胫距关节融合术和全踝关节置换术后动态距下关节间隙测量分析

IF 1.4 3区医学 Q4 ENGINEERING, BIOMEDICAL

Clinical Biomechanics Pub Date : 2025-02-17 DOI:10.1016/j.clinbiomech.2025.106464

Rich J. Lisonbee , Andrew C. Peterson , Megan K. Mills , Andrew E. Anderson , Amy L. Lenz

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引用次数: 0

摘要

背景：胫距关节融合术和全踝关节置换术是目前治疗终末期踝关节骨关节炎的标准。我们对手术后距下继发性骨关节炎的生物力学原因和危险因素的临床理解是有限的。本回顾性研究的目的是调查经胫距关节融合术或踝关节置换术治疗的个体在地上行走时可能影响距下关节测量的软骨下骨形态测量差异；结果在手术组、其未受影响肢体和无症状对照组之间进行比较。方法利用先前收集的运动学数据，利用基于对应的关节测量分析，测量和比较整个动态活动中的距下关节空间和同余性。形态学分析评估了组间跟骨距下关节软骨下骨的差异。研究结果：与对照组和未治疗的对侧肢体相比，关节融合术参与者受影响的距下关节在站立早期显示内侧关节面关节间隙距离增加，这与运动学差异有关。我们的形态计量学分析表明，与未治疗的对侧肢体相比，两个手术组的软骨下骨不对称。先前报道的关节融合术参与者接受治疗和未接受治疗的肢体之间的运动学差异可能转化为本研究中观察到的关节间隙和形态的变化。我们在关节置换术组的早期研究结果表明，治疗组和未治疗组的肢体在运动学上没有显著差异，而目前的研究显示关节间隙距离的显著差异极小。总的来说，这表明关节置换术组的关节间隙和软骨下骨形状不像关节融合术组那样受到功能不对称的强烈影响。

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Dynamic subtalar joint space measurement analysis following tibiotalar arthrodesis and total ankle replacement

Background

Tibiotalar arthrodesis and total ankle replacement are current standards for treating end-stage ankle osteoarthritis. Our clinical understanding of biomechanical causes and risk factors for subtalar secondary osteoarthritis development following surgical treatment is limited. The objective of this retrospective study was to investigate subchondral bone morphometric differences of individuals treated with a tibiotalar arthrodesis or ankle arthroplasty that may influence subtalar joint measurements during overground walking; results were compared between surgical groups, their unaffected limb, and asymptomatic controls.

Methods

Previously collected kinematics were used to measure and compare subtalar joint space and congruence throughout the dynamic activity utilizing a correspondence-based joint measurement analysis. A morphometric analysis evaluated subchondral bone differences of the calcaneus subtalar joint between groups.

Findings

The affected subtalar joint of arthrodesis participants showed increased joint space distance in the medial facet during early stance that was related to kinematic differences compared to controls and their contralateral untreated limbs. Our morphometric analyses demonstrated subchondral bone asymmetries in both surgical groups compared to their contralateral untreated limbs.

Interpretation

Previously reported kinematic differences between treated and untreated limbs in arthrodesis participants may translate to the variations in joint space and morphology observed in this study. Our earlier findings within the arthroplasty group indicated no significant kinematic differences between treated and untreated limbs, and the current study showed minimal significant differences in joint space distances. Collectively, this suggests that arthroplasty joint space and subchondral bone shapes are not as strongly influenced by functional asymmetries as those in the arthrodesis group.

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来源期刊

Clinical Biomechanics 医学-工程：生物医学

CiteScore

3.30

自引率

5.60%

发文量

189

审稿时长

12.3 weeks

期刊介绍： Clinical Biomechanics is an international multidisciplinary journal of biomechanics with a focus on medical and clinical applications of new knowledge in the field. The science of biomechanics helps explain the causes of cell, tissue, organ and body system disorders, and supports clinicians in the diagnosis, prognosis and evaluation of treatment methods and technologies. Clinical Biomechanics aims to strengthen the links between laboratory and clinic by publishing cutting-edge biomechanics research which helps to explain the causes of injury and disease, and which provides evidence contributing to improved clinical management. A rigorous peer review system is employed and every attempt is made to process and publish top-quality papers promptly. Clinical Biomechanics explores all facets of body system, organ, tissue and cell biomechanics, with an emphasis on medical and clinical applications of the basic science aspects. The role of basic science is therefore recognized in a medical or clinical context. The readership of the journal closely reflects its multi-disciplinary contents, being a balance of scientists, engineers and clinicians. The contents are in the form of research papers, brief reports, review papers and correspondence, whilst special interest issues and supplements are published from time to time. Disciplines covered include biomechanics and mechanobiology at all scales, bioengineering and use of tissue engineering and biomaterials for clinical applications, biophysics, as well as biomechanical aspects of medical robotics, ergonomics, physical and occupational therapeutics and rehabilitation.