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01-12-2014 | Review | Uitgave 1/2014 Open Access

Journal of Foot and Ankle Research 1/2014

Biomechanics of the natural, arthritic, and replaced human ankle joint

Journal of Foot and Ankle Research > Uitgave 1/2014
Alberto Leardini, John J O’Connor, Sandro Giannini
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Electronic supplementary material

The online version of this article (doi:10.​1186/​1757-1146-7-8) contains supplementary material, which is available to authorized users.

Competing interests

The Istituto Ortopedico Rizzoli and John O’Connor received royalties for the intellectual properties of the BOX Ankle device, that described in Giannini et al. [84].

Authors’ contributions

AL carried out most of literature review work, and drafted the manuscript. JJOC contributed to the original organisation of the manuscript and edited its final versions. SG participated in the discussions about the anatomical, surgical and clinical issues, and contributed to the right interpretation of the clinical studies from the literature. All authors read and approved the final version of the manuscript.


The human ankle joint complex plays a fundamental role in gait and other activities of daily living. At the same time, it is a very complicated anatomical system but the large literature of experimental and modelling studies has not fully described the coupled joint motion, position and orientation of the joint axis of rotation, stress and strain in the ligaments and their role in guiding and stabilizing joint motion, conformity and congruence of the articular surfaces, patterns of contact at the articular surfaces, patterns of rolling and sliding at the joint surfaces, and muscle lever arm lengths.
The present review article addresses these issues as described in the literature, reporting the most recent relevant findings.

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