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Yang Q, Shan C, Zhao B, Liu W, Hai J. The effect of early weight-bearing on bone fusion after triple arthrodesis. Comput Methods Biomech Biomed Engin 2024:1-11. [PMID: 38229421 DOI: 10.1080/10255842.2023.2293646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Accepted: 11/28/2023] [Indexed: 01/18/2024]
Abstract
Triple arthrodesis is an effective method for treating stiff horseshoe feet and severe osteoarthritis. However, it is still a challenge to improve postoperative bone fusion by changing early weight-bearing. This study improved the classical bone remodeling algorithm, established a mathematical relationship between density change rate and mechanical stimulation, and combined it with finite element theory. The proposed algorithm can not only predict the effect of early weight-bearing on triple arthrodesis but also visually demonstrate the change of bone mineral density with time. The analysis results indicated that 2.5% of the initial load was a potential factor leading to bone nonunion, and 50% of the initial load would result in bone resorption. Meanwhile, it was found that 25% of the external load was more conducive to postoperative rehabilitation. The study results have theoretical significance for enhancing the effect of postoperative bone fusion and formulating a more scientific rehabilitation program, thereby supporting patients' postoperative rehabilitation exercise.
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Affiliation(s)
- Qingwei Yang
- School of Mechanical Engineering, Xinjiang University, Shuimogou District, Urumqi, Xinjiang, China
| | - Chunlong Shan
- Xinjiang Medical University, Shuimogou District, Urumqi, Xinjiang, China
| | - Bo Zhao
- Xinjiang Medical University, Shuimogou District, Urumqi, Xinjiang, China
| | - Wei Liu
- Xinjiang Medical University, Shuimogou District, Urumqi, Xinjiang, China
| | - Jizhe Hai
- School of Mechanical Engineering, Xinjiang University, Shuimogou District, Urumqi, Xinjiang, China
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Cen X, Song Y, Yu P, Sun D, Simon J, Bíró I, Gu Y. Effects of plantar fascia stiffness on the internal mechanics of idiopathic pes cavus by finite element analysis: implications for metatarsalgia. Comput Methods Biomech Biomed Engin 2023:1-9. [PMID: 37817665 DOI: 10.1080/10255842.2023.2268231] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Accepted: 10/01/2023] [Indexed: 10/12/2023]
Abstract
Metatarsalgia occurring in individuals with pes cavus is typically associated with abnormal loading patterns in the forefoot resulting from structural alterations. Simultaneously, the frequent overstress of the plantar fascia (PF) caused by the persistence of this foot deformity may further exacerbate the chronic pain induced by metatarsal overload. We aimed to investigate and quantify the effects of PF stiffness on the internal biomechanics of pes cavus using a computational modelling approach. A patient-specific finite element model of the foot-ankle complex using the actual three-dimensional geometry of idiopathic pes cavus bones and soft tissues was reconstructed. A sensitivity study was conducted to evaluate the effects of varying elastic modulus (0-700 MPa) of the PF on the metatarsal stress distribution, and force transmission through the metatarsophalangeal (MTP) and tarsometatarsal (TMT) joints in the pes cavus. The results indicated that variations in PF stiffness led to stress redistribution in the metatarsal region. Peak stress gradually reduced with decreasing stiffness until the PF was released, eventually resulting in a reduction of 22.39% compared to the reference value of 350 MPa. Furthermore, adjusting the PF stiffness to twice the reference value (700 MPa) increased the contact forces through the TMT and MTP joints by up to 23% and 116%, respectively. The reduction of PF stiffness alleviated focal metatarsal loading, and therefore, surgical fascia release can be considered to alleviate metatarsalgia in patients with pes cavus.
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Affiliation(s)
- Xuanzhen Cen
- Faculty of Sports Science, Ningbo University, Ningbo, China
- Doctoral School on Safety and Security Sciences, Óbuda University, Budapest, Hungary
- Faculty of Engineering, University of Szeged, Szeged, Hungary
| | - Yang Song
- Faculty of Sports Science, Ningbo University, Ningbo, China
- Doctoral School on Safety and Security Sciences, Óbuda University, Budapest, Hungary
- Faculty of Engineering, University of Szeged, Szeged, Hungary
| | - Peimin Yu
- Faculty of Sports Science, Ningbo University, Ningbo, China
- Auckland Bioengineering Institute, The University of Auckland, Auckland, New Zealand
| | - Dong Sun
- Faculty of Sports Science, Ningbo University, Ningbo, China
| | - János Simon
- Faculty of Engineering, University of Szeged, Szeged, Hungary
| | - István Bíró
- Faculty of Engineering, University of Szeged, Szeged, Hungary
| | - Yaodong Gu
- Faculty of Sports Science, Ningbo University, Ningbo, China
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Malakoutikhah H, Latt LD. Disease-Specific Finite element Analysis of the Foot and Ankle. Foot Ankle Clin 2023; 28:155-172. [PMID: 36822685 DOI: 10.1016/j.fcl.2022.10.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Finite-element analysis is a computational modeling technique that can be used to quantify parameters that are difficult or impossible to measure externally in a geometrically complex structure such as the foot and ankle. It has been used to improve our understanding of pathomechanics and to evaluate proposed treatments for several disorders, including progressive collapsing foot deformity, ankle arthritis, syndesmotic injury, ankle fracture, plantar fasciitis, diabetic foot ulceration, hallux valgus, and lesser toe deformities. Parameters calculated from finite-element models have been widely used to make predictions about their biomechanical correlates.
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Affiliation(s)
- Hamed Malakoutikhah
- Department of Aerospace and Mechanical Engineering, University of Arizona, 1130 North Mountain Avenue, Tucson, AZ 85721, USA.
| | - Leonard Daniel Latt
- Department of Orthopaedic Surgery, University of Arizona, 1501 N. Campbell Ave, Suite 8401, Tucson, AZ, 85724 USA
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