Centre of Rotation of the Human Subtalar Joint Using Weight-Bearing Clinical Computed Tomography

Accurate in vivo quantification of subtalar joint kinematics can provide important information for the clinical evaluation of subtalar joint function; the analysis of outcome of surgical procedures of the hindfoot; and the design of a replacement subtalar joint prosthesis. The objective of the current study was to explore the potential of full weight-bearing clinical computed tomography (CT) to evaluate the helical axis and centre of rotation of the subtalar joint during inversion and eversion motion. A subject specific methodology was proposed for the definition of the subtalar joint motion combining three-dimensional (3D) weight-bearing imaging at different joint positions with digital volume correlation (DVC). The computed subtalar joint helical axis parameters showed consistency across all healthy subjects and in line with previous data under simulated loads. A sphere fitting approach was introduced for the computation of subtalar joint centre of rotation, which allows to demonstrate that this centre of rotation is located in the middle facet of the subtalar joint. Some translation along the helical axis was also observed, reflecting the elasticity of the soft-tissue restraints. This study showed a novel technique for non-invasive quantitative analysis of bone-to-bone motion under full weight-bearing of the hindfoot. Identifying different joint kinematics in patients with ligamentous laxity and instability, or in the presence of stiffness and arthritis, could help clinicians to define optimal patient-specific treatments.

[1]  D. C. Henckel,et al.  Case report. , 1995, Journal.

[2]  Matthias Buchner,et al.  Ankle Fusion Attributable to Posttraumatic Arthrosis: A Long-Term Followup of 48 Patients , 2003, Clinical orthopaedics and related research.

[3]  Na Ra Kim,et al.  Subtalar instability: imaging features of subtalar ligaments on 3D isotropic ankle MRI , 2017, BMC Musculoskeletal Disorders.

[4]  A. Lundberg,et al.  Ankle and Subtalar Kinematics Measured with Intracortical Pins during the Stance Phase of Walking , 2004, Foot & ankle international.

[5]  Elizabeth Pendry,et al.  Can the different presentation of the diabetic ischaemic foot be explained by different distributions of arterial disease , 2010, Journal of Foot and Ankle Research.

[6]  Marta Peña Fernández,et al.  Full-Field Strain Analysis of Bone-Biomaterial Systems Produced by the Implantation of Osteoregenerative Biomaterials in an Ovine Model. , 2019, ACS biomaterials science & engineering.

[7]  Thomas D Brown,et al.  Impact of comorbidities on the measurement of health in patients with ankle osteoarthritis. , 2006, The Journal of bone and joint surgery. American volume.

[8]  T. Saxby,et al.  A Comprehensive Review of Subtalar Arthrodesis , 2007, Foot & ankle international.

[9]  Thomas P Andriacchi,et al.  The knee joint center of rotation is predominantly on the lateral side during normal walking. , 2008, Journal of biomechanics.

[10]  Ulrich N Hansen,et al.  Femoral fracture type can be predicted from femoral structure: A finite element study validated by digital volume correlation experiments , 2017, Journal of orthopaedic research : official publication of the Orthopaedic Research Society.

[11]  Jan Bartoníček,et al.  Traumatic Injury to the Subtalar Joint. , 2018, Foot and ankle clinics.

[12]  Nicola Krähenbühl,et al.  The subtalar joint , 2017, EFORT open reviews.

[13]  Steven H. Low,et al.  An optimization approach to ABR control , 1998, ICC '98. 1998 IEEE International Conference on Communications. Conference Record. Affiliated with SUPERCOMM'98 (Cat. No.98CH36220).

[14]  Craig Payne,et al.  Position of the subtalar joint axis and resistance of the rearfoot to supination. , 2003, Journal of the American Podiatric Medical Association.

[15]  Gianluca Tozzi,et al.  Three-dimensional local measurements of bone strain and displacement: comparison of three digital volume correlation approaches. , 2015, Journal of biomechanical engineering.

[16]  A. J. van den Bogert,et al.  In vivo determination of the anatomical axes of the ankle joint complex: an optimization approach. , 1994, Journal of biomechanics.

[17]  Arne Burssens,et al.  Can Weightbearing Computed Tomography Scans Be Used to Diagnose Subtalar Joint Instability? A Cadaver Study , 2019, Journal of orthopaedic research : official publication of the Orthopaedic Research Society.

[18]  G W Blunn,et al.  Optimization of digital volume correlation computation in SR‐microCT images of trabecular bone and bone‐biomaterial systems , 2018, Journal of microscopy.

[19]  L. Qiu,et al.  A preliminary study , 2018, Medicine.

[20]  François Lintz,et al.  3D Biometrics for Hindfoot Alignment Using Weightbearing Computed Tomography , 2019, Foot & ankle international.

[21]  Hylton B Menz,et al.  Population prevalence and distribution of ankle pain and symptomatic radiographic ankle osteoarthritis in community dwelling older adults: A systematic review and cross-sectional study , 2018, PloS one.

[22]  William R Taylor,et al.  The weighted optimal common shape technique improves identification of the hip joint center of rotation in vivo , 2011, Journal of orthopaedic research : official publication of the Orthopaedic Research Society.

[23]  Kevin W. Eliceiri,et al.  ImageJ for the Next Generation of Scientific Image Data , 2019, Microscopy and Microanalysis.

[24]  Xavier Ohl,et al.  Long-term results of in situ subtalar arthrodesis , 2010, International Orthopaedics.

[25]  F. Veldpaus,et al.  Finite centroid and helical axis estimation from noisy landmark measurements in the study of human joint kinematics. , 1985, Journal of biomechanics.

[26]  W C H Parr,et al.  Calculating the axes of rotation for the subtalar and talocrural joints using 3D bone reconstructions. , 2012, Journal of biomechanics.

[27]  Grant Murray,et al.  Religion and perceptions of community-based conservation in Ghana, West Africa , 2018, PloS one.

[28]  Philipp Schneider,et al.  Deformable image registration and 3D strain mapping for the quantitative assessment of cortical bone microdamage. , 2012, Journal of the mechanical behavior of biomedical materials.

[29]  Guoan Li,et al.  Six DOF in vivo kinematics of the ankle joint complex: Application of a combined dual‐orthogonal fluoroscopic and magnetic resonance imaging technique , 2006, Journal of orthopaedic research : official publication of the Orthopaedic Research Society.

[30]  C Sandmann,et al.  Quality of life 20 years after arthrodesis of the ankle. A study of adjacent joints. , 2003, The Journal of bone and joint surgery. British volume.

[31]  J. O'Connor,et al.  Mobility of the subtalar joint in the intact ankle complex. , 2001, Journal of biomechanics.

[32]  J. R. Close,et al.  The function of the subtalar joint. , 1967, Clinical orthopaedics and related research.

[33]  L. Schon,et al.  Effect of Tibiotalar Joint Arthrodesis on Adjacent Tarsal Joint Pressure in a Cadaver Model , 2007, Foot & ankle international.

[34]  Peter A Gustafson,et al.  The subtalar joint: biomechanics and functional representations in the literature. , 2014, Foot.

[35]  Martinus Richter,et al.  Combination of PedCAT Weightbearing CT With Pedography Assessment of the Relationship Between Anatomy-Based Foot Center and Force/Pressure-Based Center of Gravity , 2018, Foot & ankle international.

[36]  G. Vandeputte,et al.  Measuring hindfoot alignment in weight bearing CT: A novel clinical relevant measurement method. , 2016, Foot and ankle surgery : official journal of the European Society of Foot and Ankle Surgeons.

[37]  William R Ledoux,et al.  Evaluating foot kinematics using magnetic resonance imaging: from maximum plantar flexion, inversion, and internal rotation to maximum dorsiflexion, eversion, and external rotation. , 2011, Journal of biomechanical engineering.

[38]  Scott L Delp,et al.  Evaluation of Methods That Locate the Center of the Ankle for Computer-assisted Total Knee Arthroplasty , 2005, Clinical orthopaedics and related research.

[39]  Remmet Jonges,et al.  In-vivo range of motion of the subtalar joint using computed tomography. , 2008, Journal of biomechanics.

[40]  Dishan Singh,et al.  3D Biometrics for Hindfoot Alignment Using Weightbearing CT , 2017, Foot & ankle international.

[41]  Brian K. Bay,et al.  Methods and applications of digital volume correlation , 2008 .

[42]  Andrew E Anderson,et al.  Accuracy and feasibility of high-speed dual fluoroscopy and model-based tracking to measure in vivo ankle arthrokinematics. , 2015, Gait & posture.

[43]  L. Schon,et al.  Isolated Subtalar Arthrodesis* , 2000, The Journal of bone and joint surgery. American volume.

[44]  Güven Bulut,et al.  The Results of Physical, Radiologic, Pedabarographic, and Quality‐of‐Life Assessments in Patients with Surgically Treated Intraarticular Calcaneus Fractures , 2018, The Journal of foot and ankle surgery : official publication of the American College of Foot and Ankle Surgeons.

[45]  M. Ivanovic,et al.  Weightbearing CBCT, MDCT, and 2D imaging dosimetry of the foot and ankle , 2014 .

[46]  C L Saltzman,et al.  Long-Term Results Following Ankle Arthrodesis for Post-Traumatic Arthritis , 2001, The Journal of bone and joint surgery. American volume.

[47]  I Söderkvist,et al.  Determining the movements of the skeleton using well-configured markers. , 1993, Journal of biomechanics.

[48]  Alastair Younger,et al.  Comparison of health-related quality of life between patients with end-stage ankle and hip arthrosis. , 2008, The Journal of bone and joint surgery. American volume.

[49]  W. Taylor,et al.  A survey of formal methods for determining the centre of rotation of ball joints. , 2006, Journal of biomechanics.

[50]  K. Kirby,et al.  Subtalar joint axis location and rotational equilibrium theory of foot function. , 2001, Journal of the American Podiatric Medical Association.

[51]  Stefan Wesarg,et al.  An image-based kinematic model of the tibiotalar and subtalar joints and its application to gait analysis in children with Juvenile Idiopathic Arthritis. , 2019, Journal of biomechanics.

[52]  E J van Langelaan,et al.  A kinematical analysis of the tarsal joints. An X-ray photogrammetric study. , 1983, Acta orthopaedica Scandinavica. Supplementum.

[53]  Nico Buls,et al.  Four-dimensional CT as a valid approach to detect and quantify kinematic changes after selective ankle ligament sectioning , 2019, Scientific Reports.

[54]  Frances T Sheehan,et al.  The instantaneous helical axis of the subtalar and talocrural joints: a non-invasive in vivo dynamic study , 2010, Journal of foot and ankle research.

[55]  J. O'Connor,et al.  Biomechanics of the natural, arthritic, and replaced human ankle joint , 2014, Journal of Foot and Ankle Research.

[56]  Thomas Mittlmeier,et al.  Update on Subtalar Joint Instability. , 2018, Foot and ankle clinics.

[57]  Martinus Richter,et al.  PedCAT for 3D-imaging in standing position allows for more accurate bone position (angle) measurement than radiographs or CT. , 2014, Foot and ankle surgery : official journal of the European Society of Foot and Ankle Surgeons.

[58]  Gabriela Hossu,et al.  Comparison between subtalar joint quantitative kinematic 4-D CT parameters in healthy volunteers and patients with joint stiffness or chronic ankle instability: A preliminary study. , 2019, European journal of radiology.

[59]  Kevin W. Eliceiri,et al.  ImageJ2: ImageJ for the next generation of scientific image data , 2017, BMC Bioinformatics.

[60]  Filip Stockmans,et al.  Does subtalar instability really exist? A systematic review. , 2020, Foot and ankle surgery : official journal of the European Society of Foot and Ankle Surgeons.

[61]  M. Myerson,et al.  The value of Weight-Bearing CT scan in the evaluation of subtalar distraction bone block arthrodesis: Case report. , 2015, Foot and ankle surgery : official journal of the European Society of Foot and Ankle Surgeons.

[62]  Marco Palanca,et al.  Engineering 1 3 D Local Measurements of Bone Strain and Displacement : Comparison of Three Digital Volume Correlation Approaches , 2015 .

[63]  G. Kaeley,et al.  The Elusive but Painful Subtalar Joint in Rheumatoid Arthritis , 2019, The Journal of Rheumatology.

[64]  Fang Liu,et al.  Tibiofemoral kinematics and condylar motion during the stance phase of gait. , 2009, Journal of biomechanics.

[65]  V. T. Inman,et al.  Anthropometric studies of the human foot and ankle , 1969 .

[66]  J. Manter.  Movements of the subtalar and transverse tarsal joints , 1941 .

[67]  Hisao Moritomo,et al.  Three-dimensional in vivo kinematics of the subtalar joint during dorsi-plantarflexion and inversion-eversion. , 2009, Foot & ankle international.

[68]  Andrew E. Anderson,et al.  Subject-Specific Axes of Rotation Based on Talar Morphology Do Not Improve Predictions of Tibiotalar and Subtalar Joint Kinematics , 2017, Annals of Biomedical Engineering.

[69]  Stephen J Piazza,et al.  Determination of subtalar joint axis location by restriction of talocrural joint motion. , 2007, Gait & posture.

[70]  Gianluca Tozzi,et al.  Feasibility study for a clinical application of digital volume correlation , 2017 .

[71]  E. Morgan,et al.  Accuracy and precision of digital volume correlation in quantifying displacements and strains in trabecular bone. , 2007, Journal of biomechanics.

[72]  I. Sinclair,et al.  The application of digital volume correlation (DVC) to study the microstructural behaviour of trabecular bone during compression. , 2014, Journal of the mechanical behavior of biomedical materials.

[73]  O. Svensson,et al.  The axes of rotation of the talocalcaneal and talonavicular joints , 1993 .