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Effects of Ankle Arthrodesis on Biomechanical Performance of the Entire Foot.

Wang Y, Li Z, Wong DW, Zhang M - PLoS ONE (2015)

Bottom Line: An average contact pressure of 2.14 MPa was predicted at the talonavicular joint after surgery and the maximum variation was shown to be 80% in joints of the first ray.The contact force and pressure of the subtalar joint decreased after surgery, indicating that arthritis at this joint was not necessarily a consequence of ankle arthrodesis but rather a progression of pre-existing degenerative changes.Von Mises stress in the second and third metatarsal bones at the second-peak instant increased to 52 MPa and 34 MPa, respectively, after surgery.

View Article: PubMed Central - PubMed

Affiliation: Interdisciplinary Division of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University Hong Kong, China; The Hong Kong Polytechnic University Shenzhen Research Institute, Shenzhen, China.

ABSTRACT

Background/methodology: Ankle arthrodesis is one popular surgical treatment for ankle arthritis, chronic instability, and degenerative deformity. However, complications such as foot pain, joint arthritis, and bone fracture may cause patients to suffer other problems. Understanding the internal biomechanics of the foot is critical for assessing the effectiveness of ankle arthrodesis and provides a baseline for the surgical plan. This study aimed to understand the biomechanical effects of ankle arthrodesis on the entire foot and ankle using finite element analyses. A three-dimensional finite element model of the foot and ankle, involving 28 bones, 103 ligaments, the plantar fascia, major muscle groups, and encapsulated soft tissue, was developed and validated. The biomechanical performances of a normal foot and a foot with ankle arthrodesis were compared at three gait instants, first-peak, mid-stance, and second-peak.

Principal findings/conclusions: Changes in plantar pressure distribution, joint contact pressure and forces, von Mises stress on bone and foot deformation were predicted. Compared with those in the normal foot, the peak plantar pressure was increased and the center of pressure moved anteriorly in the foot with ankle arthrodesis. The talonavicular joint and joints of the first to third rays in the hind- and mid-foot bore the majority of the loading and sustained substantially increased loading after ankle arthrodesis. An average contact pressure of 2.14 MPa was predicted at the talonavicular joint after surgery and the maximum variation was shown to be 80% in joints of the first ray. The contact force and pressure of the subtalar joint decreased after surgery, indicating that arthritis at this joint was not necessarily a consequence of ankle arthrodesis but rather a progression of pre-existing degenerative changes. Von Mises stress in the second and third metatarsal bones at the second-peak instant increased to 52 MPa and 34 MPa, respectively, after surgery. These variations can provide indications for outcome assessment of ankle arthrodesis surgery.

No MeSH data available.


Related in: MedlinePlus

Comparison of the plantar pressure distribution between normal foot model and ankle arthrodesis foot model at the three instants.
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pone.0134340.g006: Comparison of the plantar pressure distribution between normal foot model and ankle arthrodesis foot model at the three instants.

Mentions: Fig 6 displays the plantar pressure distributions at the first-peak, mid-stance, and second-peak instants in the normal and ankle arthrodesis models. The peak plantar pressure at the three respective instants was 0.33 MPa, 0.68 MPa, and 0.68 MPa in the normal model and 0.36 MPa, 0.78 MPa, and 0.93 MPa in the ankle arthrodesis model. In general, the peak plantar pressure increased due to ankle arthrodesis and was most obvious at the second-peak instant, especially over the fore-foot region. The center of pressure moved anteriorly by 15 mm, 16 mm, and 5 mm at the three instants. A slight variation in the center of pressure in the medio-lateral direction due to ankle arthrodesis was observed at the second-peak instant. It was located between the heads of the second and third metatarsal bones in the normal foot model and shifted medially to the head of the second metatarsal in the ankle arthrodesis model.


Effects of Ankle Arthrodesis on Biomechanical Performance of the Entire Foot.

Wang Y, Li Z, Wong DW, Zhang M - PLoS ONE (2015)

Comparison of the plantar pressure distribution between normal foot model and ankle arthrodesis foot model at the three instants.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4519327&req=5

pone.0134340.g006: Comparison of the plantar pressure distribution between normal foot model and ankle arthrodesis foot model at the three instants.
Mentions: Fig 6 displays the plantar pressure distributions at the first-peak, mid-stance, and second-peak instants in the normal and ankle arthrodesis models. The peak plantar pressure at the three respective instants was 0.33 MPa, 0.68 MPa, and 0.68 MPa in the normal model and 0.36 MPa, 0.78 MPa, and 0.93 MPa in the ankle arthrodesis model. In general, the peak plantar pressure increased due to ankle arthrodesis and was most obvious at the second-peak instant, especially over the fore-foot region. The center of pressure moved anteriorly by 15 mm, 16 mm, and 5 mm at the three instants. A slight variation in the center of pressure in the medio-lateral direction due to ankle arthrodesis was observed at the second-peak instant. It was located between the heads of the second and third metatarsal bones in the normal foot model and shifted medially to the head of the second metatarsal in the ankle arthrodesis model.

Bottom Line: An average contact pressure of 2.14 MPa was predicted at the talonavicular joint after surgery and the maximum variation was shown to be 80% in joints of the first ray.The contact force and pressure of the subtalar joint decreased after surgery, indicating that arthritis at this joint was not necessarily a consequence of ankle arthrodesis but rather a progression of pre-existing degenerative changes.Von Mises stress in the second and third metatarsal bones at the second-peak instant increased to 52 MPa and 34 MPa, respectively, after surgery.

View Article: PubMed Central - PubMed

Affiliation: Interdisciplinary Division of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University Hong Kong, China; The Hong Kong Polytechnic University Shenzhen Research Institute, Shenzhen, China.

ABSTRACT

Background/methodology: Ankle arthrodesis is one popular surgical treatment for ankle arthritis, chronic instability, and degenerative deformity. However, complications such as foot pain, joint arthritis, and bone fracture may cause patients to suffer other problems. Understanding the internal biomechanics of the foot is critical for assessing the effectiveness of ankle arthrodesis and provides a baseline for the surgical plan. This study aimed to understand the biomechanical effects of ankle arthrodesis on the entire foot and ankle using finite element analyses. A three-dimensional finite element model of the foot and ankle, involving 28 bones, 103 ligaments, the plantar fascia, major muscle groups, and encapsulated soft tissue, was developed and validated. The biomechanical performances of a normal foot and a foot with ankle arthrodesis were compared at three gait instants, first-peak, mid-stance, and second-peak.

Principal findings/conclusions: Changes in plantar pressure distribution, joint contact pressure and forces, von Mises stress on bone and foot deformation were predicted. Compared with those in the normal foot, the peak plantar pressure was increased and the center of pressure moved anteriorly in the foot with ankle arthrodesis. The talonavicular joint and joints of the first to third rays in the hind- and mid-foot bore the majority of the loading and sustained substantially increased loading after ankle arthrodesis. An average contact pressure of 2.14 MPa was predicted at the talonavicular joint after surgery and the maximum variation was shown to be 80% in joints of the first ray. The contact force and pressure of the subtalar joint decreased after surgery, indicating that arthritis at this joint was not necessarily a consequence of ankle arthrodesis but rather a progression of pre-existing degenerative changes. Von Mises stress in the second and third metatarsal bones at the second-peak instant increased to 52 MPa and 34 MPa, respectively, after surgery. These variations can provide indications for outcome assessment of ankle arthrodesis surgery.

No MeSH data available.


Related in: MedlinePlus