Association Between Dynamic Tibiotalar Motion and Patient-Reported Outcomes After Total Ankle Arthroplasty With a Total Talar Prosthesis
- 1Department of Orthopaedic Surgery, Nara Medical University, Nara, Japan
- 2Department of Mechanical and Aerospace Engineering, Tokyo University of Science, Noda, Chiba, Japan
- 3Department of Biomedical Engineering, Graduate School of Engineering, Tokyo University of Agriculture and Technology, Tokyo, Japan
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.
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BibTeX
@article{hiroakikurokawamd2026association,
title = {{Association Between Dynamic Tibiotalar Motion and Patient-Reported Outcomes After Total Ankle Arthroplasty With a Total Talar Prosthesis}},
author = {Hiroaki Kurokawa MD, PhD and Rea Ikeda ME and Shinichi Kosugi MD and Masataka Yamamoto PhD and Sayaka Wakiyama MD and Norihiro Tsujimoto MD and Yoshiyuki Kamatani MD and Yinghao Li MD and Nan Mei MSC, PhD and Takuma Miyamoto MD, PhD and Akira Taniguchi MD, PhD and Hiroshi Takemura PhD and Yasuhito Tanaka MD, PhD and Yoshinori Takakura MD, PhD and Kenji Kawamura MD, PhD},
journal = {Foot \& Ankle Orthopaedics},
year = {2026},
month = oct,
doi = {10.1177/24730114261496276},
url = {https://doi.org/10.1177/24730114261496276},
note = {CC BY},
}
RIS
TY - JOUR
TI - Association Between Dynamic Tibiotalar Motion and Patient-Reported Outcomes After Total Ankle Arthroplasty With a Total Talar Prosthesis
AU - Hiroaki Kurokawa MD, PhD
AU - Rea Ikeda ME
AU - Shinichi Kosugi MD
AU - Masataka Yamamoto PhD
AU - Sayaka Wakiyama MD
AU - Norihiro Tsujimoto MD
AU - Yoshiyuki Kamatani MD
AU - Yinghao Li MD
AU - Nan Mei MSC, PhD
AU - Takuma Miyamoto MD, PhD
AU - Akira Taniguchi MD, PhD
AU - Hiroshi Takemura PhD
AU - Yasuhito Tanaka MD, PhD
AU - Yoshinori Takakura MD, PhD
AU - Kenji Kawamura MD, PhD
PY - 2026
DA - 2026/10/25
JO - Foot & Ankle Orthopaedics
DO - 10.1177/24730114261496276
UR - https://doi.org/10.1177/24730114261496276
AB - 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.
SN - 2473-0114
ER -