In vivo kinematics of the talocrural and subtalar joints during weightbearing ankle rotation in chronic ankle instability.
In vivo kinematics of the talocrural and subtalar joints during weightbearing ankle rotation in chronic ankle instability.
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DOI：
10.1177/1938640013514269
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发表时间：
2014-02-01
影响因子：
--
通讯作者：
Gamada, Kazuyoshi
中科院分区：
文献类型：
--
作者：
Kobayashi, Takumi;Saka, Masayuki;Gamada, Kazuyoshi
背景技术背景：慢性踝关节不稳定（CAI）导致踝关节运动学异常，但存在有限的定量数据表征这些变化。本研究旨在探讨CAI患者距小腿关节和距下关节的运动学改变。方法：14例单侧CAI男性患者（平均年龄= 21.1 ± 2.5岁）。在负重被动踝关节复合体（AJC）旋转过程中，获得双下肢的计算机断层扫描和透视成像。从计算机断层扫描图像创建的三维骨模型与透视图像匹配，以计算6个自由度的距小腿、距下和AJC运动学。跖屈20°时，CAI患者的踝关节在AJC内旋从5°到7°时，距小腿关节的前向平移显著增加，在AJC运动弧内，距小腿关节的内旋从-1°至5°。CAI关节表现出显着增加内旋转的距下关节内的AJC弧的运动从-1°到3°。讨论：在CAI，改变距下内旋转发生与增加talocrural前平移和减少talocrural内旋转负重踝关节内旋转跖屈。这些结果表明，改变距下力学可能有助于CAI症状。
BACKGROUND: Chronic ankle instability (CAI) results in abnormal ankle kinematics, but there exists limited quantitative data characterizing these alterations. This study was undertaken to investigate kinematic alterations of the talocrural and subtalar joints in CAI.METHODS: A total of 14 male patients with unilateral CAI (mean age = 21.1 ± 2.5 years) were enrolled. Computed tomography and fluoroscopic imaging of both lower extremities during weightbearing passive ankle joint complex (AJC) rotation were obtained. Three-dimensional bone models created from the computed tomography images were matched with the fluoroscopic images to compute the 6 degrees-of-freedom talocrural, subtalar, and AJC kinematics.RESULTS: In 20° plantarflexion, ankles with CAI demonstrated significantly increased anterior translation of the talocrural joint during AJC internal rotation from 5° to 7° and significantly decreased talocrural internal rotation within an AJC arc of motion from -1° to 5°. CAI joints demonstrated significantly increased internal rotation of the subtalar joint within an AJC arc of motion from -1° to 3°.DISCUSSION: In CAI, altered subtalar internal rotation occurs with increased talocrural anterior translation and reduced talocrural internal rotation during weightbearing ankle internal rotation in plantarflexion. These results suggest that altered subtalar mechanics may contribute to CAI symptoms.