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Updated: Jan 17, 2026

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Published on: July 2, 2021
Cardan sequence selection influences subtalar and talonavicular joint kinematics.
Anthony H Le1, Kassidy Knutson2, Andrew C Peterson2
1Department of Biomedical Engineering, University of Utah, 36 S Wasatch Drive, Salt Lake City, UT 84112, USA.
Cardan angle sequences impact foot and ankle joint motion analysis. The XYZ sequence is suitable for tibiotalar, talofibular, and tibiofibular joints, while other sequences are recommended for subtalar and talonavicular joints based on motion type.
Area of Science:
- Biomechanics
- Orthopedics
- Kinesiology
Background:
- Cardan angle sequences are standard for 3D joint rotations.
- Variations in rotation order complicate interpretation, particularly in multiplanar foot and ankle joints.
- Standardization is needed for consistent kinematic analysis.
Purpose of the Study:
- To systematically evaluate how Cardan sequence selection affects foot and ankle joint kinematics.
- To compare the influence of different rotation orders on tibiotalar, talofibular, tibiofibular, subtalar, and talonavicular joints.
- To provide recommendations for optimal Cardan sequence selection based on joint and motion specificity.
Main Methods:
- In vivo biplane fluoroscopy gait analysis.
- In vitro robotic cadaveric simulation for passive joint kinematics.
- Evaluation of six different Cardan sequences for joint angle profiles and range of motion.
Main Results:
- Tibiotalar, talofibular, and tibiofibular joint kinematics showed minimal sequence-dependent variation, supporting the ISB-recommended XYZ sequence.
- Subtalar and talonavicular joint kinematics exhibited significant variations based on Cardan sequence selection.
- Sequences prioritizing Y (inversion/eversion) or Z (internal/external rotation) axes showed the most notable differences.
Conclusions:
- The XYZ Cardan sequence is recommended for tibiotalar, talofibular, and tibiofibular joints.
- Specific sequences (YZX, ZXY, ZYX, XYZ, XZY, YXZ) are recommended for subtalar and talonavicular joints depending on the desired motion (transverse, coronal, sagittal).
- Joint-specific Cardan sequence selection is crucial for improving consistency, reducing crosstalk, and enhancing clinical relevance in foot and ankle kinematic analyses.
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