In Vivo Foot and Ankle Kinematics During Activities Measured by Using a Dual Fluoroscopic Imaging System: A Narrative Review

Abstract

Foot and ankle joints are complicated anatomical structures that combine the tibiotalar and subtalar joints. They play an extremely important role in walking, running, jumping and other dynamic activities of the human body. The in vivo kinematic analysis of the foot and ankle helps deeply understand the movement characteristics of these structures, as well as identify abnormal joint movements and treat related diseases. However, the technical deficiencies of traditional medical imaging methods limit studies on in vivo foot and ankle biomechanics. During the last decade, the dual fluoroscopic imaging system (DFIS) has enabled the accurate and noninvasive measurements of the dynamic and static activities in the joints of the body. Thus, this method can be utilised to quantify the movement in the single bones of the foot and ankle and analyse different morphological joints and complex bone positions and movement patterns within these organs. Moreover, it has been widely used in the field of image diagnosis and clinical biomechanics evaluation. The integration of existing single DFIS studies has great methodological reference value for future research on the foot and ankle. Therefore, this review evaluated existing studies that applied DFIS to measure the in vivo kinematics of the foot and ankle during various activities in healthy and pathologic populations. The difference between DFIS and traditional biomechanical measurement methods was shown. The advantages and shortcomings of DFIS in practical application were further elucidated, and effective theoretical support and constructive research direction for future studies on the human foot and ankle were provided.

Influence of Shod and Barefoot Running on the In Vivo Kinematics of the First Metatarsophalangeal Joint

“…A high-speed dual fluoroscopic imaging system (DFIS), a noninvasive medical imaging measurement technology, compensates for the limitations of traditional biomechanical methods by dynamically capturing in vivo joint motion without being affected by the relative movement of the skin and other soft tissues ( Ye et al, 2021 ). The measuring precision of the DFIS in determining the joint position and capturing the six-degree-of-freedom (6DOF) motion in bony structures is on the sub-millimeter and sub-degree level, which is suitable for exploring the kinematic characteristics of the foot joint ( Cross et al, 2017 ).…”

Increased subtalar rotational motion in patients with symptomatic ankle instability under load and stress conditions

“…This study employed both axial load and mechanical stress, enabling a comparative analysis of subtalar biomechanics in unilaterally afected patients diagnosed with ankle instability and suspected subtalar instability. Deining subtalar instability biomechanics is technically challenging, thus several methodologies have been proposed to study subtalar joint kinematics [2,31]. Studies performed in vitro [12] do not consider the dynamic stabilizers and proprioceptive mechanisms of the living organism.…”

Human ankle joint movements during walking are probably not determined by talar morphology

“…Future research assessing muscle activity, ligament behaviour and articulating surfaces will be necessary to better understand the determining factors of an ankle joint axis orientation. For this, active movements could be studied using non-invasive techniques such as dual fluoroscopy 25 , which would remove the invasive nature of our approach and possibly allow more participants to be studied.…”