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Mantecón R, Ruiz A, Wheatley BM, Díaz-Álvarez J, Miguélez H, Youssef G. Feasibility Study of Experimental Protocol for the Time-Dependent Mechanical Response of Synthetic Tibia. J Biomech Eng 2024; 146:084502. [PMID: 38426592 DOI: 10.1115/1.4064974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2023] [Accepted: 02/29/2024] [Indexed: 03/02/2024]
Abstract
In this research, an experimental biomechanics construct was developed to reveal the mechanics of distal tibial fracture by submitting synthetic tibiae to cyclic loading, resulting in a combined stress state due to axial compression and bending loads. The synthetic tibia was fixed at the knee but allowed to rotate in the coronal and sagittal planes at the ankle. The first three loading regimes lasted for 4000 cycles/each, and the final until ultimate failure. After 12k±80 cycles, the observed failure patterns closely resembled distal tibial fractures. The collected data during cyclic loading were fitted into a phenomenological model to deduce the time-dependent response of the synthetic tibiae. Images were also collected and analyzed using digital image correlation to deduce the full-field state of strain. The latter revealed that longitudinal strain contours extended in the proximal-distal direction. The transverse strain contours exemplified a medial-to-lateral distribution, attributed to the combined contributions of the Poisson's effect and the flexural deformation from axial and bending components of the applied load, respectively. The experimental construct, full-field characterization, and data analysis approaches can be extended to elucidate the effect of different fixation devices on the overall mechanical behavior of the bone and validate computational models in future research.
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Affiliation(s)
- Ramiro Mantecón
- Experimental Mechanics Laboratory, Mechanical Engineering Department, San Diego State University, 5500 Campanile Dr., San Diego, CA 92182; Department of Mechanical Engineering, Universidad Carlos III de Madrid, Avenida de la Universidad 30, Leganés, Madrid 28911, Spain
- Universidad Carlos III de Madrid
| | - Alvaro Ruiz
- Experimental Mechanics Laboratory, Mechanical Engineering Department, San Diego State University, 5500 Campanile Dr., San Diego, CA 92182
- San Diego State University
| | - Benjamin M Wheatley
- Department of Orthopedic Surgery, Naval Medical Center San Diego, 34800 Bob Wilson Dr., San Diego, CA 92134
- Naval Medical Center San Diego
| | - José Díaz-Álvarez
- Department of Mechanical Engineering, Universidad Carlos III de Madrid, Avenida de la Universidad 30, Leganés, Madrid 28911, Spain
- Carlos III University of Madrid
| | - Henar Miguélez
- Department of Mechanical Engineering, Universidad Carlos III de Madrid, Avenida de la Universidad 30, Leganés, Madrid 28911, Spain
| | - George Youssef
- Experimental Mechanics Laboratory, Mechanical Engineering Department, San Diego State University, 5500 Campanile Dr., San Diego, CA 92182
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Lee HY, Boettner F, Blevins JL, Rodriguez JA, Lipman JD, Quevedo González FJ, Bostrom MP, Wright TM, Sculco PK. Hip joint center lateralization minimally affects the biomechanics of patient-specific flanged acetabular components: A computational model. J Orthop Res 2024. [PMID: 38669091 DOI: 10.1002/jor.25864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Revised: 03/29/2024] [Accepted: 04/12/2024] [Indexed: 04/28/2024]
Abstract
Patient-specific flanged acetabular components are utilized to treat failed total hip arthroplasties with large acetabular defects. Previous clinical studies from our institution showed that these implants tend to lateralize the acetabular center of rotation. However, the clinical impact of lateralization on implant survivorship is debated. Our goal was to develop a finite element model to quantify how lateralization of the native hip center affects periprosthetic strain and implant-bone micromotion distributions in a static level gait loading condition. To build the model, we computationally created a superomedial acetabular defect in a computed tomography 3D reconstruction of a native pelvis and designed a flanged acetabular implant to address this simulated bone defect. We modeled two implants, one with ~1 cm and a second with ~2 cm of hip center lateralization. We applied the maximum hip contact force and corresponding abductor force observed during level gait. The resulting strains were compared to bone fatigue strength (0.3% strain) and the micromotions were compared to the threshold for bone ingrowth (20 µm). Overall, the model demonstrated that the additional lateralization only slightly increased the area of bone at risk of failure and decreased the areas compatible with bone ingrowth. This computational study of patient-specific acetabular implants establishes the utility of our modeling approach. Further refinement will yield a model that can explore a multitude of variables and could be used to develop a biomechanically-based acetabular bone loss classification system to guide the development of patient-specific implants in the treatment of large acetabular bone defects.
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Affiliation(s)
- Haena-Young Lee
- Department of Biomechanics, Hospital for Special Surgery, New York, New York, USA
| | - Friedrich Boettner
- Stavros Niarchos Foundation Complex Joint Reconstruction Center, Hospital for Special Surgery, New York, New York, USA
| | - Jason L Blevins
- Stavros Niarchos Foundation Complex Joint Reconstruction Center, Hospital for Special Surgery, New York, New York, USA
| | - Jose A Rodriguez
- Stavros Niarchos Foundation Complex Joint Reconstruction Center, Hospital for Special Surgery, New York, New York, USA
| | - Joseph D Lipman
- Department of Biomechanics, Hospital for Special Surgery, New York, New York, USA
| | | | - Mathias P Bostrom
- Stavros Niarchos Foundation Complex Joint Reconstruction Center, Hospital for Special Surgery, New York, New York, USA
| | - Timothy M Wright
- Department of Biomechanics, Hospital for Special Surgery, New York, New York, USA
| | - Peter K Sculco
- Stavros Niarchos Foundation Complex Joint Reconstruction Center, Hospital for Special Surgery, New York, New York, USA
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Liu CD, Hu SJ, Chang SM, Du SC, Xiong WF, Chu YQ. Importance of the Posterior Plate in Three-Column Tibial Plateau Fractures: A Finite Element Analysis and Clinical Validation. Orthop Surg 2024; 16:930-942. [PMID: 38438157 PMCID: PMC10984809 DOI: 10.1111/os.14021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Revised: 01/26/2024] [Accepted: 02/01/2024] [Indexed: 03/06/2024] Open
Abstract
OBJECTIVE Dual-plate fixation was thought to be the gold standard for treating complicated bicondylar tibial plateau fractures, yet it was found to be hard to accommodate the posterior column in three-column fractures. Currently, column-specific fixation is becoming more and more recognized, but no comprehensive investigation has been performed to back it up. Therefore, the objective of this study was to validate the importance of posterior column fixation in the three-column tibial fractures by a finite element (FE) analysis and clinical study. METHODS In FE analysis, three models were developed: the longitudinal triple-plate group (LTPG), the oblique triple-plate group (OTPG), and the dual-plate group (DPG). Three loading scenarios were simulated. The distribution of the displacement and the equivalent von Mises stress (VMS) in each structure was calculated. The comparative measurements including the maximum posterior column collapse (MPCC), the maximum total displacement of the model (MTD), the maximum VMS of cortical posterior column (MPC-VMS), and the maximum VMS located on each group of plates and screws (MPS-VMS). The clinical study evaluated the indicators between the groups with or without the posterior plate, including operation time, blood loss volume, full-weight bearing period, Hospital for Special Surgery Knee Scoring system (HSS), Rasmussen score, and common postoperative complications. RESULTS In the FE analysis, the MPCC, the MPC-VMS, and the MTD were detected in much lower amounts in LTPG and OTPG than in DPG. In comparison with DPG, the LTPG and OTPG had larger MPS-VMS. In the clinical study, 35 cases were included. In the triple-plate (14) and dual-plate (21) groups, the operation took 115.6 min and 100.5 min (p < 0.05), respectively. Blood loss in both groups was 287.0 mL and 206.6 mL (p < 0.05), and the full-weight bearing period was 14.5 weeks and 16.2 weeks (p < 0.05). At the final follow-up, the HSS score was 85.0 in the triple-plate group and 77.5 in the dual-plate (p < 0.05), the Rasmussen score was 24.1 and 21.6 (p < 0.05), there were two cases with reduction loss (9.5%) in the dual-plate group and one case of superficial incision infection found in the triple-plate group. CONCLUSION The posterior implant was beneficial in optimizing the biomechanical stability and functional outcomes in the three-column tibial plateau fractures.
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Affiliation(s)
- Chen-Dong Liu
- Department of Orthopedic Surgery, Yangpu Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Sun-Jun Hu
- Department of Orthopedic Surgery, Yangpu Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Shi-Min Chang
- Department of Orthopedic Surgery, Yangpu Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Shou-Chao Du
- Department of Orthopedic Surgery, Yangpu Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Wen-Feng Xiong
- Department of Orthopedic Surgery, Yangpu Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Yong-Qian Chu
- Department of Orthopedic Surgery, Yangpu Hospital, School of Medicine, Tongji University, Shanghai, China
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Yan Z, Zou C, Kenmegne GR, Pan X, Ghimire N, Silva KMN, Fang Y. Newly designed plate for the treatment of posterolateral tibial plateau fractures: a finite element analysis. J Orthop Surg Res 2024; 19:201. [PMID: 38532441 DOI: 10.1186/s13018-024-04686-z] [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] [Received: 12/17/2023] [Accepted: 03/16/2024] [Indexed: 03/28/2024] Open
Abstract
BACKGROUND This study investigated the biomechanical properties of a new plate used for the treatment of posterolateral tibial plateau fractures using finite element analysis. METHODS The study groups were as follows: group PM, model of the new plate with posteromedial tibial plateau fracture; group PL, model of the new plate with posterolateral tibial plateau fracture; and group PC, model of the new plate with posterior tibial plateau fracture. We used two loading modes: uniform loading on the entire plateau, and loading on the posterior plateau. Data such as the displacement of the fracture and distribution of stress on the new plate and screws were recorded and analyzed. RESULTS When the whole plateau was loaded, the displacement of fractures in groups PM, PL, and PC were 0.273, 0.114, and 0.265 mm, respectively. The maximum stresses on the plates in groups PM, PL, and PC were 118.131 MPa, 44.191 MPa, and 115.433 MPa. The maximum stresses on the screws in Groups PM, PL, and PC were 166.731, 80.330, and 164.439 MPa, respectively. When the posterior tibial plateau was loaded, the displacement of the fractures in groups PM, PL, and PC was 0.410, 0.213, and 0.390 mm, respectively. The maximum stresses on the plates in groups PM, PL, and PC were 194.012 MPa, 72.806 MPa, and 185.535 MPa. The maximum stresses on the screws in Groups PM, PL, and PC were 278.265, 114.839, and 266.396 MPa, respectively. CONCLUSION The results of this study revealed that titanium plates have good fixation effects in all groups; therefore, the use of the new plate for posterolateral tibial plateau fractures appears to be safe and valid.
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Affiliation(s)
- Zhaokui Yan
- Department of Orthopedics, West China Hospital of Sichuan University, Chengdu, 610041, China
- Trauma center, West China Hospital of Sichuan University, Chengdu, 610041, China
| | - Chang Zou
- Department of Orthopedics, West China Hospital of Sichuan University, Chengdu, 610041, China
- Trauma center, West China Hospital of Sichuan University, Chengdu, 610041, China
| | - Guy Romeo Kenmegne
- Department of Orthopedics, West China Hospital of Sichuan University, Chengdu, 610041, China
- Trauma center, West China Hospital of Sichuan University, Chengdu, 610041, China
| | - Xuelin Pan
- Department of Radiology, West China Hospital of Sichuan University, Chengdu, 610041, China
| | - Nawin Ghimire
- Department of Orthopedics, West China Hospital of Sichuan University, Chengdu, 610041, China
- Trauma center, West China Hospital of Sichuan University, Chengdu, 610041, China
| | - Kuruwitage Manthi Nihara Silva
- Department of Orthopedics, West China Hospital of Sichuan University, Chengdu, 610041, China
- Trauma center, West China Hospital of Sichuan University, Chengdu, 610041, China
| | - Yue Fang
- Department of Orthopedics, West China Hospital of Sichuan University, Chengdu, 610041, China.
- Trauma center, West China Hospital of Sichuan University, Chengdu, 610041, China.
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Dong Z, Yang C, Zhang D, Dong S. The application of human medical image-based finite element analysis in the construction of mouse osteoarthritis models. Heliyon 2024; 10:e26226. [PMID: 38390145 PMCID: PMC10882037 DOI: 10.1016/j.heliyon.2024.e26226] [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: 05/05/2023] [Revised: 02/08/2024] [Accepted: 02/08/2024] [Indexed: 02/24/2024] Open
Abstract
The anterior cruciate ligament plays an important role in maintaining the stability of the knee joint. Its injury is a common cause of articular cartilage degeneration and osteoarthritis (OA). The anterior cruciate ligament transection (ACLT) method is commonly employed to construct animal models for studying osteoarthritis pathogenesis. However, the precise mechanism of how anterior cruciate ligament injury leads to osteoarthritis is not fully understood. This study utilized finite element analysis (FEA) with human medical images to simulate the biomechanical characteristics of anterior cruciate ligament (ACL) injury. Osteoarthritis models were subsequently established in C57BL/6 mice using ACLT to explore the link between ACL injury and osteoarthritis development. The results of FEA showed that, after an anterior cruciate ligament injury, abnormal stress was concentrated in the medial and lateral of the femoral and tibial articular cartilage during knee flexion and extension. In order to better display the pathological changes of articular cartilage in the stress areas, the medial tibial cartilage was selected as a representative area to observe the continuous pathological changes of articular cartilage in ACLT-induced OA mice. The articular cartilage degeneration was most dramatic at four weeks post ACLT operation and then remained relatively stable. This study may have significant implications for the development of animal models of osteoarthritis and provide a reference for histopathological research on osteoarthritis.
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Affiliation(s)
- Zicai Dong
- Department of Biomedical Materials Science, Third Military Medical University (Army Medical University), 400038, Chongqing, PR China
| | - Chunhan Yang
- School of Stomatology, Kunming Medical University, 650000, Kunming, PR China
| | - Dingsong Zhang
- Department of Hematology, 920th Hospital of Joint Logistics Support Force, PLA, 650118, Kunming, PR China
| | - Shiwu Dong
- Department of Biomedical Materials Science, Third Military Medical University (Army Medical University), 400038, Chongqing, PR China
- State Key Laboratory of Trauma and Chemical Poisoning, Third Military Medical University (Army Medical University), 400038, Chongqing, PR China
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Yang P, Liu Q, Lin T, Aikebaier A, Jiang L, Sun W, Zhang Q, Bai X, Sun W. Mechanical upside of PAO mainstream fixations: co-simulation based on early postoperative gait characteristics of DDH patients. Front Bioeng Biotechnol 2023; 11:1171040. [PMID: 37539435 PMCID: PMC10396769 DOI: 10.3389/fbioe.2023.1171040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 07/03/2023] [Indexed: 08/05/2023] Open
Abstract
Purpose: To investigate the early postoperative gait characteristics of patients who underwent periacetabular osteotomy (PAO) and predict the biomechanical performance of two commonly used PAO fixation methods: iliac screw (IS) and transverse screw (TS). Methods: A total of 12 patients with unilateral developmental dysplasia of the hip (DDH) (mean age 27.81 ± 4.64 years, 42% male) that were scheduled to undergo PAO surgery were included in this study. Their preoperative CT images and pre- and postoperative gait data were used to create subject-specific musculoskeletal models and complete the inverse dynamics analysis (IDA). Two patients with typical gait characteristics were selected using clustering analysis, and their IDA data were incorporated into finite element (FE) models of IS and TS fixations. Failure simulation was performed by applying iterative steps with increasing gait load to predict yield load. Stress results and yield loads were calculated for each FE model at different phases of the gait cycle. Results: Postoperative gait showed improvement compared to preoperative gait but remained inferior to that of healthy individuals. Postoperative gait was characterized by a lower hip range of motion, lower peri-ilium muscle forces, particularly in the abductors, and a sharper initial peak and flatter second peak of hip joint reaction force (HRF). Finite element analysis (FEA) showed a trend of increasing stress during the second-fourth phases of the gait cycle, with lower stress levels in other phases. At high-stress gait phases, the mean stress of maximum p ¯ 100 differed significantly between IS and TS (p < 0.05) and between coupled and uncoupled muscle forces (p < 0.05). Failure analysis predicted a slightly larger yield load for TS configurations (6.21*BW) than that for IS (6.16*BW), but both were well above the gait load. Coupled and uncoupled groups showed similar results, but uncoupled groups had lower yield loads (5.9*BW). Conclusion: PAO early postoperative gait shows a normalized trend, but abnormalities persist. IS and TS are both capable of resisting mechanical strain failure, with no significant mechanical advantage found for transverse screw fixation during PAO early postoperative gait. Additionally, it is important to note that the TS may have a higher risk of cyclic fatigue failure due to the localized greater stress concentration. Furthermore, the most medial screw is crucial for pelvic stability.
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Affiliation(s)
- Peng Yang
- Department of Orthopedics, Shenzhen Second People’s Hospital, Shenzhen, Guangdong, China
- Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences (CAS), Shenzhen, Guangdong, China
| | - Qi Liu
- Department of Orthopedics, Shenzhen Second People’s Hospital, Shenzhen, Guangdong, China
| | - Tianye Lin
- Traumatology and Orthopedics Institute of Chinese Medicine of Guangdong, Guangzhou, Guangdong, China
| | - Aobulikasimu Aikebaier
- Department of Orthopedics, Shenzhen Second People’s Hospital, Shenzhen, Guangdong, China
| | - Luoyong Jiang
- Department of Orthopedics, Shenzhen Second People’s Hospital, Shenzhen, Guangdong, China
| | - Weichao Sun
- Department of Orthopedics, Shenzhen Second People’s Hospital, Shenzhen, Guangdong, China
| | - Qingwen Zhang
- Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, Guangdong, China
| | - Xueling Bai
- Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences (CAS), Shenzhen, Guangdong, China
| | - Wei Sun
- Department of Orthopedics, Shenzhen Second People’s Hospital, Shenzhen, Guangdong, China
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Wei G, Niu X, Li Y, Chang T, Zhang J, Wang H, Li X, He Y, Wang R, Tian F, Xu Y. Biomechanical analysis of internal fixation system stability for tibial plateau fractures. Front Bioeng Biotechnol 2023; 11:1199944. [PMID: 37388773 PMCID: PMC10303893 DOI: 10.3389/fbioe.2023.1199944] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Accepted: 06/06/2023] [Indexed: 07/01/2023] Open
Abstract
Background: Complex bone plateau fractures have been treated with bilateral plate fixation, but previous research has overemphasized evaluating the effects of internal fixation design, plate position, and screw orientation on fracture fixation stability, neglecting the internal fixation system's biomechanical properties in postoperative rehabilitation exercises. This study aimed to investigate the mechanical properties of tibial plateau fractures after internal fixation, explore the biomechanical mechanism of the interaction between internal fixation and bone, and make suggestions for early postoperative rehabilitation and postoperative weight-bearing rehabilitation. Methods: By establishing the postoperative tibia model, the standing, walking and running conditions were simulated under three axial loads of 500 N, 1000 N, and 1500 N. Accordingly, finite element analysis (FEA) was performed to analyze the model stiffness, displacement of fractured bone fragments, titanium alloy plate, screw stress distribution, and fatigue properties of the tibia and the internal fixation system under various conditions. Results: The stiffness of the model increased significantly after internal fixation. The anteromedial plate was the most stressed, followed by the posteromedial plate. The screws at the distal end of the lateral plate, the screws at the anteromedial plate platform and the screws at the distal end of the posteromedial plate are under greater stress, but at a safe stress level. The relative displacement of the two medial condylar fracture fragments varied from 0.002-0.072 mm. Fatigue damage does not occur in the internal fixation system. Fatigue injuries develop in the tibia when subjected to cyclic loading, especially when running. Conclusion: The results of this study indicate that the internal fixation system tolerates some of the body's typical actions and may sustain all or part of the weight early in the postoperative period. In other words, early rehabilitative exercise is recommended, but avoid strenuous exercise such as running.
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Affiliation(s)
- Guoqiang Wei
- Department of Rehabilitation Medicine, Changzhi Medical College Affiliated Changzhi People’s Hospital, Changzhi, China
| | - Xiaofen Niu
- Department of Rehabilitation Medicine, Changzhi Medical College Affiliated Changzhi People’s Hospital, Changzhi, China
| | - Yuan Li
- Department of Orthopedics, Changzhi Medical College Affiliated Peace Hospital, Changzhi, China
| | - Tingjie Chang
- Department of Orthopedics, Changzhi Medical College Affiliated Peace Hospital, Changzhi, China
| | - Jianfang Zhang
- Department of Rehabilitation Medicine, Changzhi Medical College Affiliated Changzhi People’s Hospital, Changzhi, China
| | - Haiyan Wang
- Department of Anatomy, School of Basic Medical Sciences, Inner Mongolia Medical University, Hohhot, China
| | - Xiaohe Li
- Department of Anatomy, School of Basic Medical Sciences, Inner Mongolia Medical University, Hohhot, China
| | - Yujie He
- Department of Anatomy, School of Basic Medical Sciences, Inner Mongolia Medical University, Hohhot, China
| | - Ruijiang Wang
- Department of Orthopedics, Changzhi Second People’s Hospital, Changzhi, China
| | - Fei Tian
- Department of Health Management, Changzhi Medical College, Changzhi, China
- Department of Rehabilitation Medicine, Changzhi Medical College Affiliated Peace Hospital, Changzhi, China
| | - Yangyang Xu
- Beijing Key Laboratory for Design and Evaluation Technology of Advanced Implantable and Interventional Medical Devices, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing, China
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Liu W, Li F, He H, Teraili A, Wang X, Wahapu P, Wang C. Biomechanical application of finite elements in the orthopedics of stiff clubfoot. BMC Musculoskelet Disord 2022; 23:1112. [PMID: 36544111 PMCID: PMC9768888 DOI: 10.1186/s12891-022-06092-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Accepted: 12/14/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND The purpose of this study was to evaluate the effect of varying the different correction angles of hindfoot osteotomy orthosis on the biomechanical changes of the adjacent joints after triple arthrodesis in adult patients with stiff clubfoot to determine the optimal hindfoot correction angle and provide a biomechanical basis for the correction of hindfoot deformity in patients with stiff clubfoot. METHODS A 26-year-old male patient with a stiff left clubfoot was selected for the study, and his ankle and foot were scanned using dual-source computed tomography. A three-dimensional finite element model of the ankle was established, and after the validity of the model was verified by plantar pressure experiments, triple arthrodesis was simulated to analyze the biomechanical changes of the adjacent joints under the same load with "3°" of posterior varus, "0°" of a neutral position and "3°, 6°, 9°" of valgus as the correction angles. RESULTS The peak plantar pressure calculated by the finite element model of the clubfoot was in good agreement with the actual plantar pressure measurements, with an error of less than 1%. In triple arthrodesis, the peak von Mises stress in the adjacent articular cartilage was significantly different and less than the preoperative stress when the corrected angle of the hindfoot was valgus "6°". In comparison, the peak von Mises stress in the adjacent articular cartilage was not significantly different in varus "3°", neutral "0°", valgus "3°" and valgus "9°" compared with the preoperative stress. CONCLUSION The results of this study showed that different angles of hindfoot correction in triple arthrodesis did not increase the peak von Mises stress in the adjacent joints, which may not lead to the development of arthritis in the adjacent joint, and a hindfoot correction angle of "6°" of valgus significantly reduced the peak von Mises stress in the adjacent joints after triple arthrodesis.
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Affiliation(s)
- Wei Liu
- grid.459346.90000 0004 1758 0312The Affiliated Tumor Hospital of Xinjiang Medical University, Urumqi, Xinjiang 830000 People’s Republic of China
| | - Fei Li
- grid.460730.6The Sixth Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang 830000 People’s Republic of China
| | - Haiyang He
- grid.460730.6The Sixth Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang 830000 People’s Republic of China
| | - Aihelamu Teraili
- grid.460730.6The Sixth Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang 830000 People’s Republic of China
| | - Xue Wang
- grid.460730.6The Sixth Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang 830000 People’s Republic of China
| | - Paerhati Wahapu
- grid.460730.6The Sixth Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang 830000 People’s Republic of China
| | - Chengwei Wang
- grid.459346.90000 0004 1758 0312The Affiliated Tumor Hospital of Xinjiang Medical University, Urumqi, Xinjiang 830000 People’s Republic of China
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Wang Y, Liu H, Yao S, Guan Z, Li Q, Qi E, Li X, Zhang J, Tian J. Using 18F-flurodeoxyglucose and 68Ga-fibroblast activation protein inhibitor PET/CT to evaluate a new periprosthetic joint infection model of rabbit due to Staphylococcus aureus. Nucl Med Commun 2022; 43:232-241. [PMID: 35022379 DOI: 10.1097/mnm.0000000000001495] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
PURPOSE The existing periprosthetic joint infection (PJI) models have obvious limitations, and studies of PJI on animal models using PET/computed tomography (CT) for diagnosis are still lacking. Thus, the aim of this study was to establish a new PJI model and 18F-fluorodeoxyglucose (FDG) and 68Ga-fibroblast activation protein inhibitor (FAPI) were employed to study their performance. METHODS A novel PJI model of rabbit was developed by placing two screws in the tibia and femur. Based on bacteria concentration, the animals were divided into five groups, control, 104, 105, 106 and 107. 18F-FDG and 68Ga-FAPI PET/CT were performed continuously in next 2 weeks and maximum standardized uptake value (SUVmax), mean standardized uptake value (SUVmean), metabolic target volume (MTV) and total lesion glycolysis/total lesion fibrosis were calculated as the metrics. RESULTS As for SUVmax, all data of 18F-FDG were larger than that of 68Ga-FAPI in the same group for both weeks. For the performance of 18F-FDG, no definitive conclusion could be drawn for SUVmax and SUVmean. As for 68Ga-FAPI, the 104 group was significantly larger than 105, 106 and 107 groups for SUVmax and SUVmean in both weeks (P < 0.05). MTV of 68Ga-FAPI was found to be almost always larger than that of 18F-FDG in the same group. CONCLUSION The mechanism of 68Ga-FAPI is totally different from 18F-FDG and this unique property of 68Ga-FAPI shows a promising prospect in detecting infection boundary and may even distinguish a small number or a large number of bacterial infections.
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Affiliation(s)
- Yiqun Wang
- Medical School of Chinese PLA, Chinese PLA General Hospital
| | | | | | | | - Qingxiao Li
- Medical School of Chinese PLA, Chinese PLA General Hospital
| | | | - Xiang Li
- Orthopaedics, Chinese PLA General Hospital, Beijing, China
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