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Related Experiment Video

Updated: Jan 25, 2026

A Mouse Model of Ankle-Subtalar Complex Joint Instability
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Typical Shape Differences in the Subtalar Joint Bones Between Subjects with Chronic Ankle Instability and Controls.

Nazlı Tümer1, Gwendolyn Vuurberg2,3,4, Leendert Blankevoort2,3,4

  • 1Department of Biomechanical Engineering, Delft University of Technology (TU Delft), Delft, The Netherlands.

Journal of Orthopaedic Research : Official Publication of the Orthopaedic Research Society
|May 2, 2019
PubMed
Summary

Chronic ankle instability (CAI) may be linked to subtalar joint bone shapes. Specific talus and calcaneus bone shapes, like flatter joint surfaces, were found in CAI patients, suggesting a potential risk factor after lateral ankle sprains.

Keywords:
ankle sprainchronic ankle instabilitystatistical shape modelssubtalar joint

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Area of Science:

  • Orthopedics
  • Biomechanics
  • Anatomy

Background:

  • Chronic ankle instability (CAI) is a common sequela of lateral ankle sprain (LAS).
  • The role of subtalar joint (STJ) bone morphology as a risk factor for CAI remains underexplored.
  • Understanding STJ bone shape variations can provide insights into CAI development.

Purpose of the Study:

  • To compare three-dimensional (3D) shape variations of STJ bones between individuals with CAI and healthy controls.
  • To identify specific bone shape characteristics associated with CAI.

Main Methods:

  • 3D statistical shape models (SSMs) were constructed for the talus and calcaneus.
  • A cohort of 26 individuals with unilateral CAI and 26 healthy controls were analyzed.
  • Analysis of covariance was used to compare age- and gender-adjusted bone shape variations.

Main Results:

  • No significant shape differences were found between the talus and calcaneus of the ipsilateral CAI ankle and its contralateral ankle.
  • Significant shape differences were identified between CAI patients and healthy controls for both the talus (p=0.015) and calcaneus (p=0.003).
  • CAI patients exhibited flatter talar joint surfaces and a flattened calcaneal ground-contact surface compared to controls.

Conclusions:

  • Specific bone shapes of the talus and calcaneus are associated with chronic ankle instability.
  • Flatter STJ joint surfaces may represent a morphological risk factor for developing CAI after LAS.
  • These findings highlight the importance of bone morphology in ankle injury susceptibility.