Different radius of curvature at the talus trochlea measured using 3D model technology

Different radius of curvature at the talus trochlea measured using 3D model technology | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Different radius of curvature at the talus trochlea measured using 3D model technology Shixun Wu, Shizhang Liu, Minggang Huang, Zhe Liu, Jiyuan Shi, and 1 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-3931067/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 9 You are reading this latest preprint version Abstract Background To analyze the curvature characteristics of thetalus trochlea inpeople from Northwest China in different sex and age groups. Methods Computed tomography scanning data of talus from 61 specimens were collected and constructed as a three-dimensional model by MIMICS software, anteromedial(AM), posteromedial(PM), anterolateral(AL), and posterolateral(PL) edge, anterior edge of medial trochlea, posterior edge of medial trochlea and anterior edge of lateral trochlea were defined according to the anatomical landmarks on trochlear surface. The curvature radii for different areas were measured using the fitting radius and measure module. Results There were significant differences among the talus curvatures in the six areas (F=54.905, P =0.000), and more trends in the analytical results were as follows: PM > PL > MP > AL > MA > AM. The average posterolateral radius from specimens aged >38 years old was larger than that from specimens aged<=38 years (t=-2.303, P =0.038). The talus curvature of the AM for males was significantly larger than that for females (t=4.25, P =0.000), and the curvature of the AL for males was larger than that for females (t=2.629, P =0.010). For observers aged <=38 years, the AM curvature of the right talus in the male group was significantly larger than thatin the female group ( P <0.01). In age <=38years group, the MA curvature of right talus in male was significantly larger than in female group( P <0.01), fitting radius of talus for male (21.90±1.97 mm) was significantly greater than female of this(19.57±1.26 mm)(t=6.894, P =000). The average radius of the talus in the male population was larger than that in the female population. Conclusion There was no significant relationship between age and talus curvature in either males or females. The radius of curvature in the posterior area was significantly larger than that in the anterior area. We recommend that this characteristic of the talus trochlea should be considered when designingthe talus component in total ankle replacement (TAR). Curvature of talar trochlea Talus necrosis Osteoarthritis Artificial ankle prosthesis Computer-aided design Figures Figure 1 Figure 2 Figure 3 Figure 4 Figure 5 Figure 6 Figure 7 Background With the continuous improvement of people's understanding of ankle anatomical structure and disease diagnosis and treatment, ankle replacement technology and prosthesis design are constantly updated. Total ankle replacement (TAR) was considered reliable ultimate treatment planning at the end stage of ankle osteoarthritis, talus necrosis, and Kashin-Beck disease. Finite element analysis (FEA) of the ankle joint shows significant instability when the area of the defect exceeds 6 mm * 6 mm[ 1 ]. Osteochondral autologous transplantation (OAT) technology has been used for treating osteochondral lesions of the talus[ 2 – 4 ]; however, the effectiveness of treatment still needs to be confirmed by clinical follow-up results over the long term. Recently, custom 3D-printed titanium implants for treating critically sized bone defects did not need subsequent surgery (1-year follow-up)[ 2 ]. This result suggests that 3D-printed titanium alloy implants can replace damaged bone. Indications for total talus replacement (TTR) have expanded in recent years, and encouraging efficiency has been found, such as following traumatic injury[ 5 ], tumor[ 6 , 7 ], arthrodesis, and idiopathic avascular necrosis[ 8 , 9 ]. However, TTR is not an indication for total ankle arthritis, and adjacent joint arthritis was observed as the most common complication after TTR[ 10 ]. The biological models during finite element analysis of ankle hemiarthroplasty had the largest contact areas and smallest peak contact pressures[ 11 ]. Patients with high BMI ( > = 25 kg/m2) need longer treatment procedures for osteochondral lesions of the talus and have poorer 36-item short-form health survey scores at 24 months postoperation[ 12 ]. Because 60% of the surface of the talar dome is covered by articular cartilage[ 13 ], the blood supply is very poor. These factors lead to easier talar disease, such as arthritis and talar osteonecrosis. The Scandinavian total ankle replacement system is the only fourth-generation ankle prosthesis used in the USA, but the design of the talar component is symmetrically cylindrical[ 14 ], which is not similar to the true talus trochlear shape with different radii curvatures. The design of fourth-generation ankle replacement should consider many factors, including decreased bone resection, minimized disruption of the anterior tibial cortex, anatomically contoured distal tibial trays, and talar components with different curvatures of radii[ 14 ]. Due to various complications[ 15 ], the design of ankle prostheses is not ideal. The first- and second-generation designs were gradually abandoned in the medical market. At present, there are still ankle prostheses with excellent performance, but the ankle talus components are not similar to the normal talus shape design, which may lead to various clinical symptoms after TAR and the reasons for the failure of replacement. Therefore, we use 3D model technology to study the shape of the talus in a realistic way. It will provide believable evidence for optimizing the design of talar prostheses. Materials and methods Specimen acquisition and computer-assisted tool A SOMATOM Definition Flash dual-source CT machine (Siemens Healthineers, Forchheim, Germany) was selected to scan the ankle joint of subjects from Shaanxi Province People’s Hospital. Scan parameters: 120 kV, 205.50 mAs, layer thickness: 0.5-1 mm, all DICOM images (521 px×512 px) in 336 layers for each subject, were imported into a standard segmentation software - Materialise's Interactive Medical Image Control System (MIMICS) 17.0 software (Materialise, Leuven, Belgium), the region of interest (ROI) were extracted using both "Thresholding" and "region growing" module. All 3D models of the talus were automatically produced by the "calulate 3D from mask" functional block and then imported into geomagic stuido 12 to refine the model structure and improve the accuracy of the measurement results. Finally, the STL for the talar model was imported into 3 matic software for anatomical measurement. The computer workstation included a Lenovo thinkpad, Windows 7–64 bit operating system, Intel (R) Core(TM) i7-4600 processor, 8 GB of running memory, and 256 SSD hard disk. All the subjects signed the participant consent form. This research was approved by the Ethics Committee of Shaanxi Provincial People’s Hospital (No. SPPH-LLBG-17-3.2). The CT data of the talus from subjects were collected in both outpatient and inpatient departments of Shaanxi Provincial People’s Hospital. The inclusion criteria were as follows: patients without/with a history of trauma but without fracture or dislocation of the talus. The exclusion criteria were as follows: (1) talar fracture; (2) congenital or acquired skeletal deformity; (3) necrosis of the talus caused by Kashin-Beck disease/rheuma arthritis; and (4) talar tumor from various pathological types. Calibration of the coordinate system To ensure that each talus model had the same three-dimensional position in the 3matic 11.0 software, the object coordinate system (OCS) was formatted to the world coordinate system (WCS) in the 3matic 11.0 software. Origin 0 (0,0,0) was defined as the centerpoint in the world coordinate system (WCS) and is an intersection point caused by 3 orthogonal planes. The XY plane (axial plane), YZ plane (sagittal plane), and ZX plane (coronal plane) were generated separately. Definition of anatomical landmarks on the surface from the talus trochlea According to a previously published method[ 16 ], the anteromedial (AM), posteromedial (PM), anterolateral (AL), and posterolateral (PL) edges of the talar trochlea were defined, as shown in Fig. 1 A. The anterior edge of the medial trochlea and anterior edge of the lateral trochlea were defined as the most anterior point and most posterior point of the anterior trochlea, respectively. The posterior edge of the medial trochlea was defined as the most posterior point of the medial trochlea. The transverse plane (α) was a datum plane created when passing through the anterior edges of the medial trochlea, posterior edges of the medial trochlea and anterior edge of the lateral trochlea (Fig. 1 B). The coronal plane (β) was created as a datum plane perpendicular to α and passing through midpoint 1 (the anterior and posterior edges of the medial trochlea) and midpoint 2 (the anterior edge of the lateral trochlea and posterolateral edge of the talar trochlea). The sagittal plane was set perpendicular to both the transverse plane (α) and coronal plane (β). ( See Fig. 1 C) Centerpoint of talus The intersection (origin 1) of the three coordinate planes (transverse plane, sagittal plane and coronal plane) was calculated by 3matic; then, the midpoint (point 1) of the anteromedial and anterolateral edges and the midpoint (point 2) of the posteromedial and posterolateral edges of the trochlea were defined; next, the midpoint of point 1 and point 2 was marked and projected onto the trochlea surface (point 3). A circle was created according to point 1, point 2 and point 3, and the center of the circle (origin 2) was set as the center of the talus ( see Fig. 1 D). Origin 1 and origin 2 coincided with origin 0, and the centerpoint of the talus coincided with the origin of the WCS. The X axis is created through origin 0 and perpendicular to the sagittal plane, the Y axis is perpendicular to the coronal plane (β) through origin 0, and the Z axis is through origin 0 perpendicular to the transverse plane (α). All parts and analytical primitives in work area were rotated make sure X axis perpendicular to ZY plane, Y axis perpendicular to ZX plane, Z axis perpendicular to YX plane. The coordinate system of the talus is coincident with the WCS. Top point on the trochlear surface Six near coronal sections parallel to the ZY plane were produced, which passed through the anteromedial edge, midpoint of the anteromedial and posteromedial edges, posteromedial edges, anterolateral edge, midpoint of the anterolateral and posterolateral edges, and posterolateral edges previously determined[ 17 ]. The intersection top points between the trochlear surface and six near coronal sections were identified as the anteromedial top, mid-medial top, posteromedial top, anterolateral top, mid-lateral top, and posterolateral top. (Fig. 2 A) Five nearly sagittal sections According to the principle of using three points to determine a plane, an anteromedial section was established when it contained the anteromedial top, mid-medial top, and midpoint between these two tops; in a similar way, a posteromedial section, anterolateral section, and posterolateral section were defined. Each radius of curvature was calculated using the measure module in 3matic.( Fig. 2 B) Additionally, the midsagittal section is the sagittal section in the world coordinate system (WCS) in 3matic 11.0 software. Measured radius of talus curvature First, the talus was cut by the anteromedial section, the midpoint between the anteromedial top and midmedial top was defined based on the length (anteromedial midpoint), and then a circle was established through the three points. The radius was recorded as the anteromedial curvature of the talus (Fig. 3 A). In the same way, the talus was cut by the anterolateral section, the midpoint between the anterolateral top and midlateral top was defined based on the length (anterolateral midpoint), and the anterolateral curvature of the talus was defined as the radius of the circle established through three points (Fig. 3 B). Second, the talus was cut by the posteromedial section, the midpoint between the posteromedial top and midmedial top was defined based on the length (posteromedial midpoint), and the posteromedial curvature of the talus was the radius of the circle established through three points (Fig. 3 C). The talus was cut by the posterolataral section, the midpoint between the posterolataral top and midlataral top was defined based on the length (posterolataral midpoint), and the posterolataral curvature of the talus was the radius of the circle established through three points (Fig. 3 D). Third, the talus was cut by the midsagittal section, the anterior point/superior point/posterior point was marked, the anterior midpoint and posterior midpoint were calculated and marked, and the mid posterior curvature and mid anterior curvature were established through a circle containing three points (Fig. 3 E and 3 F). Fitted radius of talus curvature based on the cylinder Following the normalized coordinate system of the talus, the trochlear surface of the talus was separated as a new part, and an analytical cylinder was fitted using the separated trochlea of the talus. The radius of the analytical cylinder shown on the properties page is similar to the talus curvature (Fig. 4 ). Statistical analysis All measurements of the 3D model in this study, including each trochlea of the talus, were measured by the same researcher. All data were collected and entered into Microsoft Excel 2016, SPSS17.0 statistical software package (SPSS Statistics for Windows, Version 17.0. Chicago: SPSS Inc.) was employed to identify significant differences. Independent sample t tests were used to identify the difference between two sets of data, paired t -tests were used to analyze the difference between the left and right trochlea of the talus, and the results are expressed as the mean ± standard deviation (‾x ± SD). The difference among multiple samples was tested by the LSD multiple comparison method; the relationship between the two variables was analyzed by bivariate correlation analysis. All statistical tests were two-sided, and P < 0.05 was considered statistically significant. Results Baseline information of collected data All specimens from the CT dataset collected according to the inclusion criteria included 61 specimens (28 male and 33 female) that were reconstructed as 91 talus models, including 41 right ankles and 50 left ankles, 31 unilateral ankle joints and 30 bilateral ankle joints. The average age was 37.43 (14 y-69 y), and the median age was 38 years old. Curvature of talar radii Ninety-one ankle joints were selected during the statistical analysis, and the analytical results are shown as the mean ± standard deviation in Table 1 . Additionally, the maximum value and minimum value for each curvature of different areas from all taluses were calculated. Table 1 Average curvature from talar radii (‾X ± SD). Note: AM: anteromedial, AL: anterolateral, PL: posterolateral, PM: posteromedial, MP: mid-posterior, MA: mid-anterior. Area N Curvature(mm) Mean SD Min Max AM 91 15.97 3.08 10.19 25.51 AL 91 22.06 3.94 14.78 38.74 PL 91 27.95 12.08 16.07 89.98 PM 91 34.17 16.22 14.4 91.41 MP 91 22.44 5.05 15.34 52.98 MA 91 16.97 3.09 10.46 27.87 Characteristics of talus curvature in different areas. After analysis of variance with the LSD method, there were significant differences in talus curvature among the six areas (F = 54.905, P = 0.000). The radius of talus curvature between the anteromedial and mid-anterior regions was not significantly different ( P > 0.05), and the radius of talus curvature from the mid-posterior region was larger than that from the anterolateral region, but the result of variance analysis was not significant ( P > 0.05). In generally, radius of talus curvature from posteromedial is significantly larger than this from posterolateral ( P = 0.000), radius of talus curvature from posterolateral is significantly larger than this from mid-posterior and anterolateral ( P = 0.000 and P = 0.000), radius of talus curvature from anterolateral is significantly larger than this from mid-anterior and anteromedial ( P = 0.000 and P = 0.000). The trends in the analytical results were as follows: PM > PL > MP > AL > MA > AM. ( See Fig. 5 ) Age-related difference in the curvature of the right talus The median age was 38 years old, so the radius of curvature from the right talus was categorized according to age. Fifteen talus models in the male population were selected, including 10 specimens less than or equal to 38 years old and 5 specimens older than 38 years. In the statistical results, the average posterolateral radius of specimens older than 38 years old was larger than that of specimens younger than or equal to 38 years old (t=-2.303, P = 0.038), and the differences between these two groups in other areas were not significant. Twenty-six talar models in the female population were selected, including 10 specimens less than or equal to 38 years old and 16 specimens older than 38 years. The average radius of the six areas in our research between the two groups was not statistically significant. Table 2 Comparison of talus curvature from males at different ages for six areas (‾X ± SD). Note: AM: anteromedial, AL: anterolateral, PL: posterolateral, PM: posteromedial, MP: mid-posterior, MA: mid-anterior. Bold means P < 0.05 Right Male t/ p Female t/ p 38y(5) 38y(16) AM(mm) 19.36 ± 3.78 15.80 ± 1.56 1.986/0.069 14.41 ± 1.87 15.47 ± 2.24 -1.244/0.226 AL(mm) 25.53 ± 5.18 22.19 ± 3.34 1.299/0.216 21.03 ± 3.79 20.72 ± 3.55 0.208/0.837 PL(mm) 23.03 ± 3.49 34.71 ± 15.85 -2.303/ 0.038 23.32 ± 4.94 26.32 ± 8.24 -1.036/0.311 PM(mm) 27.71 ± 10.43 38.31 ± 10.64 -1.844/0.088 33.04 ± 18.27 32.45 ± 9.02 0.110/-0.913 MP(mm) 22.22 ± 1.97 25.06 ± 4.86 -1.643/0.124 21.07 ± 3.89 21.00 ± 2.29 0.055/0.956 MA(mm) 19.80 ± 2.54 19.62 ± 4.82 0.095/0.925 15.65 ± 2.48 15.75 ± 3.40 -0.078/0.938 Age-related difference in curvature of the left talus Twenty-two talus models in the male population were selected, including 13 specimens less than or equal to 38 years old and 9 specimens older than 38 years. In the curvature analysis for the six areas, the differences in radius between these two groups were not significant. In the female population, 28 talus models were selected, including 14 specimens less than or equal to 38 years old and 14 specimens older than 38 years. In curvature analysis for six areas, differences in radius in these two groups have no significance. Table 3 Comparison of left talus curvature from males at different ages for different areas (‾X ± SD). Note: AM: anteromedial, AL: anterolateral, PL: posterolateral, PM: posteromedial, MP: mid-posterior, MA: mid-anterior. Left Male t/ p Female t/ p 38y(9) 38y(14) AM(mm) 16.79 ± 3.77 17.36 ± 2.52 -0.389/0.701 14.89 ± 1.95 14.72 ± 3.14 0.175/0.862 AL(mm) 22.39 ± 3.62 22.89 ± 4.39 -0.291/0.774 21.68 ± 3.71 21.36 ± 3.11 0.244/0.809 PL(mm) 32.77 ± 18.86 28.45 ± 11.26 0.613/0.547 29.18 ± 16.91 28.18 ± 7.48 0.203/0.841 PM(mm) 29.37 ± 11.84 29.35 ± 7.44 0.005/0.96 35.24 ± 20.54 46.57 ± 23.46 -1.359/0.186 MP(mm) 23.95 ± 9.31 23.02 ± 3.51 0.288/0.776 21.61 ± 3.62 23.36 ± 6.20 -0.912/0.37 MA(mm) 19.01 ± 3.25 16.87 ± 1.33 1.855/0.078 15.72 ± 1.95 15.79 ± 1.73 -0.092/0.927 Sex-related difference between the left and right talus Thirty-seven talus models in the male population were included (15 right and 22 left). The statistical results show no significant differences between the right and left sides for the six talus areas. Fifty-four talar models in the female population were reconstructed (26 right and 28 left). The statistical results show no significant differences between the right and left sides for the six talus areas. Table 4 Difference between right and left for males and females (‾X ± SD). Note: AM: anteromedial, AL: anterolateral, PL: posterolateral, PM: posteromedial, MP: mid-posterior, MA: mid-anterior. Unmatched Male t/ p Female t/ p Right(15) Left(22) Right(26) Left(28) AM(mm) 18.17 ± 3.59 17.02 ± 3.26 1.009/0.320 15.06 ± 2.13 14.81 ± 2.57 0.400/0.690 AL(mm) 24.42 ± 4.80 22.60 ± 3.86 1.276/0.210 20.84 ± 3.57 21.52 ± 3.37 -0.718/0.476 PL(mm) 26.92 ± 10.59 31.00 ± 16.00 -0.864/0.393 25.17 ± 7.19 28.68 ± 12.84 -1.227/0.225 PM(mm) 31.25 ± 11.35 29.36 ± 10.06 0.531/0.599 32.67 ± 13.00 40.91 ± 22.39 -1.636/0.108 MP(mm) 23.16 ± 3.34 23.57 ± 7.38 -0.198/0.844 21.03 ± 2.93 22.48 ± 5.06 -1.275/0.208 MA(mm) 19.74 ± 3.28 18.13 ± 2.80 1.597/0.119 15.71 ± 3.02 15.76 ± 1.81 -0.063/0.950 Matched comparison between the left talus and right talus Eighteen talus models, including right and left taluses in the male population, were selected, including 9 right taluses and 9 left taluses. After paired t test analysis, there were no significant differences between the right and left sides for the six talus areas. Twenty-one bilateral talar models in the female population were selected, and there were no significant differences between the right and left sides for the six talar areas. Table 5 Matched difference between right and left for males and females (‾X ± SD). Note: AM: anteromedial, AL: anterolateral, PL: posterolateral, PM: posteromedial, MP: mid-posterior, MA: mid-anterior. Matched Male t/ p Female t/ p Right(9) Left(9) Right(21) Left(21) AM(mm) 17.48 ± 3.32 17.16 ± 3.11 0.383/0.711 15.05 ± 2.24 14.27 ± 2.26 1.255/0.224 AL(mm) 25.07 ± 6.26 25.48 ± 2.49 -0.230/0.824 21.14 ± 3.82 21.29 ± 3.39 -0.255/0.801 PL(mm) 30.33 ± 12.55 33.26 ± 11.62 -0.757/0.471 25.98 ± 7.78 30.30 ± 14.28 -1.348/0.193 PM(mm) 35.82 ± 12.71 35.37 ± 12.06 0.125/0.904 34.20 ± 13.80 44.70 ± 24.35 -1.782/0.090 MP(mm) 24.01 ± 4.12 23.41 ± 3.10 0.357/0.731 21.48 ± 2.78 22.85 ± 5.38 -1.231/0.232 MA(mm) 19.97 ± 3.79 18.16 ± 2.45 1.349/0.214 15.59 ± 3.03 15.64 ± 1.74 -0.097/0.924 Curvature difference between males and females An independent t test was used to identify significant differences. The curvature of the AM for males was significantly larger than that for females (t = 4.25, P = 0.000), and the curvature of the AL for males was larger than that for females (t = 2.629, P = 0.010); however, there were no significant differences for all radii of the talus at the PL/PM/MP/MA between males and females (Fig. 6 ). Differences in the right talus in six areas between males and females For observers aged < = 38 years, the AM curvature of the right talus in the male group was significantly larger than that in the female group ( P 38 years was larger than that in the female group ( P < 0.05), and there were no significant differences in other variables between males and females. Table 6 Different right talus radii between males and females in the two age groups (‾X ± SD). Note: AM: anteromedial, AL: anterolateral, PL: posterolateral, PM: posteromedial, MP: mid-posterior, MA: mid-anterior. Bold means P < 0.05. Right 38y t/ p Male(10) Female(10) Male(5) Female(16) AM(mm) 19.36 ± 3.78 14.41 ± 1.87 3.703/ 0.002 15.80 ± 1.56 15.47 ± 2.24 0.309/0.761 AL(mm) 25.53 ± 5.18 21.03 ± 3.79 2.217/0.04 22.19 ± 3.34 20.72 ± 3.55 0.817/0.424 PL(mm) 23.03 ± 3.49 23.32 ± 4.94 -0.152/0.881 34.71 ± 15.85 26.32 ± 8.24 1.587/0.129 PM(mm) 27.71 ± 10.43 33.04 ± 18.27 -0.800/0.434 38.31 ± 10.64 32.45 ± 9.02 1.219/0.238 MP(mm) 22.22 ± 1.97 21.07 ± 3.89 0.830/0.417 25.06 ± 4.86 21.00 ± 2.29 2.619/ 0.017 MA(mm) 19.80 ± 2.54 15.65 ± 2.48 3.694/0.002 19.62 ± 4.82 15.75 ± 3.40 2.019/0.058 Differences in the left talus in six areas between males and females In the age < = 38 years group, the MA curvature of the right talus in males was significantly larger than that in females ( P < 0.01), and there were no significant differences in other variables between males and females. Table 7 Different left talar radii between males and females in the two age groups (‾X ± SD). Note: AM: anteromedial, AL: anterolateral, PL: posterolateral, PM: posteromedial, MP: mid-posterior, MA: mid-anterior. Bold means P < 0.01. left 38y t/ p male(13) female(14) male(9) female(14) AM(mm) 16.79 ± 3.77 14.89 ± 1.95 1.667/0.108 17.36 ± 2.52 14.72 ± 3.14 2.111/0.047 AL(mm) 22.39 ± 3.62 21.68 ± 3.71 0.506/0.617 22.89 ± 4.39 21.36 ± 3.11 0.980/0.338 PL(mm) 32.77 ± 18.86 29.18 ± 16.91 0.521/0.607 28.45 ± 11.26 28.18 ± 7.48 0.070/0.945 PM(mm) 29.37 ± 11.84 35.24 ± 20.54 -0.901/0.376 29.35 ± 7.44 46.57 ± 23.46 -2.120/0.046 MP(mm) 23.95 ± 9.31 21.61 ± 3.62 0.876/0.389 23.01 ± 3.51 23.36 ± 6.20 -0.151/0.882 MA(mm) 19.01 ± 3.25 15.72 ± 1.95 3.211/ 0.004 16.87 ± 1.33 15.79 ± 1.73 1.601/0.124 Fitting radius of talus curvature The average fitted curvature for the talus was 20.52 ± 1.95 mm (range 15.18–25.30). The fitting radius of the talus for males (21.90 ± 1.97 mm) was significantly greater than that for females (19.57 ± 1.26 mm) (t = 6.894, P = 000). The fitting radius of the talus on the right side (20.69 ± 2.00 mm) was similar to that on the left side (20.37 ± 1.92 mm) (t = 0.783, P = 0.436). Correlation analysis between age and fitting talus curvature radius In the correlation analysis, there was no correlation between age and talus curvature in the general analysis (r=-0.015, P = 0.886). Stratified by sex, the fitting radius for the male and female populations was not related to age (r = 0.073, P = 0.666; r = 0.157, P = 0.258); stratified by left and right, the fitting radius for the right and left talus was not related to age (r=-0.061, P = 0.704; r = 0.014, P = 0.921). Discussion Talus ankle replacement is the ultimate treatment for severe ankle diseases. At present, there have been many studies on ankle joint replacement and prosthesis design because the characteristic shape of the human talus vault is irregular and asymmetric, which urges the human ankle joint to complete complex plantar flexion and dorsiflexion. However, it was found that the symmetrical design of the talar prosthesis at present could not meet the patient's activities of flexing the metatarsal dorsum and stretching. Therefore, researchers actively understand the anatomical characteristics of the talus dome and, based on this, design prosthesis components close to the talus structure. Conversely, a study suggested that TAR should be avoided for severe talar osteonecrosis because of subsidence of the talar component caused by poor bone quality[ 18 ]. The most complicated was reported as subsidence from the talus component, and the incidence varies greatly (1–15%)[ 19 , 20 ]. Complications were observed that predispose the structure to fragility and subsidence under the talar component after total ankle arthroplasty (TAA) caused by misposition[ 21 ]. The loosening rate of the talus component after TAR has reached 92%[ 22 ], and the salvage treatment is ankle arthrodesis, which increases the loss of ankle motion. Dorsiflexing of the talar prosthesis during TAA (INFINITY ankle system) was possibly associated with talar component subsidence and limited dorsiflexion range[ 23 ]. We supposed that complications are partly related to the design of the talus component. In a talar topography study of CT images of 21 Caucasian U.S. adult patients suffered from ankle osteoarthritis[ 24 ], and the radius of the talar dome was 20.7 ± 2.6 mm. This result was similar to our measurement; however, our result further disclosed that the curvature between males and females was different in the two different measurement methods, and the radius in males was larger than that in females. In addition, the curvature at AM and AL in the male group was larger than that in the female group. For right talus in male group, radius of AM with age = 38years were greater than in female; for left talus in male group, radius of AM with age < = 38years was greater than in female. The shape of the talus should be constant when it grows; however, a study reported that age is significantly negatively related to curvature at the superior trochlea[ 25 ]. In this study, stratified analysis by sex between the age 38 years group in the left and right sides showed no significant difference during this research; moreover, there was no significant relation between age and fitting talus curvature radius. A novel treatment of customized total talar prosthesis in combination with the tibial component of TAA for ankle revision has been verified to improve JSSF ankle hindfoot scale scores, subjective pain, and range of motion in the ankle[ 26 , 27 ]. Increasing the surface for talus coverage will help stabilize the talus component in TAR[ 28 ], which helps surgeons decide the size of the talus. It was found [ 29 ] that medial crests of the talar dome consisted of two circles with different radii, of which the posterior radius was larger, and the radius of the anterior lateral crests was nearly the same as that of the posterior lateral crests. A Chinese cohort study including 71 talus models also showed that the mean radii of lateral-anterior, lateral-posterior, medial-anterior, and medial-posterior were 19.23 ± 2.47 mm, 18.76 ± 2.90 mm, 17.02 ± 3.49 mm, and 22.75 ± 3.04 mm, respectively; however, these results did not consider sex and age[ 29 ]. This may be the reason for the difference in our research results. Our results revealed the curvature difference of the suprasurface from the talus, which was summarized as follows: PM > PL > MP > AL > MA > AM. However, slight differences were identified when confounding factors were considered, such as age and sex (Fig. 7 ). Therefore, we strongly recommend that joint surgeons consider these factors before TAR. Of course, our study has some limitations, including (1) subjects from Northwest China, which cannot represent all Chinese people; (2) the size of the sample is small, and we need more samples to explore the talus characteristics; and (3) biomechanical analysis by finite element analysis technology on the talus needs to be executed to optimize the performance of the talus component. Conclusions The talus trochlea with different radii allow the ankle joint to complete complex rotation, flexion, and extension activities during walking. Excellent design of the talus component is likely associated with fewer complications after TAR. To our knowledge, this is the first study on the characteristics of talus from Chinese people of different ages and sexes to reduce probable confounding factors. There was no significant relationship between age and talus curvature for either males or females. The average radius of the talus in the male population was larger than that in the female population. The radius of curvature in the posterior area was significantly larger than that in the anterior area. We recommend that this characteristic of the talus trochlea should be considered when designing the talus component in TAR. Our manuscript supplies very important anatomical evidence for designing talus components with different radii curvatures. Abbreviations AM Anteromedial PM Posteromedial AL Anterolateral PL Posterolateral MA Mid-anterior MP Mid-posterior TAR Total ankle replacement FEA Finite element analysis OAT Osteochondral autologous transplantation 3D Three‑dimensional TTR Total talus replacement BMI Body mass index ROI Region of interest OCS Object coordinate system WCS World coordinate system TAA Total ankle arthroplasty Declarations Acknowledgements Not applicable. Author contributions Shixun Wu and Ming Ling designed this research together, Shixun Wu and Jiyuan Shi rebuilt the 3D models, Shixun Wu also measured data and wrote the whole manuscript and revised it. Shizhang Liu and Ming Ling controlled the research quality. Minggang Huang and Zhe Liu collected the CT images. All the authors reviewed the whole paper and agreed to publish the final manuscript. Funding This research was supported by the Social Development Science and Technology Project of Shaanxi Province (Grant No. 2021SF-186 and 2024SF-YBXM-446). Availability of data and materials The data supporting the findings of this study are available within the article and its supplementary information files. Ethics approval and consent to participate This research was approved by the Ethics Committee of Shaanxi Provincial People’s Hospital (No. SPPH-LLBG-17-3.2). Consent for publication I would like to declare on behalf of my co‑authors that the work described was original research that has not been published previously, and not under consideration for publication elsewhere. All the authors listed have approved the manuscript. Competing interests The authors declare that they have no potential competing interests. Author details 1 Department of Orthopedics Surgery, Shaanxi Provincial People’s Hospital, Xi’an, 710068 Shaanxi, China. 2 Department of CT, Shaanxi Provincial People’s Hospital, Xi’an, 710068 Shaanxi, China. 3 Key Laboratory of Bone Joint Disease Basic and Clinical Translation of Shaanxi Province, Xi’an, 710068 Shaanxi, China. References Li J, Wang Y, Wei Y, Kong D, Lin Y, Wang D, et al. The effect of talus osteochondral defects of different area size on ankle joint stability: a finite element analysis. BMC Musculoskelet Disord. 2022;23(1):500. Abar B, Kwon N, Allen NB, Lau T, Johnson LG, Gall K, et al. Outcomes of surgical reconstruction using custom 3D-printed porous titanium implants for critical-sized bone defects of the foot and ankle. Foot Ankle Int. 2022;43(6):750–61. Vogel J, Soti V. Effectiveness of autograft and allograft transplants in treating athletic patients with osteochondral lesions of the talus. Cureus. 2022;14(10):e29913. Wan DD, Huang H, Hu MZ, Dong QY. Results of the osteochondral autologous transplantation for treatment of osteochondral lesions of the talus with harvesting from the ipsilateral talar articular facets. Int Orthop. 2022;46(7):1547–55. Katsui R, Takakura Y, Taniguchi A, Tanaka Y. Ceramic artificial talus as the initial treatment for comminuted talar fractures. Foot Ankle Int. 2020;41(1):79–83. Huang J, Xie F, Tan X, Xing W, Zheng Y, Zeng C. Treatment of osteosarcoma of the talus with a 3D-printed talar prosthesis. J Foot Ankle Surg. 2021;60(1):194–98. Yang QD, Mu MD, Tao X, Tang KL. Three-dimensional printed talar prosthesis with biological function for giant cell tumor of the talus: A case report and review of the literature. World J Clin Cases. 2021;9(13):3147–56. Mu MD, Yang QD, Chen W, Tao X, Zhang CK, Zhang X, et al. Three dimension printing talar prostheses for total replacement in talar necrosis and collapse. Int Orthop. 2021;45(9):2313–21. Kadakia RJ, Akoh CC, Chen J, Sharma A, Parekh SG. 3D printed total talus replacement for avascular necrosis of the talus. Foot Ankle Int. 2020;41(12):1529–36. Johnson LG, Anastasio AT, Fletcher AN, Hendren S, Adams SB. Outcomes following total talus replacement: A systematic review. Foot Ankle Surg. 2022;28(8):1194–201. Liu T, Jomha N, Adeeb S, El-Rich M, Westover L. The evaluation of artificial talus implant on ankle joint contact characteristics: a finite element study based on four subjects. Med Biol Eng Comput. 2022;60(4):1139–58. Koh D, Tan M, Zhan X, Li Z, Tay KS, Tan SM, et al. Association of elevated body mass index and outcomes of arthroscopic treatment for osteochondral lesions of the talus. Foot Ankle Orthop. 2022; doi: 10.1177/24730114221103263 . Fernandez A, Poggio D, Llusa M, Alvarez C, Cufi PM. Graphic representation of intraosseous and extraosseous talus blood supply. Rev Esp Cir Ortop Traumatol. 2022;66(5):341–47. Gross CE, Palanca AA, DeOrio JK. Design rationale for total ankle arthroplasty systems: an update. J Am Acad Orthop Surg. 2018;26(10):353–59. Williams JR, Wegner NJ, Sangeorzan BJ, Brage ME. Intraoperative and perioperative complications during revision arthroplasty for salvage of a failed total ankle arthroplasty. Foot and ankle international. 2015;36(2):135–42. Yamaguchi S, Sasho T, Kato H, Kuroyanagi Y, Banks SA. Ankle and subtalar kinematics during dorsiflexion-plantarflexion activities. Foot Ankle Int. 2009;30(4):361–66. Nozaki S, Watanabe K, Kato T, Miyakawa T, Kamiya T, Katayose M. Radius of curvature at the talocrural joint surface: inference of subject-specific kinematics. Surg Radiol Anat. 2019;41(1):53–64. Guyer AJ, Richardson G. Current concepts review: total ankle arthroplasty. Foot Ankle Int. 2008;29(2):256–64. Bonnin M, Judet T, Colombier JA, Buscayret F, Graveleau N, Piriou P. Midterm results of the Salto total ankle prosthesis. Clin Orthop Relat Res. 2004(424):6–18. Buechel FS, Buechel FJ, Pappas MJ. Twenty-year evaluation of cementless mobile-bearing total ankle replacements. Clin Orthop Relat Res. 2004(424):19–26. Li SY, Myerson MS. Management of talar component subsidence. Foot Ankle Clin. 2017;22(2):361–89. Gross C, Erickson BJ, Adams SB, Parekh SG. Ankle arthrodesis after failed total ankle replacement: a systematic review of the literature. Foot Ankle Spec. 2015;8(2):143–51. Le V, Escudero M, Symes M, Salat P, Wing K, Younger A, et al. Impact of sagittal talar inclination on total ankle replacement failure. Foot Ankle Int. 2019;40(8):900–04. Hayes A, Tochigi Y, Saltzman CL. Ankle morphometry on 3D-CT images. Iowa Orthop J. 2006;26(1):1–4. Nozaki S, Watanabe K, Teramoto A, Kamiya T, Katayose M, Ogihara N. Sex- and age-related variations in the three-dimensional orientations and curvatures of the articular surfaces of the human talus. Anat Sci Int. 2021;96(2):258–64. Morita S, Taniguchi A, Miyamoto T, Kurokawa H, Tanaka Y. Application of a customized total talar prosthesis for revision total ankle arthroplasty. JBJS Open Access. 2020;5(4):e20-34. Tracey J, Arora D, Gross CE, Parekh SG. Custom 3D-printed total talar prostheses restore normal joint anatomy throughout the hindfoot. Foot Ankle Spec. 2019;12(1):39–48. Cerrato R, Myerson MS. Total ankle replacement: the Agility LP prosthesis. Foot Ankle Clin. 2008;13(3):485–94. Zhao DH, Huang DC, Zhang GH, Fan YP, Yu J, Wang SB, et al. Talar dome investigation and talocrural joint axis analysis based on three-dimensional (3D) models: implications for prosthetic design. Biomed Res Int. 2019;2019(1):1–10. Additional Declarations No competing interests reported. Cite Share Download PDF Status: Under Review Version 1 posted Editorial decision: Revision requested 09 Mar, 2024 Reviews received at journal 09 Mar, 2024 Reviewers agreed at journal 27 Feb, 2024 Reviews received at journal 23 Feb, 2024 Reviewers agreed at journal 15 Feb, 2024 Reviewers invited by journal 14 Feb, 2024 Editor assigned by journal 08 Feb, 2024 Submission checks completed at journal 07 Feb, 2024 First submitted to journal 05 Feb, 2024 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-3931067","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":271792734,"identity":"4797209c-32f5-423a-b5ec-67543fd2e2e5","order_by":0,"name":"Shixun Wu","email":"","orcid":"","institution":"Shaanxi Provincial People's Hospital","correspondingAuthor":false,"prefix":"","firstName":"Shixun","middleName":"","lastName":"Wu","suffix":""},{"id":271792735,"identity":"df9bbc05-eed5-43bb-9228-0654f6f72a5e","order_by":1,"name":"Shizhang Liu","email":"","orcid":"","institution":"Shaanxi Provincial People's Hospital","correspondingAuthor":false,"prefix":"","firstName":"Shizhang","middleName":"","lastName":"Liu","suffix":""},{"id":271792736,"identity":"21f13f91-65ea-4013-a65a-c3d124f8d003","order_by":2,"name":"Minggang Huang","email":"","orcid":"","institution":"Shaanxi Provincial People's Hospital","correspondingAuthor":false,"prefix":"","firstName":"Minggang","middleName":"","lastName":"Huang","suffix":""},{"id":271792737,"identity":"95c22593-368a-44c0-b80f-37bb8b55fb7d","order_by":3,"name":"Zhe Liu","email":"","orcid":"","institution":"Shaanxi Provincial People's Hospital","correspondingAuthor":false,"prefix":"","firstName":"Zhe","middleName":"","lastName":"Liu","suffix":""},{"id":271792738,"identity":"dc91ff13-cd9b-4690-bd46-79612ba0bb5a","order_by":4,"name":"Jiyuan Shi","email":"","orcid":"","institution":"Shaanxi Provincial People's Hospital","correspondingAuthor":false,"prefix":"","firstName":"Jiyuan","middleName":"","lastName":"Shi","suffix":""},{"id":271792739,"identity":"756d87c5-b7c7-495a-a9cd-c20957402174","order_by":5,"name":"Ming Ling","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAAyklEQVRIiWNgGAWjYFAC5oYDDAwSPGwMhw8c+PCDKC2MIC02MnyMxxIPzuwhUguQSLORYz5jfJiDjQgNug2MjYcLfh3mYWM78+EwAw+DPL/YAfxazA4wNhye2QfUwnN2w+ECCwbDmbMTiNDC2wPUIgHUMoOHIcHgNtFa5N88AJLEauH5kQZUfIaBSC2HQbY02AAVHzMABrIEEX453nz4M88fCXv5hsOPP3z4YSPPL01ACwMzEDO2wbkSBJTDwR9iFY6CUTAKRsGIBABcIEnhxTbIngAAAABJRU5ErkJggg==","orcid":"","institution":"Shaanxi Provincial People's Hospital","correspondingAuthor":true,"prefix":"","firstName":"Ming","middleName":"","lastName":"Ling","suffix":""}],"badges":[],"createdAt":"2024-02-05 13:33:45","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-3931067/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-3931067/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":50893477,"identity":"fe0c16b8-ddbb-4711-bd66-74c96fbb6962","added_by":"auto","created_at":"2024-02-09 05:42:06","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":422217,"visible":true,"origin":"","legend":"\u003cp\u003eStandardization of the talus model based on anatomical landmarks. Seven anatomical top points on the talus trochlea;\u003cstrong\u003e B\u003c/strong\u003e. determining the transverse plane a based on three anatomical points; \u003cstrong\u003eC\u003c/strong\u003e. determining the sagittal plane and coronal plane based on the transverse plane a; \u003cstrong\u003eD\u003c/strong\u003e. fitting the origin point of the talus by three points)\u003c/p\u003e","description":"","filename":"image1.png","url":"https://assets-eu.researchsquare.com/files/rs-3931067/v1/c1e1ac25272289f677cbe551.png"},{"id":50893397,"identity":"167eb1c8-6e16-45cc-ad0f-c3419206f9bd","added_by":"auto","created_at":"2024-02-09 05:34:06","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":228313,"visible":true,"origin":"","legend":"\u003cp\u003eDefinition of the top point in six areas (\u003cstrong\u003eA\u003c/strong\u003e) and four sections (\u003cstrong\u003eB\u003c/strong\u003e)\u003c/p\u003e","description":"","filename":"image2.png","url":"https://assets-eu.researchsquare.com/files/rs-3931067/v1/7c3a1a2c3f8197d5f035c8af.png"},{"id":50893073,"identity":"a4903aa1-60cd-4160-96db-0ac82d785152","added_by":"auto","created_at":"2024-02-09 05:26:06","extension":"png","order_by":3,"title":"Figure 3","display":"","copyAsset":false,"role":"figure","size":272495,"visible":true,"origin":"","legend":"\u003cp\u003eCurvature of talus in different areas(\u003cstrong\u003eA\u003c/strong\u003e,anteromedial(AM); \u003cstrong\u003eB\u003c/strong\u003e,anterolateral(AL); \u003cstrong\u003eC\u003c/strong\u003e,posteromedial(PM); \u003cstrong\u003eD\u003c/strong\u003e, posterolateral(PL); \u003cstrong\u003eE\u003c/strong\u003e,mid-anterior(MA); \u003cstrong\u003eF\u003c/strong\u003e,mid-posterior(MP).)\u003c/p\u003e","description":"","filename":"image3.png","url":"https://assets-eu.researchsquare.com/files/rs-3931067/v1/8de52135fdaeac563fe4cdfe.png"},{"id":50893072,"identity":"bfe88968-f9b6-4a5a-a4af-8c4123d3dc36","added_by":"auto","created_at":"2024-02-09 05:26:06","extension":"png","order_by":4,"title":"Figure 4","display":"","copyAsset":false,"role":"figure","size":358755,"visible":true,"origin":"","legend":"\u003cp\u003eSchematic diagram for fitting the radius of curvature.\u003c/p\u003e","description":"","filename":"image4.png","url":"https://assets-eu.researchsquare.com/files/rs-3931067/v1/b62b651a95fb26009f314618.png"},{"id":50893076,"identity":"e0039f80-560e-4369-91c8-300695a7fb9d","added_by":"auto","created_at":"2024-02-09 05:26:06","extension":"png","order_by":5,"title":"Figure 5","display":"","copyAsset":false,"role":"figure","size":5155,"visible":true,"origin":"","legend":"\u003cp\u003eTrends in the size of the talus curvature.\u003c/p\u003e","description":"","filename":"image5.png","url":"https://assets-eu.researchsquare.com/files/rs-3931067/v1/e17b9121ab1185a91e71cc46.png"},{"id":50893077,"identity":"eae9a325-14bf-4b50-8beb-b5d40ef132d7","added_by":"auto","created_at":"2024-02-09 05:26:06","extension":"png","order_by":6,"title":"Figure 6","display":"","copyAsset":false,"role":"figure","size":6247,"visible":true,"origin":"","legend":"\u003cp\u003eDifferences between males and females in six areas.\u003c/p\u003e","description":"","filename":"image6.png","url":"https://assets-eu.researchsquare.com/files/rs-3931067/v1/622c0252386b97f7fa5f6b77.png"},{"id":50893078,"identity":"bfc4ac2f-2ffb-40a1-9ff4-db950686c4f6","added_by":"auto","created_at":"2024-02-09 05:26:06","extension":"png","order_by":7,"title":"Figure 7","display":"","copyAsset":false,"role":"figure","size":178994,"visible":true,"origin":"","legend":"\u003cp\u003eChange trend for different subject populations in six areas.\u003c/p\u003e","description":"","filename":"image7.png","url":"https://assets-eu.researchsquare.com/files/rs-3931067/v1/7a6566f3a5adc20832997706.png"},{"id":50893478,"identity":"9151c93f-f1a7-4277-b06c-3ade304dfce9","added_by":"auto","created_at":"2024-02-09 05:42:14","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":2418384,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-3931067/v1/c0bd0ee7-6398-4d92-8791-53b069b8ca92.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Different radius of curvature at the talus trochlea measured using 3D model technology","fulltext":[{"header":"Background","content":"\u003cp\u003eWith the continuous improvement of people's understanding of ankle anatomical structure and disease diagnosis and treatment, ankle replacement technology and prosthesis design are constantly updated. Total ankle replacement (TAR) was considered reliable ultimate treatment planning at the end stage of ankle osteoarthritis, talus necrosis, and Kashin-Beck disease.\u003c/p\u003e \u003cp\u003eFinite element analysis (FEA) of the ankle joint shows significant instability when the area of the defect exceeds 6 mm * 6 mm[\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]. Osteochondral autologous transplantation (OAT) technology has been used for treating osteochondral lesions of the talus[\u003cspan additionalcitationids=\"CR3\" citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]; however, the effectiveness of treatment still needs to be confirmed by clinical follow-up results over the long term. Recently, custom 3D-printed titanium implants for treating critically sized bone defects did not need subsequent surgery (1-year follow-up)[\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]. This result suggests that 3D-printed titanium alloy implants can replace damaged bone.\u003c/p\u003e \u003cp\u003eIndications for total talus replacement (TTR) have expanded in recent years, and encouraging efficiency has been found, such as following traumatic injury[\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e], tumor[\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e, \u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e], arthrodesis, and idiopathic avascular necrosis[\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e, \u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e]. However, TTR is not an indication for total ankle arthritis, and adjacent joint arthritis was observed as the most common complication after TTR[\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eThe biological models during finite element analysis of ankle hemiarthroplasty had the largest contact areas and smallest peak contact pressures[\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e]. Patients with high BMI (\u0026thinsp;\u0026gt;\u0026thinsp;=\u0026thinsp;25 kg/m2) need longer treatment procedures for osteochondral lesions of the talus and have poorer 36-item short-form health survey scores at 24 months postoperation[\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e]. Because 60% of the surface of the talar dome is covered by articular cartilage[\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e], the blood supply is very poor. These factors lead to easier talar disease, such as arthritis and talar osteonecrosis.\u003c/p\u003e \u003cp\u003eThe Scandinavian total ankle replacement system is the only fourth-generation ankle prosthesis used in the USA, but the design of the talar component is symmetrically cylindrical[\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e], which is not similar to the true talus trochlear shape with different radii curvatures. The design of fourth-generation ankle replacement should consider many factors, including decreased bone resection, minimized disruption of the anterior tibial cortex, anatomically contoured distal tibial trays, and talar components with different curvatures of radii[\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eDue to various complications[\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e], the design of ankle prostheses is not ideal. The first- and second-generation designs were gradually abandoned in the medical market. At present, there are still ankle prostheses with excellent performance, but the ankle talus components are not similar to the normal talus shape design, which may lead to various clinical symptoms after TAR and the reasons for the failure of replacement. Therefore, we use 3D model technology to study the shape of the talus in a realistic way. It will provide believable evidence for optimizing the design of talar prostheses.\u003c/p\u003e"},{"header":"Materials and methods","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eSpecimen acquisition and computer-assisted tool\u003c/h2\u003e \u003cp\u003eA SOMATOM Definition Flash dual-source CT machine (Siemens Healthineers, Forchheim, Germany) was selected to scan the ankle joint of subjects from Shaanxi Province People\u0026rsquo;s Hospital. Scan parameters: 120 kV, 205.50 mAs, layer thickness: 0.5-1 mm, all DICOM images (521 px\u0026times;512 px) in 336 layers for each subject, were imported into a standard segmentation software - Materialise's Interactive Medical Image Control System (MIMICS) 17.0 software (Materialise, Leuven, Belgium), the region of interest (ROI) were extracted using both \"Thresholding\" and \"region growing\" module. All 3D models of the talus were automatically produced by the \"calulate 3D from mask\" functional block and then imported into geomagic stuido 12 to refine the model structure and improve the accuracy of the measurement results. Finally, the STL for the talar model was imported into 3 matic software for anatomical measurement. The computer workstation included a Lenovo thinkpad, Windows 7\u0026ndash;64 bit operating system, Intel (R) Core(TM) i7-4600 processor, 8 GB of running memory, and 256 SSD hard disk. All the subjects signed the participant consent form. This research was approved by the Ethics Committee of Shaanxi Provincial People\u0026rsquo;s Hospital (No. SPPH-LLBG-17-3.2).\u003c/p\u003e \u003cp\u003eThe CT data of the talus from subjects were collected in both outpatient and inpatient departments of Shaanxi Provincial People\u0026rsquo;s Hospital. The inclusion criteria were as follows: patients without/with a history of trauma but without fracture or dislocation of the talus. The exclusion criteria were as follows: (1) talar fracture; (2) congenital or acquired skeletal deformity; (3) necrosis of the talus caused by Kashin-Beck disease/rheuma arthritis; and (4) talar tumor from various pathological types.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec4\" class=\"Section2\"\u003e \u003ch2\u003eCalibration of the coordinate system\u003c/h2\u003e \u003cp\u003eTo ensure that each talus model had the same three-dimensional position in the 3matic 11.0 software, the object coordinate system (OCS) was formatted to the world coordinate system (WCS) in the 3matic 11.0 software. Origin 0 (0,0,0) was defined as the centerpoint in the world coordinate system (WCS) and is an intersection point caused by 3 orthogonal planes. The XY plane (axial plane), YZ plane (sagittal plane), and ZX plane (coronal plane) were generated separately.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec5\" class=\"Section2\"\u003e \u003ch2\u003eDefinition of anatomical landmarks on the surface from the talus trochlea\u003c/h2\u003e \u003cp\u003eAccording to a previously published method[\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e], the anteromedial (AM), posteromedial (PM), anterolateral (AL), and posterolateral (PL) edges of the talar trochlea were defined, as shown in Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003eA. The anterior edge of the medial trochlea and anterior edge of the lateral trochlea were defined as the most anterior point and most posterior point of the anterior trochlea, respectively. The posterior edge of the medial trochlea was defined as the most posterior point of the medial trochlea.\u003c/p\u003e \u003cp\u003eThe transverse plane (α) was a datum plane created when passing through the anterior edges of the medial trochlea, posterior edges of the medial trochlea and anterior edge of the lateral trochlea (Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003eB). The coronal plane (β) was created as a datum plane perpendicular to α and passing through midpoint 1 (the anterior and posterior edges of the medial trochlea) and midpoint 2 (the anterior edge of the lateral trochlea and posterolateral edge of the talar trochlea). The sagittal plane was set perpendicular to both the transverse plane (α) and coronal plane (β). (\u003cb\u003eSee\u003c/b\u003e Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003eC)\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec6\" class=\"Section2\"\u003e \u003ch2\u003eCenterpoint of talus\u003c/h2\u003e \u003cp\u003eThe intersection (origin 1) of the three coordinate planes (transverse plane, sagittal plane and coronal plane) was calculated by 3matic; then, the midpoint (point 1) of the anteromedial and anterolateral edges and the midpoint (point 2) of the posteromedial and posterolateral edges of the trochlea were defined; next, the midpoint of point 1 and point 2 was marked and projected onto the trochlea surface (point 3). A circle was created according to point 1, point 2 and point 3, and the center of the circle (origin 2) was set as the center of the talus (\u003cb\u003esee\u003c/b\u003e Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003eD).\u003c/p\u003e \u003cp\u003eOrigin 1 and origin 2 coincided with origin 0, and the centerpoint of the talus coincided with the origin of the WCS. The X axis is created through origin 0 and perpendicular to the sagittal plane, the Y axis is perpendicular to the coronal plane (β) through origin 0, and the Z axis is through origin 0 perpendicular to the transverse plane (α). All parts and analytical primitives in work area were rotated make sure X axis perpendicular to ZY plane, Y axis perpendicular to ZX plane, Z axis perpendicular to YX plane. The coordinate system of the talus is coincident with the WCS.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec7\" class=\"Section2\"\u003e \u003ch2\u003eTop point on the trochlear surface\u003c/h2\u003e \u003cp\u003eSix near coronal sections parallel to the ZY plane were produced, which passed through the anteromedial edge, midpoint of the anteromedial and posteromedial edges, posteromedial edges, anterolateral edge, midpoint of the anterolateral and posterolateral edges, and posterolateral edges previously determined[\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e]. The intersection top points between the trochlear surface and six near coronal sections were identified as the anteromedial top, mid-medial top, posteromedial top, anterolateral top, mid-lateral top, and posterolateral top. (Fig.\u0026nbsp;\u003cspan refid=\"Fig2\" class=\"InternalRef\"\u003e2\u003c/span\u003eA)\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec8\" class=\"Section2\"\u003e \u003ch2\u003eFive nearly sagittal sections\u003c/h2\u003e \u003cp\u003eAccording to the principle of using three points to determine a plane, an anteromedial section was established when it contained the anteromedial top, mid-medial top, and midpoint between these two tops; in a similar way, a posteromedial section, anterolateral section, and posterolateral section were defined. Each radius of curvature was calculated using the \u003cem\u003emeasure\u003c/em\u003e module in 3matic.( Fig.\u0026nbsp;\u003cspan refid=\"Fig2\" class=\"InternalRef\"\u003e2\u003c/span\u003eB) Additionally, the midsagittal section is the sagittal section in the world coordinate system (WCS) in 3matic 11.0 software.\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec9\" class=\"Section2\"\u003e \u003ch2\u003eMeasured radius of talus curvature\u003c/h2\u003e \u003cp\u003eFirst, the talus was cut by the anteromedial section, the midpoint between the anteromedial top and midmedial top was defined based on the length (anteromedial midpoint), and then a circle was established through the three points. The radius was recorded as the anteromedial curvature of the talus (Fig.\u0026nbsp;\u003cspan refid=\"Fig3\" class=\"InternalRef\"\u003e3\u003c/span\u003eA). In the same way, the talus was cut by the anterolateral section, the midpoint between the anterolateral top and midlateral top was defined based on the length (anterolateral midpoint), and the anterolateral curvature of the talus was defined as the radius of the circle established through three points (Fig.\u0026nbsp;\u003cspan refid=\"Fig3\" class=\"InternalRef\"\u003e3\u003c/span\u003eB).\u003c/p\u003e \u003cp\u003eSecond, the talus was cut by the posteromedial section, the midpoint between the posteromedial top and midmedial top was defined based on the length (posteromedial midpoint), and the posteromedial curvature of the talus was the radius of the circle established through three points (Fig.\u0026nbsp;\u003cspan refid=\"Fig3\" class=\"InternalRef\"\u003e3\u003c/span\u003eC). The talus was cut by the posterolataral section, the midpoint between the posterolataral top and midlataral top was defined based on the length (posterolataral midpoint), and the posterolataral curvature of the talus was the radius of the circle established through three points (Fig.\u0026nbsp;\u003cspan refid=\"Fig3\" class=\"InternalRef\"\u003e3\u003c/span\u003eD).\u003c/p\u003e \u003cp\u003eThird, the talus was cut by the midsagittal section, the anterior point/superior point/posterior point was marked, the anterior midpoint and posterior midpoint were calculated and marked, and the mid posterior curvature and mid anterior curvature were established through a circle containing three points (Fig.\u0026nbsp;\u003cspan refid=\"Fig3\" class=\"InternalRef\"\u003e3\u003c/span\u003eE and \u003cspan refid=\"Fig3\" class=\"InternalRef\"\u003e3\u003c/span\u003eF).\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec10\" class=\"Section2\"\u003e \u003ch2\u003eFitted radius of talus curvature based on the cylinder\u003c/h2\u003e \u003cp\u003eFollowing the normalized coordinate system of the talus, the trochlear surface of the talus was separated as a new part, and an analytical cylinder was fitted using the separated trochlea of the talus. The radius of the analytical cylinder shown on the properties page is similar to the talus curvature (Fig.\u0026nbsp;\u003cspan refid=\"Fig4\" class=\"InternalRef\"\u003e4\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec11\" class=\"Section2\"\u003e \u003ch2\u003eStatistical analysis\u003c/h2\u003e \u003cp\u003eAll measurements of the 3D model in this study, including each trochlea of the talus, were measured by the same researcher. All data were collected and entered into Microsoft Excel 2016, SPSS17.0 statistical software package (SPSS Statistics for Windows, Version 17.0. Chicago: SPSS Inc.) was employed to identify significant differences. Independent sample t tests were used to identify the difference between two sets of data, paired \u003cem\u003et\u003c/em\u003e -tests were used to analyze the difference between the left and right trochlea of the talus, and the results are expressed as the mean\u0026thinsp;\u0026plusmn;\u0026thinsp;standard deviation (\u0026oline;x\u0026thinsp;\u0026plusmn;\u0026thinsp;SD). The difference among multiple samples was tested by the LSD multiple comparison method; the relationship between the two variables was analyzed by bivariate correlation analysis. All statistical tests were two-sided, and \u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.05 was considered statistically significant.\u003c/p\u003e \u003c/div\u003e"},{"header":"Results","content":"\u003cdiv id=\"Sec13\" class=\"Section2\"\u003e \u003ch2\u003eBaseline information of collected data\u003c/h2\u003e \u003cp\u003eAll specimens from the CT dataset collected according to the inclusion criteria included 61 specimens (28 male and 33 female) that were reconstructed as 91 talus models, including 41 right ankles and 50 left ankles, 31 unilateral ankle joints and 30 bilateral ankle joints. The average age was 37.43 (14 y-69 y), and the median age was 38 years old.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec14\" class=\"Section2\"\u003e \u003ch2\u003eCurvature of talar radii\u003c/h2\u003e \u003cp\u003eNinety-one ankle joints were selected during the statistical analysis, and the analytical results are shown as the mean\u0026thinsp;\u0026plusmn;\u0026thinsp;standard deviation in Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e. Additionally, the maximum value and minimum value for each curvature of different areas from all taluses were calculated.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eAverage curvature from talar radii (\u0026oline;X\u0026thinsp;\u0026plusmn;\u0026thinsp;SD). Note: AM: anteromedial, AL: anterolateral, PL: posterolateral, PM: posteromedial, MP: mid-posterior, MA: mid-anterior.\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"6\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eArea\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eN\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"4\" nameend=\"c6\" namest=\"c3\"\u003e \u003cp\u003eCurvature(mm)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003eMean\u003c/b\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003eSD\u003c/b\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003eMin\u003c/b\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003eMax\u003c/b\u003e\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAM\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e91\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e15.97\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e3.08\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e10.19\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e25.51\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAL\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e91\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e22.06\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e3.94\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e14.78\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e38.74\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePL\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e91\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e27.95\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e12.08\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e16.07\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e89.98\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePM\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e91\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e34.17\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e16.22\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e14.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e91.41\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMP\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e91\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e22.44\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e5.05\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e15.34\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e52.98\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMA\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e91\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e16.97\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e3.09\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e10.46\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e27.87\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003cb\u003eCharacteristics of talus curvature in different areas.\u003c/b\u003e \u003c/p\u003e \u003cp\u003eAfter analysis of variance with the LSD method, there were significant differences in talus curvature among the six areas (F\u0026thinsp;=\u0026thinsp;54.905, \u003cem\u003eP\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.000). The radius of talus curvature between the anteromedial and mid-anterior regions was not significantly different (\u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026gt;\u0026thinsp;0.05), and the radius of talus curvature from the mid-posterior region was larger than that from the anterolateral region, but the result of variance analysis was not significant (\u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026gt;\u0026thinsp;0.05). In generally, radius of talus curvature from posteromedial is significantly larger than this from posterolateral (\u003cem\u003eP\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.000), radius of talus curvature from posterolateral is significantly larger than this from mid-posterior and anterolateral (\u003cem\u003eP\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.000 and \u003cem\u003eP\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.000), radius of talus curvature from anterolateral is significantly larger than this from mid-anterior and anteromedial (\u003cem\u003eP\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.000 and \u003cem\u003eP\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.000). The trends in the analytical results were as follows: PM\u0026thinsp;\u0026gt;\u0026thinsp;PL\u0026thinsp;\u0026gt;\u0026thinsp;MP\u0026thinsp;\u0026gt;\u0026thinsp;AL\u0026thinsp;\u0026gt;\u0026thinsp;MA\u0026thinsp;\u0026gt;\u0026thinsp;AM. (\u003cb\u003eSee\u003c/b\u003e Fig.\u0026nbsp;\u003cspan refid=\"Fig5\" class=\"InternalRef\"\u003e5\u003c/span\u003e)\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec15\" class=\"Section2\"\u003e \u003ch2\u003eAge-related difference in the curvature of the right talus\u003c/h2\u003e \u003cp\u003eThe median age was 38 years old, so the radius of curvature from the right talus was categorized according to age. Fifteen talus models in the male population were selected, including 10 specimens less than or equal to 38 years old and 5 specimens older than 38 years. In the statistical results, the average posterolateral radius of specimens older than 38 years old was larger than that of specimens younger than or equal to 38 years old (t=-2.303, \u003cem\u003eP\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.038), and the differences between these two groups in other areas were not significant.\u003c/p\u003e \u003cp\u003eTwenty-six talar models in the female population were selected, including 10 specimens less than or equal to 38 years old and 16 specimens older than 38 years. The average radius of the six areas in our research between the two groups was not statistically significant.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eComparison of talus curvature from males at different ages for six areas (\u0026oline;X\u0026thinsp;\u0026plusmn;\u0026thinsp;SD). Note: AM: anteromedial, AL: anterolateral, PL: posterolateral, PM: posteromedial, MP: mid-posterior, MA: mid-anterior. Bold means \u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.05\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"7\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\"\u0026plusmn;\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\"\u0026plusmn;\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\"\u0026plusmn;\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\"\u0026plusmn;\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eRight\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003et/\u003cem\u003ep\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003et/\u003cem\u003ep\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026lt;=38y(10)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u0026gt;\u0026thinsp;38y(5)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;=38y(10)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u0026gt;\u0026thinsp;38y(16)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAM(mm)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e19.36\u0026thinsp;\u0026plusmn;\u0026thinsp;3.78\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e15.80\u0026thinsp;\u0026plusmn;\u0026thinsp;1.56\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1.986/0.069\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c5\"\u003e \u003cp\u003e14.41\u0026thinsp;\u0026plusmn;\u0026thinsp;1.87\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c6\"\u003e \u003cp\u003e15.47\u0026thinsp;\u0026plusmn;\u0026thinsp;2.24\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e-1.244/0.226\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAL(mm)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e25.53\u0026thinsp;\u0026plusmn;\u0026thinsp;5.18\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e22.19\u0026thinsp;\u0026plusmn;\u0026thinsp;3.34\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1.299/0.216\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c5\"\u003e \u003cp\u003e21.03\u0026thinsp;\u0026plusmn;\u0026thinsp;3.79\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c6\"\u003e \u003cp\u003e20.72\u0026thinsp;\u0026plusmn;\u0026thinsp;3.55\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.208/0.837\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePL(mm)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e23.03\u0026thinsp;\u0026plusmn;\u0026thinsp;3.49\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e34.71\u0026thinsp;\u0026plusmn;\u0026thinsp;15.85\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e-2.303/\u003cb\u003e0.038\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c5\"\u003e \u003cp\u003e23.32\u0026thinsp;\u0026plusmn;\u0026thinsp;4.94\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c6\"\u003e \u003cp\u003e26.32\u0026thinsp;\u0026plusmn;\u0026thinsp;8.24\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e-1.036/0.311\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePM(mm)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e27.71\u0026thinsp;\u0026plusmn;\u0026thinsp;10.43\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e38.31\u0026thinsp;\u0026plusmn;\u0026thinsp;10.64\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e-1.844/0.088\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c5\"\u003e \u003cp\u003e33.04\u0026thinsp;\u0026plusmn;\u0026thinsp;18.27\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c6\"\u003e \u003cp\u003e32.45\u0026thinsp;\u0026plusmn;\u0026thinsp;9.02\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.110/-0.913\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMP(mm)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e22.22\u0026thinsp;\u0026plusmn;\u0026thinsp;1.97\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e25.06\u0026thinsp;\u0026plusmn;\u0026thinsp;4.86\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e-1.643/0.124\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c5\"\u003e \u003cp\u003e21.07\u0026thinsp;\u0026plusmn;\u0026thinsp;3.89\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c6\"\u003e \u003cp\u003e21.00\u0026thinsp;\u0026plusmn;\u0026thinsp;2.29\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.055/0.956\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMA(mm)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e19.80\u0026thinsp;\u0026plusmn;\u0026thinsp;2.54\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e19.62\u0026thinsp;\u0026plusmn;\u0026thinsp;4.82\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.095/0.925\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c5\"\u003e \u003cp\u003e15.65\u0026thinsp;\u0026plusmn;\u0026thinsp;2.48\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c6\"\u003e \u003cp\u003e15.75\u0026thinsp;\u0026plusmn;\u0026thinsp;3.40\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e-0.078/0.938\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec16\" class=\"Section2\"\u003e \u003ch2\u003eAge-related difference in curvature of the left talus\u003c/h2\u003e \u003cp\u003eTwenty-two talus models in the male population were selected, including 13 specimens less than or equal to 38 years old and 9 specimens older than 38 years. In the curvature analysis for the six areas, the differences in radius between these two groups were not significant. In the female population, 28 talus models were selected, including 14 specimens less than or equal to 38 years old and 14 specimens older than 38 years. In curvature analysis for six areas, differences in radius in these two groups have no significance.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eComparison of left talus curvature from males at different ages for different areas (\u0026oline;X\u0026thinsp;\u0026plusmn;\u0026thinsp;SD). Note: AM: anteromedial, AL: anterolateral, PL: posterolateral, PM: posteromedial, MP: mid-posterior, MA: mid-anterior.\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"7\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\"\u0026plusmn;\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\"\u0026plusmn;\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\"\u0026plusmn;\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\"\u0026plusmn;\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eLeft\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003et/\u003cem\u003ep\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003et/\u003cem\u003ep\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026lt;=38y(13)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u0026gt;\u0026thinsp;38y(9)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;=38y(14)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u0026gt;\u0026thinsp;38y(14)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAM(mm)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e16.79\u0026thinsp;\u0026plusmn;\u0026thinsp;3.77\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e17.36\u0026thinsp;\u0026plusmn;\u0026thinsp;2.52\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e-0.389/0.701\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c5\"\u003e \u003cp\u003e14.89\u0026thinsp;\u0026plusmn;\u0026thinsp;1.95\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c6\"\u003e \u003cp\u003e14.72\u0026thinsp;\u0026plusmn;\u0026thinsp;3.14\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.175/0.862\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAL(mm)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e22.39\u0026thinsp;\u0026plusmn;\u0026thinsp;3.62\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e22.89\u0026thinsp;\u0026plusmn;\u0026thinsp;4.39\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e-0.291/0.774\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c5\"\u003e \u003cp\u003e21.68\u0026thinsp;\u0026plusmn;\u0026thinsp;3.71\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c6\"\u003e \u003cp\u003e21.36\u0026thinsp;\u0026plusmn;\u0026thinsp;3.11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.244/0.809\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePL(mm)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e32.77\u0026thinsp;\u0026plusmn;\u0026thinsp;18.86\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e28.45\u0026thinsp;\u0026plusmn;\u0026thinsp;11.26\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.613/0.547\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c5\"\u003e \u003cp\u003e29.18\u0026thinsp;\u0026plusmn;\u0026thinsp;16.91\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c6\"\u003e \u003cp\u003e28.18\u0026thinsp;\u0026plusmn;\u0026thinsp;7.48\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.203/0.841\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePM(mm)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e29.37\u0026thinsp;\u0026plusmn;\u0026thinsp;11.84\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e29.35\u0026thinsp;\u0026plusmn;\u0026thinsp;7.44\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.005/0.96\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c5\"\u003e \u003cp\u003e35.24\u0026thinsp;\u0026plusmn;\u0026thinsp;20.54\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c6\"\u003e \u003cp\u003e46.57\u0026thinsp;\u0026plusmn;\u0026thinsp;23.46\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e-1.359/0.186\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMP(mm)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e23.95\u0026thinsp;\u0026plusmn;\u0026thinsp;9.31\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e23.02\u0026thinsp;\u0026plusmn;\u0026thinsp;3.51\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.288/0.776\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c5\"\u003e \u003cp\u003e21.61\u0026thinsp;\u0026plusmn;\u0026thinsp;3.62\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c6\"\u003e \u003cp\u003e23.36\u0026thinsp;\u0026plusmn;\u0026thinsp;6.20\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e-0.912/0.37\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMA(mm)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e19.01\u0026thinsp;\u0026plusmn;\u0026thinsp;3.25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e16.87\u0026thinsp;\u0026plusmn;\u0026thinsp;1.33\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1.855/0.078\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c5\"\u003e \u003cp\u003e15.72\u0026thinsp;\u0026plusmn;\u0026thinsp;1.95\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c6\"\u003e \u003cp\u003e15.79\u0026thinsp;\u0026plusmn;\u0026thinsp;1.73\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e-0.092/0.927\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec17\" class=\"Section2\"\u003e \u003ch2\u003eSex-related difference between the left and right talus\u003c/h2\u003e \u003cp\u003eThirty-seven talus models in the male population were included (15 right and 22 left). The statistical results show no significant differences between the right and left sides for the six talus areas. Fifty-four talar models in the female population were reconstructed (26 right and 28 left). The statistical results show no significant differences between the right and left sides for the six talus areas.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eDifference between right and left for males and females (\u0026oline;X\u0026thinsp;\u0026plusmn;\u0026thinsp;SD). Note: AM: anteromedial, AL: anterolateral, PL: posterolateral, PM: posteromedial, MP: mid-posterior, MA: mid-anterior.\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"7\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\"\u0026plusmn;\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\"\u0026plusmn;\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\"\u0026plusmn;\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\"\u0026plusmn;\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eUnmatched\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003et/\u003cem\u003ep\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003et/\u003cem\u003ep\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eRight(15)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eLeft(22)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eRight(26)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eLeft(28)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAM(mm)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e18.17\u0026thinsp;\u0026plusmn;\u0026thinsp;3.59\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e17.02\u0026thinsp;\u0026plusmn;\u0026thinsp;3.26\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1.009/0.320\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c5\"\u003e \u003cp\u003e15.06\u0026thinsp;\u0026plusmn;\u0026thinsp;2.13\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c6\"\u003e \u003cp\u003e14.81\u0026thinsp;\u0026plusmn;\u0026thinsp;2.57\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.400/0.690\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAL(mm)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e24.42\u0026thinsp;\u0026plusmn;\u0026thinsp;4.80\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e22.60\u0026thinsp;\u0026plusmn;\u0026thinsp;3.86\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1.276/0.210\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c5\"\u003e \u003cp\u003e20.84\u0026thinsp;\u0026plusmn;\u0026thinsp;3.57\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c6\"\u003e \u003cp\u003e21.52\u0026thinsp;\u0026plusmn;\u0026thinsp;3.37\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e-0.718/0.476\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePL(mm)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e26.92\u0026thinsp;\u0026plusmn;\u0026thinsp;10.59\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e31.00\u0026thinsp;\u0026plusmn;\u0026thinsp;16.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e-0.864/0.393\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c5\"\u003e \u003cp\u003e25.17\u0026thinsp;\u0026plusmn;\u0026thinsp;7.19\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c6\"\u003e \u003cp\u003e28.68\u0026thinsp;\u0026plusmn;\u0026thinsp;12.84\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e-1.227/0.225\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePM(mm)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e31.25\u0026thinsp;\u0026plusmn;\u0026thinsp;11.35\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e29.36\u0026thinsp;\u0026plusmn;\u0026thinsp;10.06\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.531/0.599\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c5\"\u003e \u003cp\u003e32.67\u0026thinsp;\u0026plusmn;\u0026thinsp;13.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c6\"\u003e \u003cp\u003e40.91\u0026thinsp;\u0026plusmn;\u0026thinsp;22.39\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e-1.636/0.108\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMP(mm)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e23.16\u0026thinsp;\u0026plusmn;\u0026thinsp;3.34\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e23.57\u0026thinsp;\u0026plusmn;\u0026thinsp;7.38\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e-0.198/0.844\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c5\"\u003e \u003cp\u003e21.03\u0026thinsp;\u0026plusmn;\u0026thinsp;2.93\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c6\"\u003e \u003cp\u003e22.48\u0026thinsp;\u0026plusmn;\u0026thinsp;5.06\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e-1.275/0.208\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMA(mm)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e19.74\u0026thinsp;\u0026plusmn;\u0026thinsp;3.28\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e18.13\u0026thinsp;\u0026plusmn;\u0026thinsp;2.80\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1.597/0.119\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c5\"\u003e \u003cp\u003e15.71\u0026thinsp;\u0026plusmn;\u0026thinsp;3.02\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c6\"\u003e \u003cp\u003e15.76\u0026thinsp;\u0026plusmn;\u0026thinsp;1.81\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e-0.063/0.950\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec18\" class=\"Section2\"\u003e \u003ch2\u003eMatched comparison between the left talus and right talus\u003c/h2\u003e \u003cp\u003eEighteen talus models, including right and left taluses in the male population, were selected, including 9 right taluses and 9 left taluses. After paired \u003cem\u003et\u003c/em\u003e test analysis, there were no significant differences between the right and left sides for the six talus areas. Twenty-one bilateral talar models in the female population were selected, and there were no significant differences between the right and left sides for the six talar areas.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab5\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 5\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eMatched difference between right and left for males and females (\u0026oline;X\u0026thinsp;\u0026plusmn;\u0026thinsp;SD). Note: AM: anteromedial, AL: anterolateral, PL: posterolateral, PM: posteromedial, MP: mid-posterior, MA: mid-anterior.\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"7\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\"\u0026plusmn;\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\"\u0026plusmn;\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\"\u0026plusmn;\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\"\u0026plusmn;\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eMatched\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003et/\u003cem\u003ep\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003et/\u003cem\u003ep\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eRight(9)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eLeft(9)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eRight(21)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eLeft(21)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAM(mm)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e17.48\u0026thinsp;\u0026plusmn;\u0026thinsp;3.32\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e17.16\u0026thinsp;\u0026plusmn;\u0026thinsp;3.11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.383/0.711\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c5\"\u003e \u003cp\u003e15.05\u0026thinsp;\u0026plusmn;\u0026thinsp;2.24\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c6\"\u003e \u003cp\u003e14.27\u0026thinsp;\u0026plusmn;\u0026thinsp;2.26\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e1.255/0.224\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAL(mm)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e25.07\u0026thinsp;\u0026plusmn;\u0026thinsp;6.26\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e25.48\u0026thinsp;\u0026plusmn;\u0026thinsp;2.49\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e-0.230/0.824\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c5\"\u003e \u003cp\u003e21.14\u0026thinsp;\u0026plusmn;\u0026thinsp;3.82\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c6\"\u003e \u003cp\u003e21.29\u0026thinsp;\u0026plusmn;\u0026thinsp;3.39\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e-0.255/0.801\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePL(mm)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e30.33\u0026thinsp;\u0026plusmn;\u0026thinsp;12.55\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e33.26\u0026thinsp;\u0026plusmn;\u0026thinsp;11.62\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e-0.757/0.471\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c5\"\u003e \u003cp\u003e25.98\u0026thinsp;\u0026plusmn;\u0026thinsp;7.78\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c6\"\u003e \u003cp\u003e30.30\u0026thinsp;\u0026plusmn;\u0026thinsp;14.28\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e-1.348/0.193\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePM(mm)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e35.82\u0026thinsp;\u0026plusmn;\u0026thinsp;12.71\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e35.37\u0026thinsp;\u0026plusmn;\u0026thinsp;12.06\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.125/0.904\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c5\"\u003e \u003cp\u003e34.20\u0026thinsp;\u0026plusmn;\u0026thinsp;13.80\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c6\"\u003e \u003cp\u003e44.70\u0026thinsp;\u0026plusmn;\u0026thinsp;24.35\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e-1.782/0.090\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMP(mm)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e24.01\u0026thinsp;\u0026plusmn;\u0026thinsp;4.12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e23.41\u0026thinsp;\u0026plusmn;\u0026thinsp;3.10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.357/0.731\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c5\"\u003e \u003cp\u003e21.48\u0026thinsp;\u0026plusmn;\u0026thinsp;2.78\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c6\"\u003e \u003cp\u003e22.85\u0026thinsp;\u0026plusmn;\u0026thinsp;5.38\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e-1.231/0.232\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMA(mm)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e19.97\u0026thinsp;\u0026plusmn;\u0026thinsp;3.79\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e18.16\u0026thinsp;\u0026plusmn;\u0026thinsp;2.45\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1.349/0.214\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c5\"\u003e \u003cp\u003e15.59\u0026thinsp;\u0026plusmn;\u0026thinsp;3.03\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c6\"\u003e \u003cp\u003e15.64\u0026thinsp;\u0026plusmn;\u0026thinsp;1.74\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e-0.097/0.924\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec19\" class=\"Section2\"\u003e \u003ch2\u003eCurvature difference between males and females\u003c/h2\u003e \u003cp\u003eAn independent \u003cem\u003et\u003c/em\u003e test was used to identify significant differences. The curvature of the AM for males was significantly larger than that for females (t\u0026thinsp;=\u0026thinsp;4.25, \u003cem\u003eP\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.000), and the curvature of the AL for males was larger than that for females (t\u0026thinsp;=\u0026thinsp;2.629, \u003cem\u003eP\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.010); however, there were no significant differences for all radii of the talus at the PL/PM/MP/MA between males and females (Fig.\u0026nbsp;\u003cspan refid=\"Fig6\" class=\"InternalRef\"\u003e6\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec20\" class=\"Section2\"\u003e \u003ch2\u003eDifferences in the right talus in six areas between males and females\u003c/h2\u003e \u003cp\u003eFor observers aged\u0026thinsp;\u0026lt;\u0026thinsp;=\u0026thinsp;38 years, the AM curvature of the right talus in the male group was significantly larger than that in the female group (\u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.01). However, the MP radius in the male group aged\u0026thinsp;\u0026gt;\u0026thinsp;38 years was larger than that in the female group (\u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.05), and there were no significant differences in other variables between males and females.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab6\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 6\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eDifferent right talus radii between males and females in the two age groups (\u0026oline;X\u0026thinsp;\u0026plusmn;\u0026thinsp;SD). Note: AM: anteromedial, AL: anterolateral, PL: posterolateral, PM: posteromedial, MP: mid-posterior, MA: mid-anterior. Bold means \u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.05.\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"7\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\"\u0026plusmn;\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\"\u0026plusmn;\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\"\u0026plusmn;\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\"\u0026plusmn;\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eRight\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e\u0026lt;=38y\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003et/\u003cem\u003ep\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e \u003cp\u003e\u0026gt;\u0026thinsp;38y\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003et/\u003cem\u003ep\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMale(10)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eFemale(10)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eMale(5)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eFemale(16)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAM(mm)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e19.36\u0026thinsp;\u0026plusmn;\u0026thinsp;3.78\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e14.41\u0026thinsp;\u0026plusmn;\u0026thinsp;1.87\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e3.703/\u003cb\u003e0.002\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c5\"\u003e \u003cp\u003e15.80\u0026thinsp;\u0026plusmn;\u0026thinsp;1.56\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c6\"\u003e \u003cp\u003e15.47\u0026thinsp;\u0026plusmn;\u0026thinsp;2.24\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.309/0.761\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAL(mm)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e25.53\u0026thinsp;\u0026plusmn;\u0026thinsp;5.18\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e21.03\u0026thinsp;\u0026plusmn;\u0026thinsp;3.79\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e2.217/0.04\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c5\"\u003e \u003cp\u003e22.19\u0026thinsp;\u0026plusmn;\u0026thinsp;3.34\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c6\"\u003e \u003cp\u003e20.72\u0026thinsp;\u0026plusmn;\u0026thinsp;3.55\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.817/0.424\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePL(mm)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e23.03\u0026thinsp;\u0026plusmn;\u0026thinsp;3.49\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e23.32\u0026thinsp;\u0026plusmn;\u0026thinsp;4.94\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e-0.152/0.881\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c5\"\u003e \u003cp\u003e34.71\u0026thinsp;\u0026plusmn;\u0026thinsp;15.85\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c6\"\u003e \u003cp\u003e26.32\u0026thinsp;\u0026plusmn;\u0026thinsp;8.24\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e1.587/0.129\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePM(mm)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e27.71\u0026thinsp;\u0026plusmn;\u0026thinsp;10.43\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e33.04\u0026thinsp;\u0026plusmn;\u0026thinsp;18.27\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e-0.800/0.434\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c5\"\u003e \u003cp\u003e38.31\u0026thinsp;\u0026plusmn;\u0026thinsp;10.64\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c6\"\u003e \u003cp\u003e32.45\u0026thinsp;\u0026plusmn;\u0026thinsp;9.02\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e1.219/0.238\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMP(mm)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e22.22\u0026thinsp;\u0026plusmn;\u0026thinsp;1.97\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e21.07\u0026thinsp;\u0026plusmn;\u0026thinsp;3.89\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.830/0.417\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c5\"\u003e \u003cp\u003e25.06\u0026thinsp;\u0026plusmn;\u0026thinsp;4.86\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c6\"\u003e \u003cp\u003e21.00\u0026thinsp;\u0026plusmn;\u0026thinsp;2.29\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e2.619/\u003cb\u003e0.017\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMA(mm)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e19.80\u0026thinsp;\u0026plusmn;\u0026thinsp;2.54\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e15.65\u0026thinsp;\u0026plusmn;\u0026thinsp;2.48\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e3.694/0.002\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c5\"\u003e \u003cp\u003e19.62\u0026thinsp;\u0026plusmn;\u0026thinsp;4.82\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c6\"\u003e \u003cp\u003e15.75\u0026thinsp;\u0026plusmn;\u0026thinsp;3.40\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e2.019/0.058\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec21\" class=\"Section2\"\u003e \u003ch2\u003eDifferences in the left talus in six areas between males and females\u003c/h2\u003e \u003cp\u003eIn the age\u0026thinsp;\u0026lt;\u0026thinsp;=\u0026thinsp;38 years group, the MA curvature of the right talus in males was significantly larger than that in females (\u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.01), and there were no significant differences in other variables between males and females.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab7\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 7\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eDifferent left talar radii between males and females in the two age groups (\u0026oline;X\u0026thinsp;\u0026plusmn;\u0026thinsp;SD). Note: AM: anteromedial, AL: anterolateral, PL: posterolateral, PM: posteromedial, MP: mid-posterior, MA: mid-anterior. Bold means \u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.01.\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"7\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\"\u0026plusmn;\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\"\u0026plusmn;\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\"\u0026plusmn;\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\"\u0026plusmn;\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eleft\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e\u0026lt;=38y\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003et/\u003cem\u003ep\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e \u003cp\u003e\u0026gt;\u0026thinsp;38y\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003et/\u003cem\u003ep\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003emale(13)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003efemale(14)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003emale(9)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003efemale(14)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAM(mm)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e16.79\u0026thinsp;\u0026plusmn;\u0026thinsp;3.77\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e14.89\u0026thinsp;\u0026plusmn;\u0026thinsp;1.95\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1.667/0.108\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c5\"\u003e \u003cp\u003e17.36\u0026thinsp;\u0026plusmn;\u0026thinsp;2.52\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c6\"\u003e \u003cp\u003e14.72\u0026thinsp;\u0026plusmn;\u0026thinsp;3.14\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e2.111/0.047\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAL(mm)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e22.39\u0026thinsp;\u0026plusmn;\u0026thinsp;3.62\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e21.68\u0026thinsp;\u0026plusmn;\u0026thinsp;3.71\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.506/0.617\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c5\"\u003e \u003cp\u003e22.89\u0026thinsp;\u0026plusmn;\u0026thinsp;4.39\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c6\"\u003e \u003cp\u003e21.36\u0026thinsp;\u0026plusmn;\u0026thinsp;3.11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.980/0.338\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePL(mm)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e32.77\u0026thinsp;\u0026plusmn;\u0026thinsp;18.86\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e29.18\u0026thinsp;\u0026plusmn;\u0026thinsp;16.91\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.521/0.607\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c5\"\u003e \u003cp\u003e28.45\u0026thinsp;\u0026plusmn;\u0026thinsp;11.26\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c6\"\u003e \u003cp\u003e28.18\u0026thinsp;\u0026plusmn;\u0026thinsp;7.48\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.070/0.945\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePM(mm)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e29.37\u0026thinsp;\u0026plusmn;\u0026thinsp;11.84\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e35.24\u0026thinsp;\u0026plusmn;\u0026thinsp;20.54\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e-0.901/0.376\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c5\"\u003e \u003cp\u003e29.35\u0026thinsp;\u0026plusmn;\u0026thinsp;7.44\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c6\"\u003e \u003cp\u003e46.57\u0026thinsp;\u0026plusmn;\u0026thinsp;23.46\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e-2.120/0.046\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMP(mm)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e23.95\u0026thinsp;\u0026plusmn;\u0026thinsp;9.31\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e21.61\u0026thinsp;\u0026plusmn;\u0026thinsp;3.62\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.876/0.389\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c5\"\u003e \u003cp\u003e23.01\u0026thinsp;\u0026plusmn;\u0026thinsp;3.51\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c6\"\u003e \u003cp\u003e23.36\u0026thinsp;\u0026plusmn;\u0026thinsp;6.20\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e-0.151/0.882\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMA(mm)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e19.01\u0026thinsp;\u0026plusmn;\u0026thinsp;3.25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e15.72\u0026thinsp;\u0026plusmn;\u0026thinsp;1.95\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e3.211/\u003cb\u003e0.004\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c5\"\u003e \u003cp\u003e16.87\u0026thinsp;\u0026plusmn;\u0026thinsp;1.33\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c6\"\u003e \u003cp\u003e15.79\u0026thinsp;\u0026plusmn;\u0026thinsp;1.73\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e1.601/0.124\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec22\" class=\"Section2\"\u003e \u003ch2\u003eFitting radius of talus curvature\u003c/h2\u003e \u003cp\u003eThe average fitted curvature for the talus was 20.52\u0026thinsp;\u0026plusmn;\u0026thinsp;1.95 mm (range 15.18\u0026ndash;25.30). The fitting radius of the talus for males (21.90\u0026thinsp;\u0026plusmn;\u0026thinsp;1.97 mm) was significantly greater than that for females (19.57\u0026thinsp;\u0026plusmn;\u0026thinsp;1.26 mm) (t\u0026thinsp;=\u0026thinsp;6.894, \u003cem\u003eP\u003c/em\u003e\u0026thinsp;=\u0026thinsp;000). The fitting radius of the talus on the right side (20.69\u0026thinsp;\u0026plusmn;\u0026thinsp;2.00 mm) was similar to that on the left side (20.37\u0026thinsp;\u0026plusmn;\u0026thinsp;1.92 mm) (t\u0026thinsp;=\u0026thinsp;0.783, \u003cem\u003eP\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.436).\u003c/p\u003e \u003cdiv id=\"Sec23\" class=\"Section3\"\u003e \u003ch2\u003eCorrelation analysis between age and fitting talus curvature radius\u003c/h2\u003e \u003cp\u003eIn the correlation analysis, there was no correlation between age and talus curvature in the general analysis (r=-0.015, \u003cem\u003eP\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.886). Stratified by sex, the fitting radius for the male and female populations was not related to age (r\u0026thinsp;=\u0026thinsp;0.073, \u003cem\u003eP\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.666; r\u0026thinsp;=\u0026thinsp;0.157, \u003cem\u003eP\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.258); stratified by left and right, the fitting radius for the right and left talus was not related to age (r=-0.061, \u003cem\u003eP\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.704; r\u0026thinsp;=\u0026thinsp;0.014, \u003cem\u003eP\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.921).\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e"},{"header":"Discussion","content":"\u003cp\u003eTalus ankle replacement is the ultimate treatment for severe ankle diseases. At present, there have been many studies on ankle joint replacement and prosthesis design because the characteristic shape of the human talus vault is irregular and asymmetric, which urges the human ankle joint to complete complex plantar flexion and dorsiflexion. However, it was found that the symmetrical design of the talar prosthesis at present could not meet the patient's activities of flexing the metatarsal dorsum and stretching. Therefore, researchers actively understand the anatomical characteristics of the talus dome and, based on this, design prosthesis components close to the talus structure.\u003c/p\u003e \u003cp\u003eConversely, a study suggested that TAR should be avoided for severe talar osteonecrosis because of subsidence of the talar component caused by poor bone quality[\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e]. The most complicated was reported as subsidence from the talus component, and the incidence varies greatly (1\u0026ndash;15%)[\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e, \u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e]. Complications were observed that predispose the structure to fragility and subsidence under the talar component after total ankle arthroplasty (TAA) caused by misposition[\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e]. The loosening rate of the talus component after TAR has reached 92%[\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e], and the salvage treatment is ankle arthrodesis, which increases the loss of ankle motion. Dorsiflexing of the talar prosthesis during TAA (INFINITY ankle system) was possibly associated with talar component subsidence and limited dorsiflexion range[\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e]. We supposed that complications are partly related to the design of the talus component.\u003c/p\u003e \u003cp\u003eIn a talar topography study of CT images of 21 Caucasian U.S. adult patients suffered from ankle osteoarthritis[\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e], and the radius of the talar dome was 20.7\u0026thinsp;\u0026plusmn;\u0026thinsp;2.6 mm. This result was similar to our measurement; however, our result further disclosed that the curvature between males and females was different in the two different measurement methods, and the radius in males was larger than that in females. In addition, the curvature at AM and AL in the male group was larger than that in the female group. For right talus in male group, radius of AM with age\u0026thinsp;\u0026lt;\u0026thinsp;=\u0026thinsp;38years and MP with age\u0026thinsp;\u0026gt;\u0026thinsp;=\u0026thinsp;38years were greater than in female; for left talus in male group, radius of AM with age\u0026thinsp;\u0026lt;\u0026thinsp;=\u0026thinsp;38years was greater than in female.\u003c/p\u003e \u003cp\u003eThe shape of the talus should be constant when it grows; however, a study reported that age is significantly negatively related to curvature at the superior trochlea[\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e]. In this study, stratified analysis by sex between the age\u0026thinsp;\u0026lt;\u0026thinsp;=\u0026thinsp;38 years group and the age\u0026thinsp;\u0026gt;\u0026thinsp;38 years group in the left and right sides showed no significant difference during this research; moreover, there was no significant relation between age and fitting talus curvature radius.\u003c/p\u003e \u003cp\u003eA novel treatment of customized total talar prosthesis in combination with the tibial component of TAA for ankle revision has been verified to improve JSSF ankle hindfoot scale scores, subjective pain, and range of motion in the ankle[\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e, \u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e]. Increasing the surface for talus coverage will help stabilize the talus component in TAR[\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e], which helps surgeons decide the size of the talus. It was found [\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e] that medial crests of the talar dome consisted of two circles with different radii, of which the posterior radius was larger, and the radius of the anterior lateral crests was nearly the same as that of the posterior lateral crests. A Chinese cohort study including 71 talus models also showed that the mean radii of lateral-anterior, lateral-posterior, medial-anterior, and medial-posterior were 19.23\u0026thinsp;\u0026plusmn;\u0026thinsp;2.47 mm, 18.76\u0026thinsp;\u0026plusmn;\u0026thinsp;2.90 mm, 17.02\u0026thinsp;\u0026plusmn;\u0026thinsp;3.49 mm, and 22.75\u0026thinsp;\u0026plusmn;\u0026thinsp;3.04 mm, respectively; however, these results did not consider sex and age[\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e]. This may be the reason for the difference in our research results. Our results revealed the curvature difference of the suprasurface from the talus, which was summarized as follows: PM\u0026thinsp;\u0026gt;\u0026thinsp;PL\u0026thinsp;\u0026gt;\u0026thinsp;MP\u0026thinsp;\u0026gt;\u0026thinsp;AL\u0026thinsp;\u0026gt;\u0026thinsp;MA\u0026thinsp;\u0026gt;\u0026thinsp;AM. However, slight differences were identified when confounding factors were considered, such as age and sex (Fig.\u0026nbsp;\u003cspan refid=\"Fig7\" class=\"InternalRef\"\u003e7\u003c/span\u003e). Therefore, we strongly recommend that joint surgeons consider these factors before TAR.\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003eOf course, our study has some limitations, including (1) subjects from Northwest China, which cannot represent all Chinese people; (2) the size of the sample is small, and we need more samples to explore the talus characteristics; and (3) biomechanical analysis by finite element analysis technology on the talus needs to be executed to optimize the performance of the talus component.\u003c/p\u003e"},{"header":"Conclusions","content":"\u003cp\u003eThe talus trochlea with different radii allow the ankle joint to complete complex rotation, flexion, and extension activities during walking. Excellent design of the talus component is likely associated with fewer complications after TAR. To our knowledge, this is the first study on the characteristics of talus from Chinese people of different ages and sexes to reduce probable confounding factors. There was no significant relationship between age and talus curvature for either males or females. The average radius of the talus in the male population was larger than that in the female population. The radius of curvature in the posterior area was significantly larger than that in the anterior area. We recommend that this characteristic of the talus trochlea should be considered when designing the talus component in TAR. Our manuscript supplies very important anatomical evidence for designing talus components with different radii curvatures.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cp\u003eAM Anteromedial\u003c/p\u003e\u003cp\u003ePM Posteromedial\u003c/p\u003e\u003cp\u003eAL Anterolateral\u003c/p\u003e\u003cp\u003ePL Posterolateral\u003c/p\u003e\u003cp\u003eMA Mid-anterior\u003c/p\u003e\u003cp\u003eMP Mid-posterior\u003c/p\u003e\u003cp\u003eTAR Total ankle replacement\u003c/p\u003e\u003cp\u003eFEA Finite element analysis\u003c/p\u003e\u003cp\u003eOAT Osteochondral autologous transplantation\u003c/p\u003e\u003cp\u003e3D Three‑dimensional\u003c/p\u003e\u003cp\u003eTTR Total talus replacement\u003c/p\u003e\u003cp\u003eBMI Body mass index\u003c/p\u003e\u003cp\u003eROI Region of interest\u003c/p\u003e\u003cp\u003eOCS Object coordinate system\u003c/p\u003e\u003cp\u003eWCS World coordinate system\u003c/p\u003e\u003cp\u003eTAA Total ankle arthroplasty\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eAcknowledgements\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthor contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eShixun Wu\u003c/strong\u003e and \u003cstrong\u003eMing Ling\u0026nbsp;\u003c/strong\u003edesigned this research together, \u003cstrong\u003eShixun Wu\u003c/strong\u003e and \u003cstrong\u003eJiyuan Shi\u003c/strong\u003e rebuilt the\u0026nbsp;3D models, \u003cstrong\u003eShixun Wu\u003c/strong\u003e also measured data and wrote the whole manuscript and revised it. \u003cstrong\u003eShizhang Liu\u003c/strong\u003e and \u003cstrong\u003eMing Ling\u003c/strong\u003e controlled\u0026nbsp;the research quality. \u003cstrong\u003eMinggang Huang\u003c/strong\u003e and \u003cstrong\u003eZhe Liu\u003c/strong\u003e collected the CT images. All the authors reviewed the whole paper and agreed to publish the final manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis research was supported by the\u0026nbsp;Social Development Science and Technology Project of Shaanxi Province (Grant No. 2021SF-186 and 2024SF-YBXM-446).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe data supporting the findings of this study are available within the article and its supplementary information files.\u003c/p\u003e\n\n\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis research was approved by the Ethics Committee of Shaanxi Provincial People\u0026rsquo;s Hospital\u0026nbsp;(No.\u0026nbsp;SPPH-LLBG-17-3.2).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eI would like to declare on behalf of my co‑authors that the work described was original research that has not been published previously, and not under consideration for publication elsewhere. All the authors listed have approved the manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare that they have no potential competing interests.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthor details\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e1 Department of Orthopedics Surgery, Shaanxi Provincial People\u0026rsquo;s Hospital, Xi\u0026rsquo;an, 710068 Shaanxi, China. 2 Department of CT, Shaanxi Provincial People\u0026rsquo;s Hospital, Xi\u0026rsquo;an, 710068 Shaanxi, China. 3 Key Laboratory of Bone Joint Disease Basic and Clinical Translation of Shaanxi Province, Xi\u0026rsquo;an, 710068 Shaanxi, China.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eLi J, Wang Y, Wei Y, Kong D, Lin Y, Wang D, et al. The effect of talus osteochondral defects of different area size on ankle joint stability: a finite element analysis. BMC Musculoskelet Disord. 2022;23(1):500.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAbar B, Kwon N, Allen NB, Lau T, Johnson LG, Gall K, et al. Outcomes of surgical reconstruction using custom 3D-printed porous titanium implants for critical-sized bone defects of the foot and ankle. Foot Ankle Int. 2022;43(6):750\u0026ndash;61.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eVogel J, Soti V. Effectiveness of autograft and allograft transplants in treating athletic patients with osteochondral lesions of the talus. Cureus. 2022;14(10):e29913.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eWan DD, Huang H, Hu MZ, Dong QY. Results of the osteochondral autologous transplantation for treatment of osteochondral lesions of the talus with harvesting from the ipsilateral talar articular facets. Int Orthop. 2022;46(7):1547\u0026ndash;55.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eKatsui R, Takakura Y, Taniguchi A, Tanaka Y. Ceramic artificial talus as the initial treatment for comminuted talar fractures. Foot Ankle Int. 2020;41(1):79\u0026ndash;83.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eHuang J, Xie F, Tan X, Xing W, Zheng Y, Zeng C. Treatment of osteosarcoma of the talus with a 3D-printed talar prosthesis. J Foot Ankle Surg. 2021;60(1):194\u0026ndash;98.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eYang QD, Mu MD, Tao X, Tang KL. Three-dimensional printed talar prosthesis with biological function for giant cell tumor of the talus: A case report and review of the literature. World J Clin Cases. 2021;9(13):3147\u0026ndash;56.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMu MD, Yang QD, Chen W, Tao X, Zhang CK, Zhang X, et al. Three dimension printing talar prostheses for total replacement in talar necrosis and collapse. Int Orthop. 2021;45(9):2313\u0026ndash;21.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eKadakia RJ, Akoh CC, Chen J, Sharma A, Parekh SG. 3D printed total talus replacement for avascular necrosis of the talus. Foot Ankle Int. 2020;41(12):1529\u0026ndash;36.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eJohnson LG, Anastasio AT, Fletcher AN, Hendren S, Adams SB. Outcomes following total talus replacement: A systematic review. Foot Ankle Surg. 2022;28(8):1194\u0026ndash;201.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eLiu T, Jomha N, Adeeb S, El-Rich M, Westover L. The evaluation of artificial talus implant on ankle joint contact characteristics: a finite element study based on four subjects. Med Biol Eng Comput. 2022;60(4):1139\u0026ndash;58.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eKoh D, Tan M, Zhan X, Li Z, Tay KS, Tan SM, et al. Association of elevated body mass index and outcomes of arthroscopic treatment for osteochondral lesions of the talus. Foot Ankle Orthop. 2022; doi: \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1177/24730114221103263\u003c/span\u003e\u003cspan address=\"10.1177/24730114221103263\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eFernandez A, Poggio D, Llusa M, Alvarez C, Cufi PM. Graphic representation of intraosseous and extraosseous talus blood supply. Rev Esp Cir Ortop Traumatol. 2022;66(5):341\u0026ndash;47.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eGross CE, Palanca AA, DeOrio JK. Design rationale for total ankle arthroplasty systems: an update. J Am Acad Orthop Surg. 2018;26(10):353\u0026ndash;59.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eWilliams JR, Wegner NJ, Sangeorzan BJ, Brage ME. Intraoperative and perioperative complications during revision arthroplasty for salvage of a failed total ankle arthroplasty. Foot and ankle international. 2015;36(2):135\u0026ndash;42.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eYamaguchi S, Sasho T, Kato H, Kuroyanagi Y, Banks SA. Ankle and subtalar kinematics during dorsiflexion-plantarflexion activities. Foot Ankle Int. 2009;30(4):361\u0026ndash;66.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eNozaki S, Watanabe K, Kato T, Miyakawa T, Kamiya T, Katayose M. Radius of curvature at the talocrural joint surface: inference of subject-specific kinematics. Surg Radiol Anat. 2019;41(1):53\u0026ndash;64.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eGuyer AJ, Richardson G. Current concepts review: total ankle arthroplasty. Foot Ankle Int. 2008;29(2):256\u0026ndash;64.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBonnin M, Judet T, Colombier JA, Buscayret F, Graveleau N, Piriou P. Midterm results of the Salto total ankle prosthesis. Clin Orthop Relat Res. 2004(424):6\u0026ndash;18.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBuechel FS, Buechel FJ, Pappas MJ. Twenty-year evaluation of cementless mobile-bearing total ankle replacements. Clin Orthop Relat Res. 2004(424):19\u0026ndash;26.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eLi SY, Myerson MS. Management of talar component subsidence. Foot Ankle Clin. 2017;22(2):361\u0026ndash;89.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eGross C, Erickson BJ, Adams SB, Parekh SG. Ankle arthrodesis after failed total ankle replacement: a systematic review of the literature. Foot Ankle Spec. 2015;8(2):143\u0026ndash;51.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eLe V, Escudero M, Symes M, Salat P, Wing K, Younger A, et al. Impact of sagittal talar inclination on total ankle replacement failure. Foot Ankle Int. 2019;40(8):900\u0026ndash;04.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eHayes A, Tochigi Y, Saltzman CL. Ankle morphometry on 3D-CT images. Iowa Orthop J. 2006;26(1):1\u0026ndash;4.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eNozaki S, Watanabe K, Teramoto A, Kamiya T, Katayose M, Ogihara N. Sex- and age-related variations in the three-dimensional orientations and curvatures of the articular surfaces of the human talus. Anat Sci Int. 2021;96(2):258\u0026ndash;64.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMorita S, Taniguchi A, Miyamoto T, Kurokawa H, Tanaka Y. Application of a customized total talar prosthesis for revision total ankle arthroplasty. JBJS Open Access. 2020;5(4):e20-34.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eTracey J, Arora D, Gross CE, Parekh SG. Custom 3D-printed total talar prostheses restore normal joint anatomy throughout the hindfoot. Foot Ankle Spec. 2019;12(1):39\u0026ndash;48.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eCerrato R, Myerson MS. Total ankle replacement: the Agility LP prosthesis. Foot Ankle Clin. 2008;13(3):485\u0026ndash;94.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eZhao DH, Huang DC, Zhang GH, Fan YP, Yu J, Wang SB, et al. Talar dome investigation and talocrural joint axis analysis based on three-dimensional (3D) models: implications for prosthetic design. Biomed Res Int. 2019;2019(1):1\u0026ndash;10.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"journal-of-orthopaedic-surgery-and-research","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"josr","sideBox":"Learn more about [Journal of Orthopaedic Surgery and Research](http://josr-online.biomedcentral.com)","snPcode":"13018","submissionUrl":"https://submission.nature.com/new-submission/13018/3","title":"Journal of Orthopaedic Surgery and Research","twitterHandle":"@MSKmedBMC","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"em","reportingPortfolio":"BMC/SO AJ","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Curvature of talar trochlea, Talus necrosis, Osteoarthritis, Artificial ankle prosthesis, Computer-aided design","lastPublishedDoi":"10.21203/rs.3.rs-3931067/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-3931067/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground\u003c/strong\u003eTo analyze the curvature characteristics of thetalus trochlea inpeople from Northwest China in different sex and age groups.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods\u003c/strong\u003eComputed tomography scanning data of talus from 61 specimens were collected and constructed as a three-dimensional model by MIMICS software, anteromedial(AM), posteromedial(PM), anterolateral(AL), and posterolateral(PL) edge, anterior edge of medial trochlea, posterior edge of medial trochlea and anterior edge of lateral trochlea were defined according to the anatomical landmarks on trochlear surface. The curvature radii for different areas were measured using the fitting radius and measure module.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults\u003c/strong\u003e There were significant differences among the talus curvatures in the six areas (F=54.905, \u003cem\u003eP\u003c/em\u003e=0.000), and more trends in the analytical results were as follows: PM \u0026gt; PL \u0026gt; MP \u0026gt; AL \u0026gt; MA \u0026gt; AM. The average posterolateral radius from specimens aged \u0026gt;38 years old was larger than that from specimens aged\u0026lt;=38 years (t=-2.303, \u003cem\u003eP\u003c/em\u003e =0.038). The talus curvature of the AM for males was significantly larger than that for females (t=4.25, \u003cem\u003eP\u003c/em\u003e=0.000), and the curvature of the AL for males was larger than that for females (t=2.629, \u003cem\u003eP\u003c/em\u003e =0.010). For observers aged \u0026lt;=38 years, the AM curvature of the right talus in the male group was significantly larger than thatin the female group (\u003cem\u003eP\u003c/em\u003e\u0026lt;0.01). In age \u0026lt;=38years group, the MA curvature of right talus in male was significantly larger than in female group(\u003cem\u003eP\u003c/em\u003e\u0026lt;0.01), fitting radius of talus for male (21.90±1.97 mm) was significantly greater than female of this(19.57±1.26 mm)(t=6.894, \u003cem\u003eP\u003c/em\u003e=000). The average radius of the talus in the male population was larger than that in the female population.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusion\u003c/strong\u003e There was no significant relationship between age and talus curvature in either males or females. The radius of curvature in the posterior area was significantly larger than that in the anterior area. We recommend that this characteristic of the talus trochlea should be considered when designingthe talus component in total ankle replacement (TAR).\u003c/p\u003e","manuscriptTitle":"Different radius of curvature at the talus trochlea measured using 3D model technology","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-02-09 05:25:57","doi":"10.21203/rs.3.rs-3931067/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2024-03-09T10:33:44+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2024-03-09T05:40:00+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"eeb967f5-8485-402a-b8b1-fc6489387e1e","date":"2024-02-27T06:32:51+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2024-02-23T19:35:04+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"40f36c5e-8a63-482d-8184-c0c90125bd9d","date":"2024-02-15T07:36:47+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2024-02-15T00:28:40+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2024-02-08T14:28:03+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2024-02-07T14:37:37+00:00","index":"","fulltext":""},{"type":"submitted","content":"Journal of Orthopaedic Surgery and Research","date":"2024-02-05T13:32:40+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"journal-of-orthopaedic-surgery-and-research","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"josr","sideBox":"Learn more about [Journal of Orthopaedic Surgery and Research](http://josr-online.biomedcentral.com)","snPcode":"13018","submissionUrl":"https://submission.nature.com/new-submission/13018/3","title":"Journal of Orthopaedic Surgery and Research","twitterHandle":"@MSKmedBMC","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"em","reportingPortfolio":"BMC/SO AJ","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"26bb3eb5-77d9-483a-8600-3e35f446d603","owner":[],"postedDate":"February 9th, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2024-04-19T07:39:38+00:00","versionOfRecord":[],"versionCreatedAt":"2024-02-09 05:25:57","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-3931067","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-3931067","identity":"rs-3931067","version":["v1"]},"buildId":"qtupq5eGEP_6zYnWcrvyt","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}