Concomitant osteochondral lesion of the talus affects in vivo ankle kinetics in patients with chronic ankle instability.

IF 4.7 2区 医学 Q2 CELL & TISSUE ENGINEERING Bone & Joint Research Pub Date : 2024-12-04 DOI:10.1302/2046-3758.1312.BJR-2023-0217.R2
Shengxuan Cao, Yungu Chen, Yunchao Zhu, Shuyun Jiang, Yan Yu, Xu Wang, Chen Wang, Xin Ma
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Abstract

Aims: This cross-sectional study aimed to investigate the in vivo ankle kinetic alterations in patients with concomitant chronic ankle instability (CAI) and osteochondral lesion of the talus (OLT), which may offer opportunities for clinician intervention in treatment and rehabilitation.

Methods: A total of 16 subjects with CAI (eight without OLT and eight with OLT) and eight healthy subjects underwent gait analysis in a stair descent setting. Inverse dynamic analysis was applied to ground reaction forces and marker trajectories using the AnyBody Modeling System. One-dimensional statistical parametric mapping was performed to compare ankle joint reaction force and joint moment curve among groups.

Results: The patients with OLT showed significantly increased dorsiflexion moment in the ankle joint compared with healthy subjects during 38.2% to 40.9% of the gait cycle, and increased eversion moment in the ankle joint compared with patients without OLT during 25.5% to 27.6% of the gait cycle. Compared with healthy subjects, the patients with OLT showed increased anterior force during 42% to 43% of the gait cycle, and maximal medial force (p = 0.005, ηp2 = 0.399).

Conclusion: The patients with concomitant CAI and OLT exhibit increased dorsiflexion and eversion moment, as well as increased anterior and medial ankle joint reaction force during stair descent, compared with patients with CAI but without OLT and healthy subjects, respectively. Thus, a rehabilitative regimen targeting excessive ankle dorsiflexion and eversion moment may help to reduce ankle joint loading.

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伴发距骨软骨损伤影响慢性踝关节不稳定患者体内踝关节动力学。
目的:本横断面研究旨在探讨慢性踝关节不稳定(CAI)合并距骨软骨病变(OLT)患者的体内踝关节动力学改变,为临床医生干预治疗和康复提供机会。方法:共16例CAI患者(8例非OLT和8例OLT)和8例健康受试者在楼梯下行环境下进行步态分析。利用任何人建模系统对地面反作用力和标记轨迹进行逆动力学分析。采用一维统计参数映射法比较各组踝关节反作用力和关节力矩曲线。结果:在38.2% ~ 40.9%的步态周期内,经OLT治疗的患者踝关节背屈力矩明显高于正常对照组;在25.5% ~ 27.6%的步态周期内,经OLT治疗的患者踝关节外翻力矩明显高于未经OLT治疗的患者。与健康受试者相比,OLT患者在42% ~ 43%的步态周期内前侧力增加,内侧力最大(p = 0.005, ηp2 = 0.399)。结论:与CAI合并OLT患者和健康人相比,CAI合并OLT患者下楼梯时踝关节背屈、外翻力矩增大,前、内侧关节反力增大。因此,针对踝关节过度背屈和外倾的康复方案可能有助于减少踝关节负荷。
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来源期刊
Bone & Joint Research
Bone & Joint Research CELL & TISSUE ENGINEERING-ORTHOPEDICS
CiteScore
7.40
自引率
23.90%
发文量
156
审稿时长
12 weeks
期刊介绍: The gold open access journal for the musculoskeletal sciences. Included in PubMed and available in PubMed Central.
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