In this study, we review the role of wearable devices in tracking our daily locomotion. We discuss types of wearable devices that can be used, methods for gait analyses, and multiple healthcare-related applications aided by artificial intelligence. Impaired walking and locomotion are common resulting from injuries, degenerative pathologies, musculoskeletal disorders, and various neurological damages. Daily tracking and gait analysis are convenient and efficient approaches for monitoring human walking, where concreate and rich data can be obtained for examining our posture control mechanism during body movement and providing enhanced clinical pieces of evidence for diagnoses and treatments. Many sensors in wearable devices can help to record data of walking and running; spatiotemporal and kinematic variables can be further calculated in gait analysis. We report our previous works in gait analysis, discussing applications of wearable devices for detecting foot and ankle lesions, supporting surgeons in early diagnosis, and helping physicians with rehabilitation.

Background: Compared with computed tomography (CT), magnetic resonance imaging (MRI) might overestimate the condition of osteochondral lesions of the talus (OLTs) owing to subchondral bone marrow edema and the overlying cartilage defect. However, no study has compared MRI and CT directly in evaluating OLTs with subchondral cysts. Purpose: To compare the reliability and validity of MRI and CT in evaluating OLTs with subchondral cysts. Study Design: Cohort study (diagnosis); Level of evidence, 2. Methods: An institutional radiology database was queried for inpatients diagnosed with OLTs with subchondral cysts who had undergone surgical treatment between May 2015 and October 2019. A total of 48 patients met the inclusion criteria. Based on our measurement method, 2 experienced observers who were blinded to the study independently measured the length, width, and depth of the cysts using MRI and CT. The classification of cystic lesions was also performed based on MRI and CT findings. Results: Interobserver reliability was almost perfect, with intraclass correlation coefficients (ICCs) ranging from 0.935 to 0.999. ICCs for intraobserver reliability ranged from 0.944 to 0.976. The mean size of cysts measured on MRI (length, 13.38 ± 4.23 mm; width, 9.28 ± 2.28 mm; depth, 11.54 ± 3.69 mm) was not significantly different to that evaluated on CT (length, 13.40 ± 4.08 mm; width, 9.25 ± 2.34 mm; depth, 11.32 ± 3.54 mm). The size of subchondral cysts was precisely estimated on both MRI and CT. The MRI classification and CT classification revealed almost perfect agreement (kappa = 0.831). Conclusion: With our measurement method, both MRI and CT were deemed to be reliable and valid in evaluating the size of subchondral cysts of OLTs, and the MRI classification was well-correlated with the CT classification. The presented measurement method and classification systems could provide more accurate information before surgery.

Background: Tibiofibular syndesmosis (TFS) widening sometimes is not evident on radiography but can be found under arthroscopy in chronic lateral ankle instability (CLAI). This study aimed to evaluate the effect of TFS widening severity on clinical outcomes and return to activities after isolated Broström operation in CLAI patients and to propose an indication for its surgical intervention. Methods: A total of 118 CLAI patients undergoing diagnostic ankle arthroscopy and open Broström-Gould operation were included. Based on the middle width of TFS measured under arthroscopy, patients were divided into the TFS-2 group (≤2 mm, n = 44), the TFS-3 group (2-4 mm, n = 42), and the TFS-4 group (≥4 mm, n = 32). The time to return to recreational sport and work, Tegner activity score, and proportion of returning to preinjury sports at the final follow-up were evaluated and compared. Other subjective evaluations included the American Orthopaedic Foot & Ankle Society score, visual analog scale, and Karlsson-Peterson score. Results: Among the 3 groups, the TFS-4 group demonstrated the longest mean time to return to work and recreational sports, with the lowest proportion returning to preinjury sports. The TFS-4 group showed a significantly higher rate of sprain recurrence (12.5%) than the other 2 groups ( P =.021). All the other subjective scores significantly improved after the operation without differences among the 3 groups. Conclusion: Concomitant severe syndesmotic widening adversely affects the return to activities after Broström operation in CLAI cases. The CLAI patients with a middle TFS width ≥4 mm were associated with delayed return to work and sports, a lower proportion of returning to preinjury sports, and more sprain recurrence, which might require further surgical intervention for syndesmosis in addition to Broström surgery. Level of Evidence: Level III, retrospective cohort study.

Pretension of the viscoelastic graft by cyclic knee motion has been confirmed to decrease the graft creep and improve the outcome of anterior cruciate ligament (ACL) reconstruction. The purpose of the present study was to investigate the effect of cyclic knee motion on the elongation of the four-strand hamstring tendon autograft in situ and to explore the stable level cycle, in which the tendon length achieved a stable level. The study was performed with 53 consecutive patients undergoing transtibial ACL reconstruction with four strand hamstring tendon from Aug 2013 to Apr 2015. 43 males and 10 females were included with mean age of 29 ± 10 years. The pretension of the tendons was operated by cyclical knee motion ranging from 0 to 110°after the femoral fixation with Endo-button. The tendon length after 10, 20, 30 and 40 cycles was measured respectively and compared by repeated measure ANOVA. Then multivariate logistic regression was used to investigate the effect of the patients’ parameters (age, gender, height, body weight, tendon length, etc.) on the elongation of the graft and the stable level cycle. The mean lengthening of the graft at 10, 20, 30 and 40 times was 3.0 ± 1.4 mm, 4.3 ± 1.5 mm, 4.8 ± 1.7 mm and 4.8 ± 1.8 mm respectively. No significant correlation was found between the elongation and the patients’ parameters. There was significant difference of the tendon length from 0 to 30 cycles (F = 264.8, df = 1.95, p<0.001). However, the tendon length achieved a stable level after 30 cycles and the median elongation from 30 cycles to 40 cycles was 0 (0–1) mm with no significant difference (F = 2.039, p = 0.159). The male and female tendon length achieved to a stable level at 20 cycles and 30 cycles respectively but with no significant difference (p = 0.074). The four-strand hamstring tendon was elongated after cyclic knee motion and the elongation achieved a stable level after 30 cycles for the transtibial technique. Both of the tendon elongation and the stable level cycle were not correlated with patients’ gender, age, preoperative duration, graft diameter and length.