{
  "abstract": "Background: Although numerous studies have investigated the influence of preoperative deformity and postoperative implant alignment on clinical outcomes after total ankle arthroplasty (TAA), the relationship between dynamic tibiotalar motion and patient-reported outcomes remains unclear. This pilot study investigated whether preoperative, postoperative, and longitudinal changes in computed tomography (CT)-based tibiotalar kinematics are associated with clinical outcomes after combined TAA. Methods: Thirteen ankles that underwent combined TAA for end-stage varus ankle osteoarthritis were retrospectively evaluated. CT was performed preoperatively and 3 months postoperatively with the ankle in active dorsiflexion and plantarflexion under nonweightbearing. Preoperative and postoperative tibial models were registered using a globally optimal iterative closest point algorithm, enabling direct comparison of tibiotalar kinematics within a common tibial coordinate system. Spearman rank correlation was used to assess associations among preoperative kinematics, postoperative kinematics, longitudinal changes, and 2-year postoperative Self-Administered Foot Evaluation Questionnaire (SAFE-Q) scores. Results: All SAFE-Q subscale scores improved significantly ( P < .05 for all) after surgery. Postoperatively, inversion decreased and the rotational pattern between the 2 end positions shifted from external to internal rotation. Postoperative inversion correction, preservation of a physiological internal rotational relationship between the talus and tibia, and plantarflexion-related kinematic parameters showed associations with postoperative SAFE-Q scores. Greater longitudinal correction of plantarflexion inversion and dorsiflexion internal rotation was associated with superior postoperative pain-related outcomes. Conclusion: CT-based tibiotalar kinematics at maximum active dorsiflexion and plantarflexion showed exploratory associations with postoperative patient-reported outcomes after combined TAA. Restoration of postoperative inversion alignment, physiological internal rotational motion, and plantarflexion-related dynamic motion were associated with superior clinical outcomes. Given the small sample size, these findings should be interpreted as hypothesis-generating and require confirmation in larger cohorts. CT-based tibiotalar kinematics assessment using a common tibial coordinate system may provide a basis for further investigation of the relationship between postoperative tibiotalar kinematics and patient-reported outcomes after combined TAA. Level of Evidence: Level III, retrospective cohort study.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Orthopaedic Surgery, Nara Medical University, Nara, Japan",
    "Department of Mechanical and Aerospace Engineering, Tokyo University of Science, Noda, Chiba, Japan",
    "Department of Biomedical Engineering, Graduate School of Engineering, Tokyo University of Agriculture and Technology, Tokyo, Japan"
  ],
  "article_type": null,
  "arxiv": null,
  "author_total": 15,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Hiroaki Kurokawa MD, PhD"
    },
    {
      "affs": [
        1
      ],
      "name": "Rea Ikeda ME"
    },
    {
      "affs": [
        0
      ],
      "name": "Shinichi Kosugi MD"
    },
    {
      "affs": [
        2
      ],
      "name": "Masataka Yamamoto PhD"
    },
    {
      "affs": [
        0
      ],
      "name": "Sayaka Wakiyama MD"
    },
    {
      "affs": [
        0
      ],
      "name": "Norihiro Tsujimoto MD"
    },
    {
      "affs": [
        0
      ],
      "name": "Yoshiyuki Kamatani MD"
    },
    {
      "affs": [
        0
      ],
      "name": "Yinghao Li MD"
    },
    {
      "affs": [
        0
      ],
      "name": "Nan Mei MSC, PhD"
    },
    {
      "affs": [
        0
      ],
      "name": "Takuma Miyamoto MD, PhD"
    },
    {
      "affs": [
        0
      ],
      "name": "Akira Taniguchi MD, PhD"
    },
    {
      "affs": [
        1
      ],
      "name": "Hiroshi Takemura PhD"
    },
    {
      "affs": [
        0
      ],
      "name": "Yasuhito Tanaka MD, PhD"
    },
    {
      "affs": [
        0
      ],
      "name": "Yoshinori Takakura MD, PhD"
    },
    {
      "affs": [
        0
      ],
      "name": "Kenji Kawamura MD, PhD"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/3ajmbdsrwfeze.bib",
  "cited_by": 0,
  "doi": "10.1177/24730114261496276",
  "fulltext_url": "https://doi.org/10.1177/24730114261496276",
  "id": "3ajmbdsrwfeze",
  "issns": [
    "2473-0114"
  ],
  "landing_url": "https://doi.org/10.1177/24730114261496276",
  "language": "en",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "journal",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "lcc",
      "RD701-811"
    ],
    [
      "openalex",
      "2732|Foot and Ankle Surgery"
    ]
  ],
  "openalex": "W7223549034",
  "pdf_url": null,
  "pmcid": null,
  "pmid": null,
  "published": "2026-10-25",
  "publisher": "SAGE Publishing",
  "ris": "https://research.draconitic.com/paper/3ajmbdsrwfeze.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T13:45:33Z",
      "native_id": "3e29fc94086c42d58f42fa24166b0453",
      "source": "doaj",
      "url": "https://doi.org/10.1177/24730114261496276"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2732|Foot and Ankle Surgery",
      "subfield": "surgery"
    }
  ],
  "title": "Association Between Dynamic Tibiotalar Motion and Patient-Reported Outcomes After Total Ankle Arthroplasty With a Total Talar Prosthesis",
  "title_text": "Association Between Dynamic Tibiotalar Motion and Patient-Reported Outcomes After Total Ankle Arthroplasty With a Total Talar Prosthesis",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T13:45:33Z",
  "url": "https://research.draconitic.com/paper/3ajmbdsrwfeze",
  "venue": "Foot & Ankle Orthopaedics",
  "versions": []
}