A geometric model of the human ankle joint.

A two-dimensional four-bar linkage model of the ankle joint is formulated to describe dorsi/plantarflexion in unloaded conditions as observed in passive tests on ankle complex specimens. The experiments demonstrated that the human ankle joint complex behaves as a single-degree-of-freedom system during passive motion, with a moving axis of rotation. The bulk of the movement occurred at the level of the ankle. Fibres within the calcaneofibular and tibiocalcaneal ligaments remained approximately isometric. The experiments showed that passive kinematics of the ankle complex is governed only by the articular surfaces and the ligaments. It was deduced that the ankle is a single-degree-of-freedom mechanism where mobility is allowed by the sliding of the articular surfaces upon each other and the isometric rotation of two ligaments about their origins and insertions, without tissue deformation. The linkage model is formed by the tibia/fibula and talus/calcaneus bone segments and by the calcaneofibular and tibiocalcaneal ligament segments. The model predicts the path of calcaneus motion, ligament orientations, instantaneous axis of rotation, and conjugate talus surface profile as observed in the experiments. Many features of ankle kinematics such as rolling and multiaxial rotation are elucidated. The geometrical model is a necessary preliminary step to the study of ankle joint stability in response to applied loads and can be used to predict the effects of changes to the original geometry of the intact joint. Careful reconstruction of the original geometry of the ligaments is necessary after injury or during total ankle replacement.