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Talonavicular Joint Coverage and Talar Morphology Over Different Foot Types Philip K. Louie 1,2 , William R. Ledoux 1,3,4 , Michael J. Fassbind 1,3 , Bruce J. Sangeorzan 1,4

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Talonavicular Joint Coverage and Talar Morphology Over Different Foot Types

Philip K. Louie1,2, William R. Ledoux1,3,4, Michael J. Fassbind1,3, Bruce J. Sangeorzan1,4

1VA RR&D Center of Excellence for Limb Loss Prevention and Prosthetic Engineering, Seattle, WA, 2School of Medicine, University of WA, Seattle, WA,

Departments of 3Mechanical Engineering and 4Orthopaedics & Sports Medicine, University of Washington, Seattle, WA

INTRODUCTION

The pesplanus and pescavusfoot deformities, as well as talonavicular joint arthritis can present with extreme pain causing deficits in balance and mobility. Characterization of the talonavicular joint coverage and talus morphology will aid in exploring the effects of various surgical and conservative treatment options as well as determining which feet are at greater risk of subsequent talonavicular joint arthritis.

METHODS: Talar Measurements and Positional Relationships

RESULTS

% Joint

Coverage1

TL/TW2

TL/TH2

Foot Type

  • Hyperbolic or elliptic parabaloid was fit to talocrural joint.
  • The fit shape was used to imbed a coordinate system.
  • 2 planes created along 2 axes of the coordinate system to measure dimensions.

PesCavus

Neutrally Aligned

PesPlanus

68.10* 1.512 1.764

75.45 1.432 1.748

71.16 1.436 1.781

PURPOSE

The purpose of this study is to develop 3D computer models of the talonavicular joint to observe biomechanical differences in multiple planes among pescavus, neutrally aligned, and pesplanus feet. In addition, variations in talarmorphology.

We hypothesize that flat feet will have less talonavicular coverage than neutrally aligned or high arched feet. In addition, we hypothesize that talar morphology will be altered among the different foot types.

  • *Significantly different from neutrally aligned
  • 1 partial analysis of 13 pescavus, 19 neutrally algned, and 26 pesplanus
  • 2 partial analysis of 6 pescavus, 6 neutrally aligned, and 10 pesplanus
  • Coordinate systems were imbedded in both the talus head and body
  • Axes used to detemine the angular rotation of the talus head to the talus body

CONCLUSIONS

  • Position of navicular differ between the different foot types
  • Reduced joint coverage in pescavus and pesplanus feet when compared to neutrally aligned
  • Pescavus feet trend towards being longer and narrower than neutrally algined and pesplanus

METHODS: Joint Coverage

L

M

L

L

M

M

L

M

A

B

SIGNIFICANCE

Characterization of the talonavicular joint coverage and talus morphology will aid in exploring the effects of various surgical and conservative treatment options as well as determining which feet are at greater risk of subsequent talonavicular joint arthritis.

PesCavus

Neutrally Aligned

C

D

L

L

L

M

M

M

L

M

  • ACKNOWLEDGEMENTS
  • - University of Washington School of Medicine Medical School Research Training Program (MSRTP)
  • - VA RR&D Grant A4843C
  • - Members of the lab

(A) CT Scan, (B) Simulated Volumetric data, (C) Segmented Talus and Navicular Bone Surfaces, (D) Talus and Navicular Joint Surfaces

Asymptomatic PesPlanus

Symptomatic PesPlanus