Six DOF in vivo kinematics of the ankle joint complex: Application of a combined dual-orthogonal fluoroscopic and magnetic resonance imaging technique
Six DOF in vivo kinematics of the ankle joint complex: Application of a combined dual-orthogonal fluoroscopic and magnetic resonance imaging technique
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DOI：
10.1002/jor.20142
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发表时间：
2006-05-01
影响因子：
2.8
通讯作者：
Li, G
中科院分区：
文献类型：
--
作者：
de Asla, RJ;Wan, L;Li, G
准确了解体内踝关节复合体（AJC）的生物力学对于了解AJC疾病状态和改善手术治疗至关重要。本研究采用双正交荧光透视和磁共振成像（MRI）技术研究了6个自由度（DOF）的人体AJC体内运动学。五个健康的踝关节的生活科目进行了研究，在三个在体内活动的脚，包括最大跖屈和背屈，最大旋后和旋前，和三个负重位置在模拟的立场阶段的步行。使用足部的3D MR图像构建AJC（包括胫骨、腓骨、距骨和跟骨）的三维（3D）计算机模型。使用两个正交定位的荧光镜捕获足部每个选定位置的体内AJC位置。在体内AJC运动，然后可以通过耦合的正交图像与三维AJC模型在一个虚拟的双正交荧光透视系统。从最大背屈到跖屈，距小腿关节的运动弧（47.5 ± 2.2度）明显大于距下关节（3.1 ± 6.8度）。两个关节表现出相似程度的内-外旋转和内翻-外翻旋转。从最大旋后到旋前，距下关节的所有旋转和平移均显著大于距小腿关节。从脚跟着地到站立中期，距小腿关节的跖屈贡献（9.1 +/- 5.3度）显著大于距下关节的跖屈贡献（-0.9 +/- 1.2度）。从站立中期到脚趾离地，距下关节的内旋和内翻（分别为12.3 +/- 8.3度和-10.7 +/- 3.8度）明显大于距小腿关节的内旋和内翻（分别为-1.6 +/- 5.9度和-1.7 +/- 2.7度）。在体内AJC活动期间，观察到距小腿关节和距下关节之间的强运动学耦合。距小腿关节对主动背-跖屈的贡献高于距下关节，而距下关节对主动旋后-旋前的贡献高于距小腿关节。此外，距小腿关节表现出更大的运动在早期的一部分，而距下关节提供更多的运动在后期的一部分的立场阶段。这些结果为正常人的体内数据库增加了定量数据，可用于损伤后AJC的临床诊断，治疗和评估。(c)2006骨科研究学会。出版社：Wiley Periodicals，Inc.
Accurate knowledge of in vivo ankle joint complex (AJC) biomechanics is critical for understanding AJC disease states and for improvement of surgical treatments. This study investigated 6 degrees-of-freedom (DOF) in vivo kinematics of the human AJC using a combined dual-orthogonal fluoroscopic and magnetic resonance imaging (MRI) technique. Five healthy ankles of living subjects were studied during three in vivo activities of the foot, including maximum plantarflexion and dorsiflexion, maximum supination and pronation, and three weight-bearing positions in simulated stance phases of walking. A three-dimensional (3D) computer model of the AJC (including tibia, fibula, talus, and calcaneus) was constructed using 3D MR images of the foot. The in vivo AJC position at each selected position of the foot was captured using two orthogonally positioned fluoroscopes. In vivo AJC motion could then be reproduced by coupling the orthogonal images with the 3D AJC model in a virtual dual-orthogonal fluoroscopic system. From maximum dorsiflexion to plantarflexion, the arc of motion of the talocrural joint (47.5 +/- 2.2 degrees) was significantly larger than that of the subtalar joint (3.1 +/- 6.8 degrees). Both joints showed similar degrees of internal-external and inversion-eversion rotation. From maximum supination to pronation, all rotations and translations of the subtalar joint were significantly larger than those of the talocrural joint. From heel strike to midstance, the plantarflexion contribution from the talocrural joint (9.1 +/- 5.3 degrees) was significantly larger than that of the subtalar joint (-0.9 +/- 1.2 degrees). From midstance to toe off, internal rotation and inversion of the subtalar joint (12.3 +/- 8.3 degrees and -10.7 +/- 3.8 degrees, respectively) were significantly larger than those of the talocrural joint (-1.6 +/- 5.9 degrees and -1.7 +/- 2.7 degrees). Strong kinematic coupling between the talocrural and subtalar joints was observed during in vivo AJC activities. The contribution of the talocrural joint to active dorsi-plantarflexion was higher than that of the subtalar joint, whereas the contribution of the subtalar joint to active supination-pronation was higher than that of the talocrural joint. In addition, the talocrural joint demonstrated larger motion during the early part of stance phase while the subtalar joint contributes more motion during the later part of stance phase. The results add quantitative data to an in vivo database of normals that can be used in clinical diagnosis, treatment, and evaluation of the AJC after injuries. (c) 2006 Orthopaedic Research Society. Published by Wiley Periodicals, Inc.