[Loading of the tibiotalar joint and Chopart's joint following subtalar arthrodesis: dynamic cadaver study of 5 specimens]. / Belastung des oberen Sprunggelenkes und des Chopart-Gelenkes infolge der subtalaren Arthrodese: Untersuchung von 5 Kadaverpräparaten in einem dynamischen Modell.

AIM: Little has been known until now about biomechanical intra-articular changes in the condition of adjacent joints following subtalar arthrodeses. METHOD: We tested 5 cadaver specimens in a dynamic axially loaded foot model under computer-regulated load application on 9 extrinsic tendons of the foot regarding changes in load under native conditions and following an anatomically fixed subtalar arthrodesis. RESULTS: We saw an averaged native force transmission in the talonavicular joint of 87 N, increasing post-arthrodesis to 92 N. In the calcaneocuboid joint we measured an increase from 72 N to 74 N. For peak pressure, the increase was from native 3152 kPa to 3286 kPa in the talonavicular joint and in the calcaneocuboid joint we recorded a reduction from 3282 kPa to 3277 kPa. The effects are not striking from a statistical viewpoint. However, we observed a reduction in force from native 103 N to 90 N and in peak pressure from 4778 kPa to 4261 kPa in the ankle. When the ankle was divided into discrete zones in the sagittal and frontal planes there was no evidence of load displacement. CONCLUSION: Our measurements show that anatomically fixed arthrodeses of the talocalcanear joint do not lead to any striking increase in loads on adjacent joints. Any adjacent segment degeneration following subtalar arthrodeses may be the result of changes in joint kinematics or non-anatomically reconstructed hindfoot positions.