Ligament Balancing for Total Ankle Arthroplasty: An <i>in vitro</i> Evaluation of the Elongation of the Hind- and Midfoot Ligaments
Bibliographic record
Abstract
BACKGROUND: The changes in length of the hindfoot ligaments in response to alterations in ankle and subtalar joint orientation under physiologic load in eight fresh-frozen cadaver limbs were documented. RESULTS: In eversion, the tibiocalcaneal (11% ± 4%, mean ± SD], calcaneofibular (6% ± 4%), posterior talofibular (7% ± 4%), posterolateral talocalcaneal (21% ± 9%), posteromedial talocalcaneal (33% ± 45%) and calcaneonavicular (bifurcate) (8% ± 7%) ligaments were elongated relative to their lengths in inversion. In inversion, the anterior capsular (talocalcaneal) (5% ± 3%) and the plantar cuboidnavicular (5% ± 6%) ligaments were elongated relative to their everted lengths. In dorsiflexion, the superficial (26% ± 8%) and deep posterior tibiotalar (30% ± 13%), calcaneofibular (8% ± 4%), tibiocalcaneal (4% ± 2%) and lateral talocalcaneal (cervical) (2% ± 1%) ligaments were elongated. In plantarflexion, the tibionavicular (26% ± 5%) and the anterior talofibular (7% ± 4%) ligaments were lengthened. No statistically significant elongation was documented in any ankle position for the anterior tibiotalar, talocalcaneal interosseous, plantar calcaneocuboid, calcaneocuboid (bifurcate), all components of the spring ligament, and the dorsal cuboidnavicular ligaments. CONCLUSION: Components of the deltoid ligament complex elongated largest at the ankle joint with any hindfoot movement but inversion. Therefore, selective release of components of the deltoid ligament complex may provide a means for achieving optimal ligament balancing in total ankle arthroplasty. Specifically, release of the superficial and deep posterior tibiotalar ligament may improve range of motion in total ankle arthroplasties, whereas the release of the tibiocalcaneal ligament may correct a varus talar tilt.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".