The influence of selective arthrodesis on three-dimensional range of motion of hindfoot joint: A cadaveric study

Abstract

BackgroundThe purpose of this study was to measure the three-dimensional range of motion of adjacent, unfused joint or joints after different arthrodesis of hindfoot. MethodsSixteen fresh frozen cadaver feet were immobilized in the non-weight bearing position. The three-dimensional coordinates of markers in tarsal were measured in six directions (involving dorsiflexion-plantarflexion, eversion-inversion, and adduction-abduction) before and after single (involving subtalar joint, talonavicular joint, and calcaneocuboid joint) and double (talonavicular and calcaneocuboid joints) arthrodesis with a three-dimensional coordinate instrument. The range of motion of the joint was calculated with the least square method and matrix transformation. FindingsWe found that the range of motion of joints in all direction was reduced significantly after any combination of selective arthrodesis (all p < 0.001). After arthrodesis of the subtalar joint, the motion of talonavicular joint was reduced by 72%, and that of calcaneocuboid joint by 36%. After arthrodesis of talonavicular joint, the motion of subtalar joint was diminished by 36%, and that of calcaneocuboid joint by 51%. After arthrodesis of calcaneocuboid joint, the motion of subtalar joint was decreased by 21%, and that of talonavicular joint by 42%. After double arthrodesis, the motion of subtalar joint was reduced by 62%. InterpretationIn single arthrodesis, subtalar arthrodesis had the greatest effect on the motion of unfused joints, and the least was the calcaneocuboid arthrodesis. The motion of the subtalar joint was eliminated more than half after double arthrodesis. The data provide a biomechanical rationale to ascertain the clinical implication of the arthrodesis.