The effect of extra-osseous talotarsal stabilization (EOTTS) to reduce medial knee compartment forces – An in vivo study

Autoři: Lukas Kolodziej aff001;  Rodney K. Summers aff002;  Michael E. Graham aff003
Působiště autorů: Clinic of Orthopaedics Traumatology and Orthopaedic Oncology, Pomeranian Medical University, Szczecin, Poland aff001;  Engineering Center for Orthopaedic Research Excellence (ECORE), Departments of Bioengineering and Orthopaedic Surgery, Colleges of Engineering and Medicine, The University of Toledo, Toledo, OH, United States of America aff002;  Department of Foot and Ankle Surgery, Graham International Implant Institute, Macomb, MI, United States of America aff003
Vyšlo v časopise: PLoS ONE 14(12)
Kategorie: Research Article
doi: 10.1371/journal.pone.0224694



Excessive hindfoot pronation, talotarsal joint (TTJ) instability, has been attributed to an increase in medial knee compartment pathology. Advocacy for hindfoot realignment has been the subject of research. An internal solution for TTJ instability, extra-osseous talotarsal stabilization (EOTTS), exists but its effect on knee forces is unknown. This is the first study to measure the in vivo forces acting within the medial knee compartment before and after EOTTS. We hypothesized that following EOTTS there should be a reduction of force acting on the medial knee compartment.


10 fresh frozen cadaver lower extremities exhibiting clinical and radiographic evidence of TTJ instability were evaluated. The proximal femur segment was mounted to a mechanical testing unit. Pressure sensors were placed within the medial knee compartment. A force of 1000 newtons was then applied, and the femur was internally rotated 10 degrees. Measurements were recorded before and after the insertion of a type II EOTTS stent.


Pre-EOTTS resulted in an average of 842 ± 247N acting within the medial knee joint compartment. These forces then decreased to an average of 565 ± 260N (<0.05) following EOTTS, representing an average reduction of force by 32.8%.


EOTTS has been shown to decrease the in vivo forces action within the medial knee compartment. This helps to further illustrate the importance of realigning and stabilizing the hindfoot for the prevention and treatment of chronic knee pain.

Klíčová slova:

Body limbs – Feet – Knee joints – Knees – MTS assay – Osteoarthritis – Skeletal joints – Surgical and invasive medical procedures


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