽  
Vol 3 (3) ◽  
pp. 2473011418S0037
Author(s):  
Yoo Jung Park ◽  
Yougun Won
Keyword(s):  
Range Of Motion ◽  
Ankle Joint ◽  
Screw Fixation ◽  
Cannulated Screw ◽  
Medial Malleolus ◽  
Posterior Malleolus ◽  
Significant Difference ◽  
Group 2 ◽  
Group 1

Category: Trauma Introduction/Purpose: Posterior malleolus fractures occur most commonly in the setting of a rotational ankle fracture. In the treatment of posterior malleolus fractures, the indications for the surgical procedure are determined by the size of the fragment and the articular congruity of the tibiotalar joint. In general, the size of the bone fragment is known to be an indication of surgery if it involves more than 25% of the joint surface, and if it is less than that, anatomical reduction and fixation of only lateral or medial malleolus was suggested. We evaluate the clinical and radiological results of fixation and early range of motion exercise using a single cannulated screw when the fragment of the posterior malleolus fracture is less than 25%. Methods: Among 60 patients with SER stage 3 or 4 who had undergone surgery from March 2010 to March 2014, percutaneous cannulated screw fixation was performed for posterior malleolus in 30 cases (Group 1). In the other 30 cases (Group 2), we did not perform the fixation for posterior malleolus fracture and only cast immobilization was done after fixation for lateral or medial malleolus. Mean follow-up period was 14.8 weeks(12~18) for the Group 1, 12.9 weeks(12~18) for Group 2. Mean age of patients was 46.6(19~78) for Group 1, 50.2(19~74) for Group 2. The range of motion was checked at week 2, 4, 12, and at last follow-up. Results: There was no significant difference of time to union and union rate between two groups, and AOFAS score between two groups also showed no significant difference(91.94(83~100) vs 90.8(85~100), p = 0.45). The range of motion of ankle joint at the final follow-up showed significant difference (Ankle ROM 52.7’ (45’~65’) vs 45.3’(35’~65’), (p<0.01) and complications between two groups also showed no significant difference. Conclusion: A single percutaneous cannulated screw fixation in posterior malleolus fracture accompanied by medial or lateral malleolus fracture can be performed in fractures with small fragment size and minimal displacement. We found that it can be a effective method to achieve early and wide range of motion of ankle joint after posterior mallolus fracture.

Variations in Mortise Anatomy

2005 ◽  
Vol 33 (6) ◽  
pp. 852-855 ◽  
Author(s):  
Christopher T. LeBrun ◽  
John O. Krause
Keyword(s):  
Computed Tomography ◽  
Ankle Instability ◽  
Articular Surface ◽  
New Method ◽  
Medial Malleolus ◽  
Level Of Evidence ◽  
Predisposing Factor ◽  
Index Method ◽  
Significant Difference ◽  
Computed Tomography Scans

Background Variations in ankle mortise anatomy may be a predisposing factor to ankle instability. Hypothesis A posteriorly positioned fibula associated with ankle instability may not be a true pathologic entity but rather the result of measuring off an internally rotated talus. Study Design Cohort study (diagnosis); Level of evidence, 2. Methods The authors reviewed 60 ankle computed tomography scans performed on patients from their institution for reasons unrelated to ankle instability. They also reviewed ankle computed tomography scans on 21 patients surgically treated for clinical ankle instability. The position of the fibula in relation to the talar articular surface was calculated and expressed as the axial malleolar index, as described by Scranton et al. They also calculated the intermalleolar index, a new method that references the medial malleolus, not the talus. Results Using the method of Scranton et al, the axial malleolar index in the control and instability patients was similar to values previously described, and there was a significant difference between control and instability patients (P <. 01). However, using the intermalleolar index method referencing the medial malleolus, there was not a significant difference between control and instability patients (P =. 43). Conclusion The new method of referencing the medial malleolus assesses fibular position independent of talar rotation. The data, when referencing the medial malleolus, do not show significant variation in fibular position in patients with and without ankle instability.

Comparison of Tibial and Talar Bone Density in Patients Undergoing Total Ankle Replacement vs Non–Ankle Arthritis Matched Controls

2019 ◽  
Vol 40 (12) ◽  
pp. 1408-1415
Author(s):  
Thos Harnroongroj ◽  
Lauren G. Volpert ◽  
Scott J. Ellis ◽  
Carolyn M. Sofka ◽  
Jonathan T. Deland ◽  
...  
Keyword(s):  
Bone Density ◽  
Ankle Joint ◽  
Articular Surface ◽  
Distal Tibia ◽  
Total Ankle Replacement ◽  
Control Group ◽  
Ankle Arthritis ◽  
Level Of Evidence ◽  
Ankle Replacement ◽  
Significant Difference

Background: Bone quality in the distal tibia and talus is an important factor contributing to initial component stability in total ankle replacement (TAR). However, the effect of ankle arthritis on bone density in the tibia and talus remains unclear. The objective of this study was to compare bone density of tibia and talus in arthritic and nonarthritic ankles as a function of distance from ankle joint. Methods: We retrospectively reviewed 93 end-stage ankle arthritis patients who had preoperative nonweightbearing ankle computed tomography (CT) and identified a cohort of 83 nonarthritic ankle patients as a demographic-matched control group. A region of interest tool was used to calculate Hounsfield unit (HU) values in the cancellous region of the tibia and talus. Measurements were obtained on axial cut CTs from 6 to 12 mm above the tibial plafond, and 1 to 4 mm below the talar dome. HU measurements between groups and the decrease of HU at the relative level in each group were compared. Results: Arthritic ankles demonstrated significantly greater mean bone density than nonarthritic ankles at between 6 and 10 mm above the joint in the tibia ( P < .05). No significant difference in bone density between 10 and 12 mm from the joint in the tibia nor at any level of the talus was found between groups. In both groups, bone density decreased significantly at each successive level away from the ankle joint. Conclusion: Ankle arthritis patients demonstrated greater or equal bone density in both the tibia and talus compared to demographic-matched controls. In both groups, bone density decreased with increasing distance away from the articular surface. In TAR, tibial bone resection between 6 and 8 mm may provide improved initial implant stability. Level of Evidence: Level III, comparative study.

scholarly journals Relations of ankle alignment and MRI findings of ankle osteoarthritis

2017 ◽  
Vol 2 (3) ◽  
pp. 2473011417S0002
Author(s):  
Hiroyuki Mitsui ◽  
Takaaki Hirano ◽  
Akiyama Yui ◽  
Shingo Maeda ◽  
Hisateru Niki
Keyword(s):  
Ankle Joint ◽  
Roc Curve ◽  
Joint Surface ◽  
Medial Malleolus ◽  
Training Set ◽  
Mri Findings ◽  
X Ray ◽  
Chopart Joint ◽  
Significant Difference ◽  
Validation Set

Category: Ankle Arthritis Introduction/Purpose: MRI is gaining attention as a tool for examining the severity of osteoarthritis (OA) over X-ray findings. However, there are few reports on the relationship between MRI and X-ray findings in ankle joints. We assessed the combination of ankle joint alignment and MRI to find the factor to predict MRI findings from X-ray findings in OA. Methods: Of the 341 patients who had a diagnosis of ankle OA in our hospital from May 2009 to August 2015, we assessed 46 feet of 45 patients who underwent MRI. We determined ankle joint alignment by measuring tibial anterior surface (TAS) angle, and tibial lateral surface (TLS) angle on X-ray, and determined the areas of Bone Marrow Edema (BME) appearing on STIR, by partitioning 22 areas for talocrural, tarocalcaneal, Chopart joint. In the statistics analysis, we divided into two groups with and without BME, and we compared TAS angle and TLS angle. Moreover, for predicting the occurrence of BME, we divided the disease group into 2 groups, training set and validation set. We then verified the validity of the results by measuring cut-off value of TAS angle and TLS angle from ROC curve, an area which had statistically significant difference. Results: TAS angles or TLS angles were significantly lower in the group which showed BME at the anterior medial part of the tibia canopy and medial malleolus joint surface. From the ROC curve of the training set, the cut-off value (TAS angle of 82 degrees or less and TLS angle of 76 degrees or less) was obtained. Applying the obtained cut-off value to the validation set, it was possible to predict the occurrence of BME on the medial malleolus joint surface (sensitivity 71%, specificity 67%). Conclusion: Association with BME and clinical symptoms as well as disease prognosis has been reported in the OA area, so predicting the appearance of BME can be a useful index for prescribing a treatment plan. It was suggested that the appearance of BME could be predicted from X-ray findings because it was related to ankle alignment and MRI. It is possible that these findings could be used as a new diagnostic tool to estimate disease severity in the future.

scholarly journals Percentage of Articular Surface Debridement is Equivalent in Arthroscopic and Open Ankle Fusions

2017 ◽  
Vol 2 (3) ◽  
pp. 2473011417S0000
Author(s):  
Michael Anderson ◽  
Ashlee MacDonald ◽  
Sandeep Soin ◽  
Adolph Flemister ◽  
John Ketz
Keyword(s):  
Soft Tissue ◽  
Ankle Joint ◽  
Articular Surface ◽  
Wound Complications ◽  
Arthroscopic Debridement ◽  
Talar Dome ◽  
Ankle Arthritis ◽  
Tibial Plafond ◽  
Significant Difference ◽  
Open Debridement

Category: Ankle Arthritis, Arthroscopy Introduction/Purpose: Tibiotalar arthrodesis is a reliable option in the treatment of end-stage ankle arthritis and both open and arthroscopically assisted techniques are well described. When compared head to head, multiple studies have demonstrated advantages of arthroscopic arthrodesis over open fusions including decreased morbidity, and shorter hospital stays while achieving equivalent or increased rates of fusion. It is unclear why arthroscopic fusion may be favorable to open surgery, however, it is hypothesized that patient selection and soft tissue trauma may play a role. No study, however, has evaluated the extent of articular debridement afforded by each technique. The purpose of this study was to evaluate the amount of articular cartilage denuded via open arthrodesis and via arthroscopic arthrodesis with time of procedure evaluated as a secondary measure. Methods: Six matched sets of fresh frozen cadaver lower extremities were acquired for study. One limb from each set was randomly assigned to open articular debridement while the other limb was assigned to arthroscopic debridement. The duration of each procedure was timed. The tibiotalar joints were disarticulated following debridement and the talus was dissected free of all soft tissue attachments. Photographs of the weight bearing portion of the articular surfaces were then taken and residual cartilage was mapped using ImageJ software. The percentage of the joint debrided was determined by the area of denuded bone divided by the total area of the articular surface to allow for comparison across specimens. The mapping process was blinded to the type of debridement undertaken. Repeated measurements were taken to determine intra- and inter-reliability of the measurements. Student t-tests were used to compare the percentage of joint debrided and differences in time of the procedure. Results: The average percentage of cartilage debrided in the arthroscopic procedure was 88.99+11.19% for the tibial plafond and 88.84.08+5.45% for the talar dome. For the open procedure, 82.93+6.91% of the tibial plafond was debrided and 84.08+5.45% of the talar dome was debrided. There were no significant differences of the tibia or talus between the open and arthroscopic procedures (p>0.05). Inter- and intra-reliability were calculated for all measurements with r>.8. There was a significant difference in the time of the procedure with the arthroscopic debridement taking 50.17+5.57 minutes to complete while the open debridement took 30.67+5.16 minutes to complete (p<0.01). Conclusion: There were no differences in the percentage of articular surface debrided when comparing arthroscopic versus open arthrodesis of the ankle joint in cadaver specimens. The arthroscopic debridement took significantly longer, however this difference may be offset by a decrease in time required for wound closure. Furthermore, an increased time of debridement may be warranted if it results in decreased wound complications and pain. The results of this study support previous clinical findings that arthroscopic debridement can yield fusion rates comparable to, or better, than open debridement of the ankle joint.

scholarly journals Morphologic Analysis of Nonosseous Talocalcaneal Coalitions Using 3D Reconstruction

2021 ◽  
Vol 6 (4) ◽  
pp. 247301142110394
Author(s):  
Azusa Yoneda ◽  
Yasuhito Tanaka ◽  
Hiromasa Fujii ◽  
Shinji Isomoto ◽  
Kazuya Sugimoto
Keyword(s):  
Articular Surface ◽  
Relative Size ◽  
Three Dimensional ◽  
Control Group ◽  
Level Of Evidence ◽  
Surface Areas ◽  
Talocalcaneal Joint ◽  
Talocalcaneal Coalition ◽  
Significant Difference ◽  
Retrospective Comparative Study

Background: Resection of talocalcaneal coalitions has generally involved osseous coalitions. We attempted to evaluate the morphology of nonosseous talocalcaneal coalitions. This study aimed to investigate if the calcaneal articular surface area of feet with talocalcaneal coalitions is different than that of normal feet. Methods: Twenty nonosseous talocalcaneal coalition cases with analyzable computed tomography (CT) scans were compared to 20 control cases. Three-dimensional models of the talus and calcaneus were constructed, and the surface areas of the posterior facet (SPF), whole talocalcaneal joint of the calcaneus (SWJ), and coalition site (SCS) of each 3D-CT model were measured. “Calibrated” values of the 2 groups were created to adjust for relative size of the tali and then compared. The preoperative and postoperative AOFAS Ankle-Hindfoot scale was calculated for 9 cases that had undergone single coalition resection. Results: The calibrated SPF and SWJ were significantly greater in the coalition group than in the control group (40% and 12%, respectively). No significant difference was detected between the calibrated (SWJ – SCS) value of the coalition group and the calibrated SWJ value of the control group. The AOFAS scale was improved postoperatively in all 9 cases analyzed. Conclusion: The calcaneal articular surface of nonosseous talocalcaneal coalition feet in our series was larger than that of the normal feet. This study indicates that the total calcaneal articular surface after coalition resection may be comparable to the calcaneal articular surface of normal feet. We suggest that the indication for coalition resection be reconsidered for nonosseous coalition. Level of Evidence: Level III, retrospective comparative study.

scholarly journals Effects of Different Assistive Seats on Ability of Elderly in Sit-To-Stand and Back-To-Sit Movements

Healthcare ◽  
2021 ◽  
Vol 9 (4) ◽  
pp. 485
Author(s):  
Shu-Zon Lou ◽  
Jia-Yuan You ◽  
Yi-Chuan Tsai ◽  
Yu-Chi Chen
Keyword(s):  
Ankle Joint ◽  
Repeated Measures ◽  
Three Dimensional ◽  
The Elderly ◽  
Joint Moments ◽  
Healthy Older Adults ◽  
3D Motion Analysis ◽  
Sit To Stand ◽  
Significant Difference ◽  
Analysis System

The ability to perform sit-to-stand (STS) and back-to-sit (BTS) movements is important for the elderly to live independently and maintain a reasonable quality of life. Accordingly, this study investigated the STS and BTS motions of 28 healthy older adults (16 male and 12 female) under three different seat conditions, namely nonassisted, self-designed lifting seat, and UpLift seat. The biomechanical data were acquired using a three-dimensional (3D) motion analysis system and force plates, and were examined by one-way repeated-measures ANOVA to investigate the effects of the different seat conditions on the joint angle, joint moments, and movement duration time (α = 0.05). No significant difference was observed in the STS duration among the three test conditions. However, the BTS duration was significantly increased in the UpLift seat condition. Moreover, the peak flexion angle of the hip during STS motion was also significantly higher in the UpLift condition. For both motions (STS and BTS), the lifting seats significantly decreased the knee and hip joint moments, but significantly increased the ankle joint moment. Moreover, compared to the nonassistive seat, both assistive lifting seats required a greater ankle joint strength to complete the STS and BTS motions.

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