Details of a Researcher - TERAMOTO Atsushi

Papers - TERAMOTO Atsushi

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Suture-button fixation and anterior inferior tibiofibular ligament augmentation with suture-tape for syndesmosis injury: A biomechanical cadaveric study.

Hiroaki Shoji, Atsushi Teramoto, Daisuke Suzuki, Yohei Okada, Yuzuru Sakakibara, Takashi Matsumura, Tomoyuki Suzuki, Kota Watanabe, Toshihiko Yamashita

Clinical biomechanics (Bristol, Avon) 60 121 - 126 2018.12 [Refereed] [International journal]

BACKGROUND: Suture-button (SB) fixation has been widely performed for syndesmosis injuries, but it has been reported unstable in some biomechanical studies. The purpose of this study was to evaluate the stability of the syndesmosis using SB fixation with anterior inferior tibiofibular ligament augmentation using suture-tape (ST). METHODS: Eight normal fresh-frozen cadaveric legs were used. After initial tests of intact and injured models, SB fixation, SB fixation with ST augmentation, ST augmentation alone, and screw fixation were performed sequentially for each specimen. Loading tests stimulating dorsiflexion, inversion, and external rotation of the ankle joint were performed for each model. The tibiofibular diastasis (TFD) and the fibular rotational angle related to the tibia (FRA) were measured using a magnetic tracking system. FINDINGS: In the injured model, both TFD and FRA increased significantly compared with the intact model in all directions (P < .05). In the SB fixation model, TFD and FRA generally showed significant increases (P < .05, except for TFD in external rotation). In the SB fixation with ST augmentation model and ST augmentation alone, TFD and FRA were not significantly different compared with the intact model (P > .05). In the screw fixation model, FRA with inversion force at the ankle was significantly decreased compared with the intact model (P = .027). INTERPRETATION: SB fixation alone did not provide stability of the syndesmosis, and screw fixation became too rigid compared with the intact model. Using ST augmentation achieved dynamic stability similar to the intact model for syndesmotic injuries.

DOI PubMed

Early surgical management of traumatic dislocation of the tibialis posterior tendon: a case report and review of the literature.

Yuzuru Sakakibara, Hideji Kura, Atsushi Teramoto, Toshihiko Yamashita

Journal of medical case reports 12 ( 1 ) 348 - 348 2018.11 [Refereed] [International journal]

BACKGROUND: Traumatic dislocation of the tibialis posterior tendon at the ankle is a rare injury. Some of these cases are misdiagnosed as ankle sprains and are not treated properly. In addition, because the conservative treatment is not as effective as the surgical treatment, it is essential that patients be diagnosed early so that proper surgical treatment can be performed. We report the early surgical management of traumatic dislocation of the tibialis posterior tendon. CASE PRESENTATION: A 44-year-old Japanese man, who was a karate coach, was injured while acting as an umpire in a karate competition. On the same day of his injury, he came to our hospital. He complained of swelling and pain in the medial malleolus. Anterior dislocation of the tibialis posterior tendon was detected upon palpation. Magnetic resonance imaging showed the presence of anterior dislocation of the tibialis posterior tendon with retinaculum injury. Four days after the injury, we performed the Das De procedure as the surgical treatment. Three months after the surgery, the patient was able to participate in karate again. CONCLUSIONS: Dislocation of the tibialis posterior tendon is likely to be misdiagnosed, thus delaying the start of proper treatment. It is essential to diagnose the patient accurately by carefully assessing the physical symptoms manifested. Moreover, magnetic resonance imaging can also be used for better diagnosis, thereby leading to an early and proper surgical treatment.

DOI PubMed

Investigation of factors related to the occurrence of osteochondral lesions of the talus by 3D bone morphology of the ankle

Teramoto, A., Shoji, H., Sakakibara, Y., Kamiya, T., Yamashita, T., Kura, H., Watanabe, K.

Bone and Joint Journal 100B ( 11 ) 1487 - 1490 2018.11 [Refereed]

DOI

Effect of Initial Graft Tension During Calcaneofibular Ligament Reconstruction on Ankle Kinematics and Laxity.

Yuzuru Sakakibara, Atsushi Teramoto, Tetsuya Takagi, Satoshi Yamakawa, Yohei Okada, Hiroaki Shoji, Takuma Kobayashi, Mineko Fujimiya, Hiromichi Fujie, Kota Watanabe, Toshihiko Yamashita

The American journal of sports medicine 46 ( 12 ) 2935 - 2941 2018.10 [Refereed] [International journal]

BACKGROUND: Although a variety of surgical procedures for lateral ankle ligament reconstruction have frequently been reported, little is known about the effects of initial graft tension. Purpose/Hypothesis: The purpose was to investigate the effects of initial graft tension in calcaneofibular ligament (CFL) reconstruction. It was hypothesized that a high degree of initial graft tension would cause abnormal kinematics, laxity, and excessive graft tension. STUDY DESIGN: Controlled laboratory study. METHODS: Twelve cadaveric ankles were tested with a 6 degrees of freedom robotic system to apply passive plantarflexion-dorsiflexion motion and multidirectional loads. A repeated-measures experiment was designed with the CFL intact, CFL transected, and CFL reconstructed with 4 initial tension conditions (10, 30, 50, and 70 N). The 3-dimensional path and reconstructed graft tension were simultaneously recorded. RESULTS: The calcaneus in CFL reconstruction with an initial tension of 70 N had the most eversion relative to the intact condition (mean eversion translations of 1.2, 3.0, 5.0, and 6.2 mm were observed at initial tensions of 10, 30, 50, and 70 N, respectively). The calcaneus also moved more posteriorly with external rotation as the initial tension increased. The reconstructed graft tension tended to increase as the initial tension increased. CONCLUSION: Ankle kinematic patterns and laxity after CFL reconstruction tended to become more abnormal as the initial graft tension increased at the time of surgery. Moreover, excessive initial graft tension caused excessive tension on the reconstructed graft. CLINICAL RELEVANCE: This study indicated the importance of initial graft tension during CFL reconstruction. Overtensioning during CFL reconstruction should be avoided to imitate a normal ankle.

DOI PubMed

ACL Function in Bicruciate-Retaining Total Knee Arthroplasty.

Yohei Okada, Atsushi Teramoto, Tetsuya Takagi, Satoshi Yamakawa, Yuzuru Sakakibara, Hiroaki Shoji, Kota Watanabe, Mineko Fujimiya, Hiromichi Fujie, Toshihiko Yamashita

The Journal of bone and joint surgery. American volume 100 ( 17 ) e114 2018.09 [Refereed] [International journal]

BACKGROUND: Bicruciate-retaining total knee arthroplasty (BCR-TKA) is attracting attention because of the functional and satisfaction outcomes associated with keeping the anterior cruciate ligament (ACL) intact. However, knowledge of the functional importance of the ACL after BCR-TKA is limited. We performed a biomechanical investigation of ACL function following BCR-TKA compared with that in the intact knee. METHODS: We investigated 8 fresh-frozen human cadaveric knees using a 6-degrees-of-freedom robotic system that allowed natural joint motion. Three knee states-intact knee, BCR-TKA, and BCR-TKA with ACL transection (BCR-TKA + ACLT)-were evaluated. For each knee state, the kinematics during passive flexion-extension motion (from 0° to 120°) and anteroposterior laxity at 0°, 15°, 30°, 60°, and 90° of flexion in response to a 100-N load were investigated. The recorded knee motions of the intact and BCR-TKA knees during each test were repeated after ACLT to calculate the ACL in situ force. RESULTS: The femur in the BCR-TKA group translated posteriorly and rotated externally during passive knee flexion and was in an anterior position compared with the femur in the intact-knee state. After ACLT, the femur translated posteriorly, compared with the BCR-TKA group, at 0° and 10° (p < 0.05). The anteroposterior laxities of the BCR-TKA and intact knees were comparable at all flexion angles and increased 2-fold or more after ACLT (p < 0.01). The ACL in situ force in the BCR-TKA knees was 2-fold to 6-fold higher than that in the intact knees at 0°, 15°, 90°, and 120° during a passive path (p < 0.05) and equivalent to that in the intact knees under anterior loading. CONCLUSIONS: The preserved ACL in the BCR-TKA knees was functional, like the ACL in the intact knees, under anterior tibial loading and contributed to good anteroposterior stability. However, the kinematics and ACL in situ force differed between the intact and BCR-TKA knees during passive flexion-extension movements. CLINICAL RELEVANCE: Surgeons may not be able to prevent overtensioning of the ACL during a standardized BCR-TKA procedure, which could potentially limit range of motion.

DOI PubMed

Radiographic assessment and clinical outcomes after total knee arthroplasty using an accelerometer-based portable navigation device.

Hiroaki Shoji, Atsushi Teramoto, Tomoyuki Suzuki, Yohei Okada, Kota Watanabe, Toshihiko Yamashita

Arthroplasty today ( Elsevier Inc ) 4 ( 3 ) 319 - 322 2018.09 [Refereed] [International journal]

It has been reported that an accelerometer-based portable navigation device can achieve accurate bone cuts, but there have been few studies of clinical outcomes after total knee arthroplasty (TKA) using such a device. The aim of this study was to evaluate lower limb alignment and clinical outcomes after TKA using an accelerometer-based portable navigation device. Thirty-five patients (40 knees) underwent primary TKAs using an accelerometer-based portable navigation device. Postoperative radiographic assessments included the hip-knee-ankle angle, femoral component angle (FCA), and tibial component angle (TCA) in the coronal plane and the sagittal FCA and sagittal TCA in the sagittal plane. Clinical outcomes were evaluated by the Japanese Orthopedic Association score for osteoarthritic knees, Japanese Knee Osteoarthritis Measure, and the New Knee Society Score. The frequency of outliers (>3 degrees) was 10% for the hip-knee-ankle angle, 8% for FCA, 0% for TCA, 19% for sagittal FCA, and 9% for sagittal TCA. The Japanese Orthopedic Association score and Japanese Knee Osteoarthritis Measure were significantly improved postoperatively. The postoperative New Knee Society Score was 67.2% for symptoms, 50.3% for satisfaction, 58.6% for expectation, and 44.1% for function. TKA using an accelerometer-based portable navigation device achieved good results for both lower limb alignment and clinical outcomes.

DOI PubMed

The distal margin of the lateral malleolus visible under ankle arthroscopy (articular tip) from the anteromedial portal, is separate from the ATFL attachment site of the fibula: A cadaver study.

Atsushi Teramoto, Hiroaki Shoji, Yuzuru Sakakibara, Tomoyuki Suzuki, Kota Watanabe, Toshihiko Yamashita

Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association ( Elsevier ) 23 ( 3 ) 565 - 569 2018.05 [Refereed] [Domestic journal]

PURPOSE: The purpose of this study was to evaluate the relationship between the lateral malleolus view under ankle arthroscopy and the anterior talofibular ligament (ATFL) attachment site. METHODS: Seven normal ankles from Thiel-embalmed cadavers were investigated. Ankle arthroscopy was performed using a 2.7 mm-diameter, 30-degree, oblique-viewing endoscope. An antero-medial portal (AM), a medial midline portal (MML), and an antero-central portal (AC) were created in order, and the ankle arthroscope was inserted. The lateral malleolus was visualized as distally as possible, and the site that appeared to be the distal margin was marked with a 1.5 mm-diameter K-wire. Visualization with arthroscopy was carried out from all portals to mark the distal margin, and the ankle was subsequently exposed to directly measure the distance from the center of the ATFL attachment site at the fibula to each marking. RESULTS: The distances from the ATFL attachment site to the markings made under arthroscopy from the AM, MML, and AC portals were 10.4 ± 2.6 mm, 7.4 ± 1.9 mm, and 7.3 ± 1.9 mm, respectively. Compared to markings made from the MML or AC portal, the marking made from the AM portal was significantly further away from the ATFL attachment site. CONCLUSIONS: A typical ankle arthroscopy portal may not allow complete visualization of the tip of the lateral malleolus, indicating that it may not be feasible to thoroughly observe the ATFL attachment site. It is necessary to perform arthroscopic surgeries with the understanding that the distal margin of the lateral malleolus that appears under ankle arthroscopy is 7-10 mm proximal to the ATFL attachment site.

DOI PubMed

Suture-Button Fixation and Mini-Open Anterior Inferior Tibiofibular Ligament Augmentation Using Suture Tape for Tibiofibular Syndesmosis Injuries

Atsushi Teramoto, Hiroaki Shoji, Yuzuru Sakakibara, Tomoyuki Suzuki, Kota Watanabe, Toshihiko Yamashita

JOURNAL OF FOOT & ANKLE SURGERY ( ELSEVIER SCIENCE INC ) 57 ( 1 ) 159 - 161 2018.01 [Refereed]

Tibiofibular fixation using suture-button implants is an optional method for the surgical treatment of syndesmosis injuries. Although good clinical outcomes have been reported, inadequate stability between the tibia and fibula has also been documented. Thus, suture-button fixation is not considered the reference standard. For surgical treatment of lateral ligament injuries of the ankle, good treatment outcomes have also been reported with ligament augmentation using nonabsorbable suture tape. Ligament augmentation tape with suture-button fixation could also be promising for improved treatment outcomes in syndesmosis injuries. We describe suture-button fixation together with mini-open anterior inferior tibiofibular ligament augmentation using suture tape for treatment of syndesmosis injuries. (C) 2017 by the American College of Foot and Ankle Surgeons. All rights reserved.

DOI PubMed

前距腓靱帯再建術における足関節肢位が足関節キネマティクスと制動性、再建靱帯張力に与える影響

榊原醸, 寺本篤史, 高木鉄也, 山川学志, 岡田葉平, 小路弘晃, 小林拓馬, 神谷智昭, 藤宮峯子, 渡邉耕太, 藤江裕道, 山下敏彦

北海道整形災害外科学会雑誌 ( 北海道整形災害外科学会 ) 60 ( 135th suppl ) 25 - 25 2018

前距腓靱帯再建術における初期固定張力が足関節キネマティクスと制動性に及ぼす影響

榊原醸, 寺本篤史, 高木鉄也, 山川学志, 岡田葉平, 小路弘晃, 小林拓馬, 渡邉耕太, 藤江裕道, 山下敏彦

北海道整形災害外科学会雑誌 ( 北海道整形災害外科学会 ) 60 ( 134th suppl ) 38 - 38 2018

足関節固定術におけるスクリュー内固定とイリザロフ創外固定の治療成績比較

寺本篤史, 野坂光司, 神谷智昭, 柏倉剛, 小路弘晃, 渡邉耕太, 島田洋一, 山下敏彦

北海道整形災害外科学会雑誌 ( 北海道整形災害外科学会 ) 60 ( 135th suppl ) 62 - 62 2018

両十字靱帯温存型TKAにおいてインサート厚がACL及びPCLの張力に与える影響

岡田葉平, 寺本篤史, 高木鉄矢, 山川学志, 榊原醸, 小路弘晃, 渡邉耕太, 藤宮峯子, 藤江裕道, 山下敏彦

北海道整形災害外科学会雑誌 ( 北海道整形災害外科学会 ) 60 ( 134th suppl ) 56 - 56 2018

関節リウマチの滑膜にはアポトーシス抵抗性を示すリン酸化PDGFR陽性細胞が蓄積する

松村崇史, 千見寺貴子, 齋藤悠城, 小笹泰宏, 鈴木智之, 寺本篤史, 山下敏彦, 藤宮峰子

北海道整形災害外科学会雑誌 ( 北海道整形災害外科学会 ) 60 ( 135th suppl ) 57 - 57 2018

超音波診断装置による足部腱滑走距離の評価 Thiel法固定標本を用いた妥当性検証

谷口達也, 渡邉耕太, 寺本篤史

北海道整形災害外科学会雑誌 ( 北海道整形災害外科学会 ) 60 ( 135th suppl ) 60 - 60 2018

Preoperative corrections are required for planning of patient-specific instrumentation in total knee arthroplasty.

Yohei Okada, Atsushi Teramoto, Tomoyuki Suzuki, Yuichiro Kii, Kota Watanabe, Toshihiko Yamashita

The Knee ( Elsevier B.V. ) 24 ( 6 ) 1492 - 1497 2017.12 [Refereed] [International journal]

BACKGROUND: Patient-specific instrumentation (PSI) is attracting attention as a mechanical method of ensuring the accuracy of osteotomy during total knee arthroplasty (TKA). Few studies have focused on preoperative plans; thus, it is unclear how often initial plans have to be corrected preoperatively and intraoperatively. We investigated the frequency of corrections, the accuracy of intraoperative osteotomy, and postoperative alignment. METHODS: We analyzed 45 knees of 40 patients who underwent TKA using magnetic resonance imaging (MRI)-based PSI. We evaluated the frequency of corrections to preoperative plans and intraoperative corrections for each part. We also evaluated osteotomy error, defined as the difference between the planned and actual thickness of resected bone. Hip-knee-ankle angle (HKA), femoral component angle (FCA), and tibial component angle (TCA) on plain X-rays were evaluated for postoperative alignment. RESULTS: Corrections were made to the initial plans in 91.1% of cases with a mean of 3.3 corrections per knee. Intraoperative corrections were made in 57.8% of cases, with a mean of 0.6 corrections per knee. Mean absolute osteotomy error was around one millimeter, and values were within two millimeters over 80% of cases on most parts except the proximal lateral tibia. In terms of postoperative alignment, HKA was 178.5±1.7°, FCA was 89.0±1.6°, and TCA was 89.4±1.9°. Proportions of outliers were 11.1%, 15.6%, and 20.0%, respectively. CONCLUSIONS: Most of the cases required preoperative corrections for planning of PSI. PSI may be useful for ensuring the accuracy of osteotomy and postoperative alignment.

DOI PubMed

Tibiotalocalcaneal Arthrodesis Using a Soft Tissue-Preserved Fibular Graft for Treatment of Large Bone Defects in the Ankle.

Kota Watanabe, Atsushi Teramoto, Takuma Kobayashi, Izaya Ogon, Yuzuru Sakakibara, Tomoaki Kamiya, Tomoyuki Suzuki, Toshihiko Yamashita

Foot & ankle international ( SAGE PUBLICATIONS INC ) 38 ( 6 ) 671 - 676 2017.06 [Refereed] [International journal]

BACKGROUND: Pathogenesis of ankle disorders with a large bone defect is varied and treatment for those problems is challenging for orthopaedic surgeons. The aims of this study were to present an operative technique of arthrodesis for the reconstruction of the ankle and hindfoot with a large bone defect using a soft tissue-preserved fibular strut graft and to report outcomes of consecutively treated patients. METHODS: Twelve feet from 11 patients, including feet with aseptic necrosis of the talus and total ankle implant loosening, were treated. Bone defects were filled using iliac bone and/or resected fibula and tibiotalocalcaneal arthrodesis was performed using a retrograde intramedullary nail. A modified transfibular approach was used to expose the affected joint while preserving the lateral to posterior skin and soft tissues on the fibula. The periods of bony fusion and outcomes were radiographically and clinically evaluated. The mean follow-up period was 33.4 months. RESULTS: Bony fusion was achieved within 3 months in all cases. Coronal and sagittal alignments were acceptable, and the mean American Orthopaedic Foot & Ankle Score improved from 53.8 to 75.5 at the final follow-up. All patients graded their results of treatment as "satisfied." CONCLUSION: This procedure did not require special techniques and it should be applicable to complicated cases with large bone defects. High fusion rates that we believe are due to preserving blood supply to the fibular graft can be expected with preservation of the hindfoot height. LEVEL OF EVIDENCE: Level IV, case series.

DOI PubMed

Soleal vein dilatation assessed by ultrasonography is an independent predictor for deep vein thrombosis after major orthopedic surgery.

Kiyoshi Abe, Satoshi Yuda, Kenji Yasui, Ayumi Okubo, Chihiro Kobayashi, Atsuko Muranaka, Hirofumi Ohnishi, Akiyoshi Hashimoto, Atsushi Teramoto, Satoshi Nagoya, Kazufumi Tsuchihashi, Toshihiko Yamashita, Satoshi Takahashi, Tetsuji Miura

Journal of cardiology ( ELSEVIER SCIENCE BV ) 69 ( 5 ) 756 - 762 2017.05 [Refereed] [International journal]

BACKGROUND: Deep vein thrombosis (DVT) develops after major orthopedic surgery despite the current use of prophylaxis. DVT frequently develops in the soleal vein (SV) and might develop easily at the site of SV dilatation because of blood flow stasis. However, whether preoperative SV dilatation detected by ultrasonography predicts DVT after major orthopedic surgery remains unknown. OBJECTIVE: We examined whether SV dilatation detected by preoperative ultrasonography predicts DVT after major orthopedic surgery. METHODS: Ultrasonography was performed preoperatively and postoperatively in 243 patients with orthopedic diseases (mean age of 67±13 years, 77% women) who underwent total hip arthroplasty (THA, n=180) or total knee arthroplasty (TKA, n=63). Presence of DVT was diagnosed by ultrasonography and SV diameter ≥10mm was defined as SV dilatation. Patients with preoperative DVT were excluded. RESULTS: Sixty-nine patients (28%) developed postoperative DVT. SV dilatation was found in 24 patients (10%), and 16 (67%) of those patients had postoperative DVT. Multivariate logistic regression analysis showed that female gender [odds ratio (OR): 4.09, p=0.004], TKA (OR: 2.52, p=0.011), and SV dilatation (OR: 6.67, p<0.001), but not presence of comorbidities, medications, or plasma d-dimer value, independently predict postoperative DVT. Subgroup analyses according to the operation site showed that female gender (OR: 3.27, p=0.043) and SV dilatation (OR: 3.72, p=0.022) were independent predictors of postoperative DVT in the THA group. SV dilatation (OR: 12.0, p=0.027) was an independent predictor of postoperative DVT also in the TKA group. CONCLUSIONS: In addition to gender and TKA, SV dilatation detected by ultrasonography is an independent predictor of DVT after major orthopedic surgery. Determination of SV diameter by ultrasonography before major orthopedic surgery is useful for assessing the risk of postoperative DVT.

DOI PubMed

Three-dimensional analysis of tarsal bone response to axial loading in patients with hallux valgus and normal feet.

Kota Watanabe, Yasutoshi Ikeda, Daisuke Suzuki, Atsushi Teramoto, Takuma Kobayashi, Tomoyuki Suzuki, Toshihiko Yamashita

Clinical biomechanics (Bristol, Avon) ( ELSEVIER SCI LTD ) 42 65 - 69 2017.02 [Refereed] [International journal]

BACKGROUND: Patients with hallux valgus present a variety of symptoms that may be related to the type of deformity. Weightbearing affects the deformities, and the evaluation of the load response of tarsal bones has been mainly performed using two-dimensional plane radiography. The purpose of this study was to investigate and compare structural changes in the medial foot arch between patients with hallux valgus and normal controls using a computer image analysis technique and weightbearing computed tomography data. METHODS: Eleven patients with hallux valgus and eleven normal controls were included. Computed tomograms were obtained with and without simulated weightbearing using a compression device. Computed tomography data were transferred into a personal computer, and a three-dimensional bone model was created using image analysis software. The load responses of each tarsal bone in the medial foot arch were measured three-dimensionally and statistically compared between the two groups. FINDINGS: Displacement of each tarsal bone under two weightbearing conditions was visually observed by creating three-dimensional bone models. At the first metatarsophalangeal joint, the proximal phalanges of the hallux valgus group showed significantly different displacements in multiple directions. Moreover, opposite responses to axial loading were also observed in both translation and rotation between the two groups. INTERPRETATION: Weightbearing caused deterioration of the hallux valgus deformity three-dimensionally at the first metatarsophalangeal joint. Information from the computer image analysis was useful for understanding details of the pathology of foot disorders related to the deformities or instability and may contribute to the development of effective conservative and surgical treatments.

DOI PubMed

A Novel Rat Model of Ankle Osteoarthritis Induced by the Application of Monoiodoacetate

Jimbo S, Terashima Y, Takebayashi T, Teramoto A, Ogon I, Watanabe K, Sato T, Ichise N, Tohse N, Yamashita T

J Arthritis 6 260 2017 [Refereed]

The in situ force in the calcaneofibular ligament and the contribution of this ligament to ankle joint stability.

Takuma Kobayashi, Satoshi Yamakawa, Kota Watanabe, Kei Kimura, Daisuke Suzuki, Hidenori Otsubo, Atsushi Teramoto, Mineko Fujimiya, Hiromichi Fujie, Toshihiko Yamashita

Clinical biomechanics (Bristol, Avon) ( ELSEVIER SCI LTD ) 40 8 - 13 2016.12 [Refereed] [International journal]

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.

DOI PubMed

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Papers - TERAMOTO Atsushi