In vivo Three-Dimensional Kinematics of the Ankle Joint Complex in Patients with Lateral Ankle Instability During Functional Activities Using Biplane Fluoroscopy

• Main Authors: Hsin-Yi Lu, 盧欣怡
• Other Authors: Tung-Wu Lu
• Format: Others
• Language: zh-TW
• Published: 2018
• Online Access: http://ndltd.ncl.edu.tw/handle/tyuj93

碩士 === 國立臺灣大學 === 醫學工程學研究所 === 106 === Among the sport injuries of the lower extremities, ankle sprain is arguably the most frequent injury, which often results in lateral ligament injuries. Lateral ligament injuries of the ankle joint complex (AJC) had been found to alter the normal kinematic patterns of the AJC during weight-bearing activities. Abnormal kinematics of the AJC may contribute to the lesion of the articular cartilage and chronic instability of the joint, leading to persistent pain. Chronic lateral instability of the ankle has been shown to be associated with various pathological conditions of the ligaments, capsules and cartilage with high risk of joint osteoarthritis (OA). The purposes of the current study were to establish a platform for measuring AJC kinematics during functional activities based on the technique combining CT bone models and bi-planer fluoroscopy. The health AJC subjects and the patients with CAI are recruited, aiming to measure the AJC kinematics during during functional activities. The lateral ligament elongation of AJC is calculated from MRI model. This study will provide a better understanding of the effect of lateral instability on the kinematics of the AJC during functional activities and clarify the roles of the lateral ligaments in controlling the mobility and stability of the AJC. The results show that, chronic ankle instability (CAI) alters the kinematic of the talocrural and subtalat joint. Furthermore, CAI leads to increased range of motion and variability in the return path of kinematic motion of the talocrural joint and subtalar joint in the sagittal plane and transverse plane. The coupled patterns of the motion component in sagittal plane significantly different between joints with CAI with and health ankle joints. Additionally, CAI joints demonstrate the greater change in length of ATFL during plantarflexion and internal rotation. In-vivo measurement of the three-dimensional kinematics of the ankle joint complex during functional activities helps to establish a better understanding of the functions of the AJC as well as its surrounding passive and active structures in the normal and pathological conditions. Such study hence provides necessary knowledge for the establishment of the mechanisms of relevant injuries, the etiology and diagnosis of joint diseases, as well as the planning and evaluation of subsequent treatment and rehabilitation programs.