Relative movement on the articular surfaces of the tibiotalar and subtalar joints during walking

Abstract

Objectives :The objective of this study was to quantify the relative movement between the articular surfaces in the tibiotalar and subtalar joints during normal walking in asymptomatic individuals. Methods :3D movement data of the ankle joint complex were acquired from 18 subjects using a biplanar fluoroscopic system and 3D-to-2D registration of bone models obtained from CT images. Surface relative velocity vectors (SRVVs) of the articular surfaces of the tibiotalar and subtalar joints were calculated. The relative movement of the articulating surfaces was quantified as the mean relative speed (RS) and synchronization index (SIENT) of the SRVVs. Results: SIENT and mean RS data showed that the tibiotalar joint exhibited translational movement throughout the stance, with a mean SIENT of 0.54 (sd 0.21). The mean RS of the tibiotalar joint during the 0% to 20% post heel-strike phase was 36.0 mm/s (sd 14.2), which was higher than for the rest of the stance period. The subtalar joint had a mean SIENT value of 0.43 (sd 0.21) during the stance phase and exhibited a greater degree of rotational movement than the tibiotalar joint. The mean relative speeds of the subtalar joint in early (0% to 10%) and late (80% to 90%) stance were 23.9 mm/s (sd 11.3) and 25.1 mm/s (sd 9.5), respectively, which were significantly higher than the mean RS during mid-stance (10% to 80%). Conclusion:The tibiotalar and subtalar joints exhibited significant translational and rotational movement in the initial stance, whereas only the subtalar joint exhibited significant rotational movement during the late stance. The relative movement on the articular surfaces provided deeper insight into the interactions between articular surfaces, which are unobtainable using the joint coordinate system.