Takuma Kobayashi1, Satoshi Yamakawa2, Kota Watanabe3, Kei Kimura2, Daisuke Suzuki4, Hidenori Otsubo5, Atsushi Teramoto5, Mineko Fujimiya6, Hiromichi Fujie2, Toshihiko Yamashita5. 1. Department of Orthopaedic Surgery, Sapporo Medical University School of Medicine, South-1 West-16 Chuo-ku, Sapporo, Hokkaido 060-8543, Japan. Electronic address: a98m040@yahoo.co.jp. 2. Biomechanics Laboratory, Faculty of System Design, Tokyo Metropolitan University, 6-6 Asahigaoka, Hino-shi, Tokyo 191-0065, Japan. 3. Department of Physical Therapy, Sapporo Medical University School of Health Sciences, South-1, West-17, Chuo-ku, Sapporo, Hokkaido 060-8556, Japan. 4. Department of Musculoskeletal Biomechanics and Surgical Development, Sapporo Medical University, South-1 West-16 Chuo-ku, Sapporo, Hokkaido 060-8543, Japan. 5. Department of Orthopaedic Surgery, Sapporo Medical University School of Medicine, South-1 West-16 Chuo-ku, Sapporo, Hokkaido 060-8543, Japan. 6. Department of Anatomy, Sapporo Medical University School of Medicine, South-1 West-16 Chuo-ku, Sapporo, Hokkaido 060-8543, Japan.
Abstract
BACKGROUND: Numerous biomechanical studies of the lateral ankle ligaments have been reported; however, the isolated function of the calcaneofibular ligament has not been clarified. We hypothesize that the calcaneofibular ligament would stabilize the ankle joint complex under multidirectional loading, and that the in situ force in the calcaneofibular ligament would change in each flexed position. METHODS: Using seven fresh frozen cadaveric lower extremities, the motions and forces of the intact ankle under multidirectional loading were recorded using a 6-degree-of-freedom robotic system. On repeating these intact ankle joint complex motions after the calcaneofibular ligament transection, the in situ force in the calcaneofibular ligament and the contribution of the calcaneofibular ligament to ankle joint complex stability were calculated. Finally, the motions of the calcaneofibular ligament-transected ankle joint complex were recorded. FINDINGS: Under an inversion load, significant increases of inversion angle were observed in all the flexed positions following calcaneofibular ligament transection, and the calcaneofibular ligament accounted for 50%-70% of ankle joint complex stability during inversion. The in situ forces in the calcaneofibular ligament under an anterior force, inversion moment, and external rotation moment were larger in the dorsiflexed position than in the plantarflexed position. INTERPRETATION: The calcaneofibular ligament plays a role in stabilizing the ankle joint complex to multidirectional loads and the role differs with load directions. The in situ force of the calcaneofibular ligament is larger at the dorsiflexed position. This ligament provides the primary restraint to the inversion ankle stability. Copyright Â
BACKGROUND: Numerous biomechanical studies of the lateral ankle ligaments have been reported; however, the isolated function of the calcaneofibular ligament has not been clarified. We hypothesize that the calcaneofibular ligament would stabilize the ankle joint complex under multidirectional loading, and that the in situ force in the calcaneofibular ligament would change in each flexed position. METHODS: Using seven fresh frozen cadaveric lower extremities, the motions and forces of the intact ankle under multidirectional loading were recorded using a 6-degree-of-freedom robotic system. On repeating these intact ankle joint complex motions after the calcaneofibular ligament transection, the in situ force in the calcaneofibular ligament and the contribution of the calcaneofibular ligament to ankle joint complex stability were calculated. Finally, the motions of the calcaneofibular ligament-transected ankle joint complex were recorded. FINDINGS: Under an inversion load, significant increases of inversion angle were observed in all the flexed positions following calcaneofibular ligament transection, and the calcaneofibular ligament accounted for 50%-70% of ankle joint complex stability during inversion. The in situ forces in the calcaneofibular ligament under an anterior force, inversion moment, and external rotation moment were larger in the dorsiflexed position than in the plantarflexed position. INTERPRETATION: The calcaneofibular ligament plays a role in stabilizing the ankle joint complex to multidirectional loads and the role differs with load directions. The in situ force of the calcaneofibular ligament is larger at the dorsiflexed position. This ligament provides the primary restraint to the inversion ankle stability. Copyright Â
Authors: Soichi Hattori; Kentaro Onishi; Calvin K Chan; Satoshi Yamakawa; Yuji Yano; Philipp W Winkler; MaCalus V Hogan; Richard E Debski Journal: Orthop J Sports Med Date: 2022-08-05