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Journal of Bone and Joint Surgery - British Volume, Vol 89-B, Issue 12, 1660-1665.
doi: 10.1302/0301-620X.89B12.19849  
Copyright © 2007 by British Editorial Society of Bone and Joint Surgery
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Ankle joint pressure in pes cavovarus

F. Krause, MD, Orthopaedic Surgeon1; M. Windolf, MSc, Engineer2; K. Schwieger, PhD, Head of Research Services2; and M. Weber, MD, Orthopaedic Surgeon1

1 Department of Orthopaedic Surgery, Inselspital, Berne, Freiburgstrasse, CH-3010, Switzerland.
2 AO Research Institute, Clavadelerstrasse 8, Davos Platz, CH-7270, Switzerland.

Correspondence should be sent to Dr M. Weber; e-mail: martin.weber{at}insel.ch

A cavovarus foot deformity was simulated in cadaver specimens by inserting metallic wedges of 15° and 30° dorsally into the first tarsometatarsal joint. Sensors in the ankle joint recorded static tibiotalar pressure distribution at physiological load.

The peak pressure increased significantly from neutral alignment to the 30° cavus deformity, and the centre of force migrated medially. The anterior migration of the centre of force was significant for both the 15° (repeated measures analysis of variance (ANOVA), p = 0.021) and the 30° (repeated measures ANOVA, p = 0.007) cavus deformity. Differences in ligament laxity did not influence the peak pressure.

These findings support the hypothesis that the cavovarus foot deformity causes an increase in anteromedial ankle joint pressure leading to anteromedial arthrosis in the long term, even in the absence of lateral hindfoot instability.






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Hip, Knee, Trauma, Upper limb, Foot & Ankle, Paediatrics, Oncology, Spine, Arthroplasty, General