1
|
Li Y, Tong J, Wang H, Ji X, Hua Y, Cheng CK. Investigation into the effect of deltoid ligament injury on rotational ankle instability using a three-dimensional ankle finite element model. Front Bioeng Biotechnol 2024; 12:1386401. [PMID: 38751867 PMCID: PMC11094218 DOI: 10.3389/fbioe.2024.1386401] [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: 02/15/2024] [Accepted: 04/17/2024] [Indexed: 05/18/2024] Open
Abstract
Background Injury to the lateral collateral ligament of the ankle may cause ankle instability and, when combined with deltoid ligament (DL) injury, may lead to a more complex situation known as rotational ankle instability (RAI). It is unclear how DL rupture interferes with the mechanical function of an ankle joint with RAI. Purpose To study the influence of DL injury on the biomechanical function of the ankle joint. Methods A comprehensive finite element model of an ankle joint, incorporating detailed ligaments, was developed from MRI scans of an adult female. A range of ligament injury scenarios were simulated in the ankle joint model, which was then subjected to a static standing load of 300 N and a 1.5 Nm internal and external rotation torque. The analysis focused on comparing the distribution and peak values of von Mises stress in the articular cartilages of both the tibia and talus and measuring the talus rotation angle and contact area of the talocrural joint. Results The dimensions and location of insertion points of ligaments in the finite element ankle model were adopted from previous anatomical research and dissection studies. The anterior drawer distance in the finite element model was within 6.5% of the anatomical range, and the talus tilt angle was within 3% of anatomical results. During static standing, a combined rupture of the anterior talofibular ligament (ATFL) and anterior tibiotalar ligament (ATTL) generates new stress concentrations on the talus cartilage, which markedly increases the joint contact area and stress on the cartilage. During static standing with external rotation, the anterior talofibular ligament and anterior tibiotalar ligament ruptured the ankle's rotational angle by 21.8% compared to an intact joint. In contrast, static standing with internal rotation led to a similar increase in stress and a nearly 2.5 times increase in the talus rotational angle. Conclusion Injury to the DL altered the stress distribution in the tibiotalar joint and increased the talus rotation angle when subjected to a rotational torque, which may increase the risk of RAI. When treating RAI, it is essential to address not only multi-band DL injuries but also single-band deep DL injuries, especially those affecting the ATTL.
Collapse
Affiliation(s)
- Yuandong Li
- School of Biomedical Engineering, Shanghai Jiao Tong University, Engineering Research Center for Digital Medicine of the Ministry of Education, Shanghai, China
| | - Jiahui Tong
- Department of Sports Medicine, Huashan Hospital, Shanghai, China
| | - Huizhi Wang
- Center for Intelligent Medical Equipment and Devices, Institute for Innovative Medical Devices, University of Science and Technology of China, Hefei, China
- Suzhou Institute for Advanced Research, University of Science and Technology of China, Suzhou, China
| | - Xiaoxi Ji
- Department of Sports Medicine, Huashan Hospital, Shanghai, China
| | - Yinghui Hua
- Department of Sports Medicine, Huashan Hospital, Shanghai, China
| | - Cheng-Kung Cheng
- School of Biomedical Engineering, Shanghai Jiao Tong University, Engineering Research Center for Digital Medicine of the Ministry of Education, Shanghai, China
| |
Collapse
|
2
|
Zhou H, Xu D, Quan W, Ugbolue UC, Gu Y. Effects of different contact angles during forefoot running on the stresses of the foot bones: a finite element simulation study. Front Bioeng Biotechnol 2024; 12:1337540. [PMID: 38390360 PMCID: PMC10882086 DOI: 10.3389/fbioe.2024.1337540] [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: 11/13/2023] [Accepted: 01/29/2024] [Indexed: 02/24/2024] Open
Abstract
Introduction: The purpose of this study was to compare the changes in foot at different sole-ground contact angles during forefoot running. This study tried to help forefoot runners better control and improve their technical movements by comparing different sole-ground contact angles. Methods: A male participant of Chinese ethnicity was enlisted for the present study, with a recorded age of 25 years, a height of 183 cm, and a body weight of 80 kg. This study focused on forefoot strike patterns through FE analysis. Results: It can be seen that the peak von Mises stress of M1-5 (Metatarsal) of a (Contact angle: 9.54) is greater than that of b (Contact angle: 7.58) and c (Contact angle: 5.62) in the three cases. On the contrary, the peak von Mises stress of MC (Medial Cuneiform), IC (Intermediate Cuneiform), LC (Lateral Cuneiform), C (Cuboid), N (Navicular), T (Tarsal) in three different cases is opposite, and the peak von Mises stress of c is greater than that of a and b. The peak von Mises stress of b is between a and c. Conclusion: This study found that a reduced sole-ground contact angle may reduce metatarsal stress fractures. Further, a small sole-ground contact angle may not increase ankle joint injury risk during forefoot running. Hence, given the specialized nature of the running shoes designed for forefoot runners, it is plausible that this study may offer novel insights to guide their athletic pursuits.
Collapse
Affiliation(s)
- Huiyu Zhou
- Faculty of Sports Science, Ningbo University, Ningbo, China
- School of Health and Life Sciences, University of the West of Scotland, Paisley, United Kingdom
| | - Datao Xu
- Faculty of Sports Science, Ningbo University, Ningbo, China
- Faculty of Engineering, University of Pannonia, Veszprem, Hungary
| | - Wenjing Quan
- Faculty of Sports Science, Ningbo University, Ningbo, China
- Faculty of Engineering, University of Pannonia, Veszprem, Hungary
| | - Ukadike Chris Ugbolue
- School of Health and Life Sciences, University of the West of Scotland, Paisley, United Kingdom
| | - Yaodong Gu
- Faculty of Sports Science, Ningbo University, Ningbo, China
| |
Collapse
|
3
|
Prang TC. The relative size of the calcaneal tuber reflects heel strike plantigrady in African apes and humans. AMERICAN JOURNAL OF BIOLOGICAL ANTHROPOLOGY 2024; 183:e24865. [PMID: 38058279 DOI: 10.1002/ajpa.24865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Revised: 08/30/2023] [Accepted: 10/10/2023] [Indexed: 12/08/2023]
Abstract
OBJECTIVES The positional repertoire of the human-chimpanzee last common ancestor is critical for reconstructing the evolution of bipedalism. African apes and humans share a heel strike plantigrade foot posture associated with terrestriality. Previous research has established that modern humans have a relatively large and intrinsically robust calcaneal tuber equipped to withstand heel strike forces associated with bipedal walking and running. However, it is unclear whether African apes have a relatively larger calcaneal tuber than non-heel-striking primates, and how this trait might have evolved among anthropoids. Here, I test the hypothesis that heel-striking primates have a relatively larger calcaneal tuber than non-heel-striking primates. METHODS The comparative sample includes 331 individuals and 53 taxa representing hominoids, cercopithecoids, and platyrrhines. Evolutionary modeling was used to test for the effect of foot posture on the relative size of the calcaneal tuber in a phylogenetic framework that accounts for adaptation and inertia. Bayesian evolutionary modeling was used to identify selective regime shifts in the relative size of the calcaneal tuber among anthropoids. RESULTS The best fitting evolutionary model was a Brownian motion model with regime-dependent trends characterized by relatively large calcaneal tubers among African apes and humans. Evolutionary modeling provided support for an evolutionary shift toward a larger calcaneal tuber at the base of the African ape and human clade. CONCLUSIONS The results of this study support the view that African apes and humans share derived traits related to heel strike plantigrady, which implies that humans evolved from a semi-terrestrial quadrupedal ancestor.
Collapse
Affiliation(s)
- Thomas C Prang
- Department of Anthropology, Washington University in St. Louis, St. Louis, Missouri, USA
| |
Collapse
|
4
|
Wang J, Sun Z, Yu C, Zhao H, Yan M, Sun S, Han X, Jiang T, Wang T, Yu T, Zhang Y. Single-cell RNA sequencing reveals differences between force application and bearing in ankle cartilage. Cell Biol Toxicol 2023; 39:3235-3253. [PMID: 37783808 DOI: 10.1007/s10565-023-09829-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Accepted: 09/07/2023] [Indexed: 10/04/2023]
Abstract
Chondrocytes are the major functional elements of articular cartilage. Force has been demonstrated to influence the structure and function of articular cartilage and chondrocytes. Therefore, it is necessary to evaluate chondrocytes under different force conditions to gain deep insight into chondrocyte function. Six cartilage tissues from the distal tibia (referred to as the AT group) and five cartilage tissues from the trochlear surface of the talus (referred to as the ATa group) were obtained from 6 donors who had experienced fatal accidents. Single-cell RNA sequencing was used on these samples. A total of 149,816 cells were analyzed. Nine chondrocyte subsets were ultimately identified. Pseudotime analyses, enrichment analyses, cell-cell interaction studies, and single-cell regulatory network inference and clustering were performed for each cell type, and the differences between the AT and ATa groups were analyzed. Immunohistochemical staining was used to verify the existence of each chondrocyte subset and its distribution. The results suggested that reactive oxygen species related processes were active in the force-applied region, while tissue repair processes were common in the force-bearing region. Although the number of prehypertrophic chondrocytes was small, these chondrocytes seemed to play an important role in the ankle.
Collapse
Affiliation(s)
- Junjie Wang
- Qingdao Medical College, Qingdao University, Qingdao, China
- Department of Orthopaedic Surgery, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Zewen Sun
- Qingdao Medical College, Qingdao University, Qingdao, China
- Department of Orthopaedic Surgery, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Chenghao Yu
- Qingdao Medical College, Qingdao University, Qingdao, China
- Department of Orthopaedic Surgery, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Haibo Zhao
- Qingdao Medical College, Qingdao University, Qingdao, China
- Department of Orthopaedic Surgery, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Mingyue Yan
- Qingdao Medical College, Qingdao University, Qingdao, China
- Department of Orthopaedic Surgery, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Shenjie Sun
- Qingdao Medical College, Qingdao University, Qingdao, China
- Department of Emergency, Qingdao Municipal Hospital, Qingdao, China
| | - Xu Han
- Qingdao Medical College, Qingdao University, Qingdao, China
- Department of Orthopaedic Surgery, The Affiliated Hospital of Qingdao University, Qingdao, China
| | | | - Tianrui Wang
- Department of Orthopaedic Surgery, The Affiliated Hospital of Qingdao University, Qingdao, China.
| | - Tengbo Yu
- Department of Orthopaedic Surgery, Qingdao Hospital of the University of Health and Rehabilitation Sciences (Qingdao Municipal Hospital), Qingdao, China.
| | - Yingze Zhang
- Department of Orthopaedic Surgery, The Affiliated Hospital of Qingdao University, Qingdao, China
| |
Collapse
|
5
|
Cheng ESW, Lai DKH, Mao YJ, Lee TTY, Lam WK, Cheung JCW, Wong DWC. Computational Biomechanics of Sleep: A Systematic Mapping Review. Bioengineering (Basel) 2023; 10:917. [PMID: 37627802 PMCID: PMC10451553 DOI: 10.3390/bioengineering10080917] [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: 06/30/2023] [Revised: 07/24/2023] [Accepted: 07/31/2023] [Indexed: 08/27/2023] Open
Abstract
Biomechanical studies play an important role in understanding the pathophysiology of sleep disorders and providing insights to maintain sleep health. Computational methods facilitate a versatile platform to analyze various biomechanical factors in silico, which would otherwise be difficult through in vivo experiments. The objective of this review is to examine and map the applications of computational biomechanics to sleep-related research topics, including sleep medicine and sleep ergonomics. A systematic search was conducted on PubMed, Scopus, and Web of Science. Research gaps were identified through data synthesis on variants, outcomes, and highlighted features, as well as evidence maps on basic modeling considerations and modeling components of the eligible studies. Twenty-seven studies (n = 27) were categorized into sleep ergonomics (n = 2 on pillow; n = 3 on mattress), sleep-related breathing disorders (n = 19 on obstructive sleep apnea), and sleep-related movement disorders (n = 3 on sleep bruxism). The effects of pillow height and mattress stiffness on spinal curvature were explored. Stress on the temporomandibular joint, and therefore its disorder, was the primary focus of investigations on sleep bruxism. Using finite element morphometry and fluid-structure interaction, studies on obstructive sleep apnea investigated the effects of anatomical variations, muscle activation of the tongue and soft palate, and gravitational direction on the collapse and blockade of the upper airway, in addition to the airflow pressure distribution. Model validation has been one of the greatest hurdles, while single-subject design and surrogate techniques have led to concerns about external validity. Future research might endeavor to reconstruct patient-specific models with patient-specific loading profiles in a larger cohort. Studies on sleep ergonomics research may pave the way for determining ideal spine curvature, in addition to simulating side-lying sleep postures. Sleep bruxism studies may analyze the accumulated dental damage and wear. Research on OSA treatments using computational approaches warrants further investigation.
Collapse
Affiliation(s)
- Ethan Shiu-Wang Cheng
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong
- Department of Electronic and Information Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong
| | - Derek Ka-Hei Lai
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong
| | - Ye-Jiao Mao
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong
| | - Timothy Tin-Yan Lee
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong
| | - Wing-Kai Lam
- Sports Information and External Affairs Centre, Hong Kong Sports Institute, Hong Kong
| | - James Chung-Wai Cheung
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong
- Research Institute for Sports Science and Technology, The Hong Kong Polytechnic University, Hong Kong
| | - Duo Wai-Chi Wong
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong
- Research Institute for Sports Science and Technology, The Hong Kong Polytechnic University, Hong Kong
| |
Collapse
|
6
|
Shi G, Lin Z, Liu W, Liao X, Xu X, Luo X, Zhan H, Cai X. 3D mapping of intra-articular calcaneal fractures. Sci Rep 2023; 13:8827. [PMID: 37258588 DOI: 10.1038/s41598-023-34711-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Accepted: 05/05/2023] [Indexed: 06/02/2023] Open
Abstract
To determine the pattern of intra-articular calcaneal fractures (ICFs) by a three-dimensional (3D) mapping and determine whether there were consistent fracture patterns and comminution zones. In this study, 67 patients with ICFS by CT scan were included. The calcaneal fractures fragments in CT were multiplanar reconstructed and virtual reduced. 3D heat mapping was subsequently created by graphically superimposing all fracture lines onto a standard calcaneal template. The cohort included 26 (38.8%) left calcaneal fractures, 27 (40.30%) right calcaneal fractures, and 14 (20.9%) cases with bilateral fractures. Comminuted fractures accounted for 92.5%. Sagittal 3D mapping shows that the fracture line is mainly concentrated at the critical angle of Gissane and extending rear to the posterior of the tuberosity of the lateral wall and the anterior of the medial process of the calcaneus tuberosity but with more significant variation in the medial wall. The average angle of fracture lines concerning the long calcaneal axis (LCA) was 29.1° and 19.2° in the lateral and medial walls. Axial 3D mapping shows that fracture lines were primarily concentrated in the anterior area to the posterior joint facet and extending along the rear joint facet and calcaneus sulcus to the posteriorly of the tuberosity. The mean angle of fracture lines concerning the LAC was 11° in the axial wall. Our data provided elucidated that ICFs have consistent characteristic fracture patterns and comminution zones. This study provides visual guidelines for understanding fracture morphology, which may assist with fracture classification, preoperative planning, development of fixation concepts.
Collapse
Affiliation(s)
- Guang Shi
- Department of Orthopedics, The Fifth Affiliated Hospital of Sun Yat-Sen University, Zhuhai, 519000, Guangdong, China
| | - Zhao Lin
- Department of Orthopedics, The Fifth Affiliated Hospital of Sun Yat-Sen University, Zhuhai, 519000, Guangdong, China
| | - Wei Liu
- Department of Orthopedics, The Fifth Affiliated Hospital of Sun Yat-Sen University, Zhuhai, 519000, Guangdong, China
| | - Xun Liao
- Department of Orthopedics, The Fifth Affiliated Hospital of Sun Yat-Sen University, Zhuhai, 519000, Guangdong, China
| | - Xingming Xu
- Department of Orthopedics, The Fifth Affiliated Hospital of Sun Yat-Sen University, Zhuhai, 519000, Guangdong, China
| | - Xue Luo
- Department of Orthopedics, The Fifth Affiliated Hospital of Sun Yat-Sen University, Zhuhai, 519000, Guangdong, China
| | - Hongrui Zhan
- Department of Rehabilitation, The Fifth Affiliated Hospital of Sun Yat-Sen University, Zhuhai, 519000, Guangdong, China.
| | - Xiyu Cai
- Department of Orthopedics, The Fifth Affiliated Hospital of Sun Yat-Sen University, Zhuhai, 519000, Guangdong, China.
| |
Collapse
|
7
|
Talbott H, Jha S, Gulati A, Brockett C, Mangwani J, Pegg EC. Clinically useful finite element models of the natural ankle - A review. Clin Biomech (Bristol, Avon) 2023; 106:106006. [PMID: 37245282 DOI: 10.1016/j.clinbiomech.2023.106006] [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: 12/23/2022] [Revised: 04/19/2023] [Accepted: 05/17/2023] [Indexed: 05/30/2023]
Abstract
BACKGROUND Biomechanical simulation of the foot and ankle complex is a growing research area but compared to simulation of joints such as hip and knee, it has been under investigated and lacks consistency in research methodology. The methodology is variable, data is heterogenous and there are no clear output criteria. Therefore, it is very difficult to correlate clinically and draw meaningful inferences. METHODS The focus of this review is finite element simulation of the native ankle joint and we will explore: the different research questions asked, the model designs used, ways the model rigour has been ensured, the different output parameters of interest and the clinical impact and relevance of these studies. FINDINGS The 72 published studies explored in this review demonstrate wide variability in approach. Many studies demonstrated a preference for simplicity when representing different tissues, with the majority using linear isotropic material properties to represent the bone, cartilage and ligaments; this allows the models to be complex in another way such as to include more bones or complex loading. Most studies were validated against experimental or in vivo data, but a large proportion (40%) of studies were not validated at all, which is an area of concern. INTERPRETATION Finite element simulation of the ankle shows promise as a clinical tool for improving outcomes. Standardisation of model creation and standardisation of reporting would increase trust, and enable independent validation, through which successful clinical application of the research could be realised.
Collapse
Affiliation(s)
| | - Shilpa Jha
- University Hospitals of Leicester, Leicester, UK
| | - Aashish Gulati
- Sandwell and West Birmingham Hospitals NHS Trust, Birmingham, UK
| | - Claire Brockett
- Department of Mechanical Engineering, University of Sheffield, Sheffield, UK
| | | | - Elise C Pegg
- Department of Mechanical Engineering, University of Bath, Bath, UK.
| |
Collapse
|
8
|
Augmented reality (AR) and fracture mapping model on middle-aged femoral neck fracture: A proof-of-concept towards interactive visualization. MEDICINE IN NOVEL TECHNOLOGY AND DEVICES 2022. [DOI: 10.1016/j.medntd.2022.100190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
|
9
|
Yang Z, Cui C, Wan X, Zheng Z, Yan S, Liu H, Qu F, Zhang K. Design feature combinations effects of running shoe on plantar pressure during heel landing: A finite element analysis with Taguchi optimization approach. Front Bioeng Biotechnol 2022; 10:959842. [PMID: 36177186 PMCID: PMC9513060 DOI: 10.3389/fbioe.2022.959842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Accepted: 08/15/2022] [Indexed: 11/28/2022] Open
Abstract
Large and repeated impacts on the heel during running are among the primary reasons behind runners’ injuries. Reducing plantar pressure can be conducive to reducing running injury and improving running performance and is primarily achieved by modifying the design parameters of running shoes. This study examines the effect of design parameters of running shoes (i.e., heel-cup, insole material, midsole material, and insole thickness) on landing peak plantar pressure and determines the combination of different parameters that optimize cushion effects by employing the Taguchi method. We developed the foot–shoe finite element (FE) model through reverse engineering. Model assembly with different design parameters was generated in accordance with the Taguchi method orthogonal table. The effectiveness of the model was verified using the static standing model in Ansys. The significance and contribution of different design parameters, and the optimal design to reduce plantar pressure during landing, were determined using the Taguchi method. In the descending order of percentage contribution was a conforming heel-cup (53.18%), insole material (25.89%), midsole material (7.81%), and insole thickness (2.69%). The more conforming heel-cup (p < 0.001) and softer insole (p = 0.001) reduced the heel pressure during landing impact. The optimal design of running shoe in this study was achieved with a latex insole, a 6 mm insole thickness, an Asker C-45 hardness midsole, and a 100% conforming heel-cup. The conforming heel-cup and the insole material significantly affected the peak plantar pressure during heel landing. The implementation of a custom conforming heel-cup is imperative for relieving high plantar pressure for long-distance heel-strike runners.
Collapse
Affiliation(s)
- Zihan Yang
- School of Biomedical Engineering, Capital Medical University, Beijing, China
- Beijing Key Laboratory of Fundamental Research on Biomechanics in Clinical Application, Capital Medical University, Beijing, China
- School of Sport Sciences, Beijing Sport University, West Lafayette, IN, United States
- Fashion Accessory Art and Engineering College, Beijing Institute Of Fashion Technology, Beijing, China
| | - Chuyi Cui
- College of Health and Human Sciences, Purdue University, West Lafayette, IN, United States
| | - Xianglin Wan
- School of Sport Sciences, Beijing Sport University, West Lafayette, IN, United States
| | - Zhiyi Zheng
- Anta Sports Science Laboratory, Xiamen, China
| | - Songhua Yan
- School of Biomedical Engineering, Capital Medical University, Beijing, China
- Beijing Key Laboratory of Fundamental Research on Biomechanics in Clinical Application, Capital Medical University, Beijing, China
| | - Hui Liu
- School of Sport Sciences, Beijing Sport University, West Lafayette, IN, United States
- China Institute of Sport and Health Science, Beijing Sport University, Beijing, China
| | - Feng Qu
- School of Sport Sciences, Beijing Sport University, West Lafayette, IN, United States
| | - Kuan Zhang
- School of Biomedical Engineering, Capital Medical University, Beijing, China
- Beijing Key Laboratory of Fundamental Research on Biomechanics in Clinical Application, Capital Medical University, Beijing, China
- *Correspondence: Kuan Zhang,
| |
Collapse
|
10
|
Kang Y, Kim S, Kim J, Lee JW, Park JC. Evaluating the validity of lightweight talar replacement designs: rational models and topologically optimized models. Biomater Res 2022; 26:10. [PMID: 35287743 PMCID: PMC8919543 DOI: 10.1186/s40824-022-00256-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Accepted: 02/21/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Total talar replacement is normally stable and satisfactory. We studied a rational scaffold talus model for each size range created through topology optimization (TO) and comparatively evaluated a topologically optimized scaffold bone talus model using a finite element analysis (FEA). We hypothesized that the rational scaffold would be more effective for application to the actual model than the topologically optimized scaffold.
Methods
Size specification for the rational model was performed via TO and inner scaffold simplification. The load condition for worst-case selection reflected the peak point according to the ground reaction force tendency, and the load directions “plantar 10°” (P10), “dorsi 5°” (D5), and “dorsi 10°” (D10) were applied to select worst-case scenarios among the P10, D5, and D10 positions (total nine ranges) of respective size specifications. FEA was performed on each representative specification-standard model, reflecting a load of 5340 N. Among the small bone models selected as the worst-case, an arbitrary size was selected, and the validity of the standard model was evaluated. The standard model was applied to the rational structure during validity evaluation, and the TO model reflecting the internal structure derived by the TO of the arbitrary model was implemented.
Result
In worst-case selection, the highest peak von Mises stress (PVMS) was calculated from the minimum D5 model (532.11 MPa). Thereafter, FEA revealed peak von Mises stress levels of 218.01 MPa and 565.35 MPa in the rational and topologically optimized models, respectively, confirming that the rational model yielded lower peak von Mises stress. The weight of the minimum model was reduced from 1106 g to 965.4 g after weight reduction through rational scaffold application.
Conclusion
The rational inner-scaffold-design method is safer than topologically optimized scaffold design, and three types of rational scaffold, according to each size range, confirmed that all sizes of the talus within the anatomical dimension could be covered, which was a valid result in the total talar replacement design. Accordingly, we conclude that an implant design meeting the clinical design requirements, including patient customization, weight reduction, and mechanical stability, should be possible by applying a rational inner scaffold without performing TO design. The scaffold model weight was lower than that of the solid model, and the safety was also verified through FEA.
Collapse
|
11
|
Zhu J, Forman J. A Review of Finite Element Models of Ligaments in the Foot and Considerations for Practical Application. J Biomech Eng 2022; 144:1133332. [PMID: 35079785 DOI: 10.1115/1.4053401] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Indexed: 11/08/2022]
Abstract
PURPOSE Finite element (FE) modeling has been used as a research tool for investigating underlying ligaments biomechanics and orthopedic applications. However, FE models of the ligament in the foot have been developed with various configurations, mainly due to their complex 3D geometry, material properties, and boundary conditions. Therefore, the purpose of this review was to summarize the current state of finite element modeling approaches that have been used in the ?eld of ligament biomechanics, to discuss their applicability to foot ligament modeling in a practical setting, and also to acknowledge current limitations and challenges. METHODS A comprehensive literature search was performed. Each article was analyzed in terms of the methods used for: (a) ligament geometry, (b) material property, (c) boundary and loading condition related to its application, and (d) model verification and validation. RESULTS Of the reviewed studies, 80% of the studies used simplified representations of ligament geometry, the non-linear mechanical behavior of ligaments was taken into account in only 19.2% of the studies, 33% of included studies did not include any kind of validation of the FE model. CONCLUSION Further refinement in the functional modeling of ligaments, the micro-structure level characteristics, nonlinearity, and time-dependent response, may be warranted to ensure the predictive ability of the models.
Collapse
Affiliation(s)
- Junjun Zhu
- School of Mechatronic Engineering and Automation, Shanghai University, 333 Nanchen Rd., Shanghai, China, 200444
| | - Jason Forman
- Center for Applied Biomechanics, Department of Mechanical and Aerospace Engineering, University of Virginia, Charlottesville, VA 22911, USA
| |
Collapse
|
12
|
Suchoń S, Burkacki M, Joszko K, Gzik-Zroska B, Wolański W, Sławiński G, Tavares JMRS, Gzik M. Lower Leg Injury Mechanism Investigation During an IED Blast Under a Vehicle Using an Anatomic Leg Model. Front Bioeng Biotechnol 2021; 9:725006. [PMID: 34869249 PMCID: PMC8635724 DOI: 10.3389/fbioe.2021.725006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Accepted: 10/15/2021] [Indexed: 11/13/2022] Open
Abstract
Attacks with improvised explosive device (IED) constituted the main threat to, for example, Polish soldiers in Iraq and Afghanistan. Improving safety during transport in an armored vehicle has become an important issue. The main purpose of the presented research is to investigate the mechanism of lower leg injuries during explosion under an armored vehicle. Using a numerical anatomic model of the lower leg, the analysis of the leg position was carried out. In all presented positions, the stress limit of 160 (MPa) was reached, which indicates bone damage. There is a difference in stress distribution in anatomic elements pointing to different injury mechanisms.
Collapse
Affiliation(s)
- Sławomir Suchoń
- Department of Biomechatronics, Faculty of Biomedical Engineering, Silesian University of Technology, Zabrze, Poland
| | - Michał Burkacki
- Department of Biomechatronics, Faculty of Biomedical Engineering, Silesian University of Technology, Zabrze, Poland
| | - Kamil Joszko
- Department of Biomechatronics, Faculty of Biomedical Engineering, Silesian University of Technology, Zabrze, Poland
| | - Bożena Gzik-Zroska
- Department of Biomaterials and Medical Devices Engineering, Faculty of Biomedical Engineering, Silesian University of Technology, Zabrze, Poland
| | - Wojciech Wolański
- Department of Biomechatronics, Faculty of Biomedical Engineering, Silesian University of Technology, Zabrze, Poland
| | - Grzegorz Sławiński
- Faculty of Mechanical Engineering, Institute of Mechanics and Computational Engineering, Military University of Technology, Warszawa, Poland
| | - João Manuel R S Tavares
- Departamento de Engenharia Mecânica, Faculdade de Engenharia, Instituto de Ciência e Inovação em Engenharia Mecânica e Engenharia Industrial, Universidade do Porto, Porto, Portugal
| | - Marek Gzik
- Department of Biomechatronics, Faculty of Biomedical Engineering, Silesian University of Technology, Zabrze, Poland
| |
Collapse
|
13
|
Barkaoui A, Ait Oumghar I, Ben Kahla R. Review on the use of medical imaging in orthopedic biomechanics: finite element studies. COMPUTER METHODS IN BIOMECHANICS AND BIOMEDICAL ENGINEERING: IMAGING & VISUALIZATION 2021. [DOI: 10.1080/21681163.2021.1888317] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Affiliation(s)
- Abdelwahed Barkaoui
- Laboratoire des Énergies Renouvelables et Matériaux Avancés, Université Internationale de Rabat, Sala Al Jadida Morocco
| | - Imane Ait Oumghar
- Laboratoire des Énergies Renouvelables et Matériaux Avancés, Université Internationale de Rabat, Sala Al Jadida Morocco
- Aix Marseille Univ, CNRS, ISM, Inst Movement Sci, Marseille, France
| | - Rabeb Ben Kahla
- Laboratoire de Systémes et de Mécanique Appliquée, Ecole Polytechnique de Tunis, Université de Carthage, Tunis, Tunisia
- Ecole Nationale d’Ingénieurs de Tunis, Université de Tunis el Manar, Campus Universitaire, Tunis, Tunisia
| |
Collapse
|
14
|
Phan PK, Vo ATN, Bakhtiarydavijani A, Burch R, Smith B, Ball JE, Chander H, Knight A, Prabhu RK. In Silico Finite Element Analysis of the Foot Ankle Complex Biomechanics: A Literature Review. J Biomech Eng 2021; 143:090802. [PMID: 33764401 DOI: 10.1115/1.4050667] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Indexed: 11/08/2022]
Abstract
Computational approaches, especially finite element analysis (FEA), have been rapidly growing in both academia and industry during the last few decades. FEA serves as a powerful and efficient approach for simulating real-life experiments, including industrial product development, machine design, and biomedical research, particularly in biomechanics and biomaterials. Accordingly, FEA has been a "go-to" high biofidelic software tool to simulate and quantify the biomechanics of the foot-ankle complex, as well as to predict the risk of foot and ankle injuries, which are one of the most common musculoskeletal injuries among physically active individuals. This paper provides a review of the in silico FEA of the foot-ankle complex. First, a brief history of computational modeling methods and finite element (FE) simulations for foot-ankle models is introduced. Second, a general approach to build an FE foot and ankle model is presented, including a detailed procedure to accurately construct, calibrate, verify, and validate an FE model in its appropriate simulation environment. Third, current applications, as well as future improvements of the foot and ankle FE models, especially in the biomedical field, are discussed. Finally, a conclusion is made on the efficiency and development of FEA as a computational approach in investigating the biomechanics of the foot-ankle complex. Overall, this review integrates insightful information for biomedical engineers, medical professionals, and researchers to conduct more accurate research on the foot-ankle FE models in the future.
Collapse
Affiliation(s)
- P K Phan
- Department of Agricultural and Biological Engineering, Mississippi State University, Mississippi, MS 39762; Center of Advanced Vehicular System (CAVS), Mississippi State University, Mississippi, MS 39762
| | - A T N Vo
- Department of Agricultural and Biological Engineering, Mississippi State University, Mississippi, MS 39762; Center of Advanced Vehicular System (CAVS), Mississippi State University, Mississippi, MS 39762
| | - A Bakhtiarydavijani
- Center of Advanced Vehicular System (CAVS), Mississippi State University, Mississippi, MS 39762
| | - R Burch
- Center of Advanced Vehicular System (CAVS), Mississippi State University, Mississippi, MS 39762; Department of Industrial and Systems Engineering, Mississippi State University, Mississippi, MS 39762
| | - B Smith
- Department of Industrial and Systems Engineering, Mississippi State University, Mississippi, MS 39762
| | - J E Ball
- Department of Electrical and Computer Engineering, Mississippi State University, Mississippi, MS 39762
| | - H Chander
- Department of Kinesiology, Mississippi State University, Mississippi, MS 39762
| | - A Knight
- Department of Kinesiology, Mississippi State University, Mississippi, MS 39762
| | - R K Prabhu
- Department of Agricultural and Biological Engineering, Mississippi State University, Mississippi, MS 39762; Center of Advanced Vehicular System (CAVS), Mississippi State University, Mississippi, MS 39762
| |
Collapse
|
15
|
Wong DWC, Chen TLW, Peng Y, Lam WK, Wang Y, Ni M, Niu W, Zhang M. An instrument for methodological quality assessment of single-subject finite element analysis used in computational orthopaedics. MEDICINE IN NOVEL TECHNOLOGY AND DEVICES 2021. [DOI: 10.1016/j.medntd.2021.100067] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
|
16
|
Wang C, He X, Zhang Z, Lai C, Li X, Zhou Z, Ruan K. Three-Dimensional Finite Element Analysis and Biomechanical Analysis of Midfoot von Mises Stress Levels in Flatfoot, Clubfoot, and Lisfranc Joint Injury. Med Sci Monit 2021; 27:e931969. [PMID: 34455415 PMCID: PMC8411861 DOI: 10.12659/msm.931969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background Midfoot deformity and injury can affect the internal pressure distribution of the foot. This study aimed to use 3D finite element and biomechanical analyses of midfoot von Mises stress levels in flatfoot, clubfoot, and Lisfranc joint injury. Material/Methods Normal feet, flatfeet, clubfeet (30 individuals each), and Lisfranc injuries (50 individuals) were reconstructed by CT, and 3D finite element models were established by ABAQUS. Spring element was used to simulate the plantar fascia and ligaments and set hyperelastic coefficients in encapsulated bone and ligaments. The stance phase was simulated by applying 350 N on the top of the talus. The von Mises stress of the feet and ankle was visualized and analyzed. Results The von Mises stress on healthy feet was higher in the lateral metatarsal and ankle bones than in the medial metatarsal bone. Among the flatfoot group, the stress on the metatarsals, talus, and navicular bones was significantly increased compared with that on healthy feet. Among patients with clubfeet, stress was mainly concentrated on the talus, and stress on the lateral metatarsal and navicular bones was significantly lower. The von Mises stress on the fractured bone was decreased, and the stress on the bone adjacent to the fractured bone was higher in Lisfranc injury. During bone dislocation alone or fracture accompanied by dislocation, the von Mises stress of the dislocated bone tended to be constant or increased. Conclusions Prediction of von Mises stress distribution may be used clinically to evaluate the effects of deformity and injury on changes in structure and internal pressure distribution on the midfoot.
Collapse
Affiliation(s)
- Chaoqiang Wang
- Department of Orthopedics, Mingdong Hospital affiliated to Fujian Medical University, Ningde, Fujian, China (mainland)
| | - Xiaoyu He
- Department of Orthopedics, Mingdong Hospital affiliated to Fujian Medical University, Ningde, Fujian, China (mainland)
| | - Zhongning Zhang
- Department of Orthopedics, Mingdong Hospital affiliated to Fujian Medical University, Ningde, Fujian, China (mainland)
| | - Caosheng Lai
- Department of Orthopedics, Mingdong Hospital affiliated to Fujian Medical University, Ningde, Fujian, China (mainland)
| | - Xueli Li
- Department of Dermatology, Mingdong Hospital affiliated to Fujian Medical University, Ningde, Fujian, China (mainland)
| | - Zhiping Zhou
- Department of Orthopedics, Mingdong Hospital affiliated to Fujian Medical University, Ningde, Fujian, China (mainland)
| | - Kangming Ruan
- Department of Orthopedics, Mingdong Hospital affiliated to Fujian Medical University, Ningde, Fujian, China (mainland)
| |
Collapse
|
17
|
Moayedi M, Arshi AR, Salehi M, Akrami M, Naemi R. Associations between changes in loading pattern, deformity, and internal stresses at the foot with hammer toe during walking; a finite element approach. Comput Biol Med 2021; 135:104598. [PMID: 34346320 DOI: 10.1016/j.compbiomed.2021.104598] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 06/15/2021] [Accepted: 06/18/2021] [Indexed: 10/21/2022]
Abstract
Over the past decade, Finite Element (FE) modelling has been used as a method to understand the internal stresses within the diabetic foot. Foot deformities such as hammer toe have been associated with increased risk of foot ulcers in diabetic patients. Hence the aim of this study is to investigate the influence of hammer toe deformity on internal stresses during walking. A 3D finite element model of the human foot was constructed based on capturing Magnetic Resonance Imaging (MRI) of a diabetic neuropathic volunteer exhibiting hammer toe. 3D gait measurements and a multi-body musculoskeletal model for the same participant were used to define muscle forces. FE simulations were run at five different instances during the stance phase of gait. Peak plantar pressure and pressure distribution results calculated from the model showed a good agreement with the experimental measurement having less than 11% errors. Maximum von Mises internal stresses in the forefoot hard tissue were observed at the 3rd and 5th metatarsals and 4th proximal phalanx. Moreover, presence of hammer toe deformity was found to shift the location of maximum internal stresses on the soft tissue to the forefoot by changing the location of centre of pressure with internal stress 1.64 times greater than plantar pressure. Hammer toe deformity also showed to reduce the involvement of the first phalanx in internal/external load-bearing during walking. The findings of this study support the association between changes in loading pattern, deformity, and internal stresses in the soft tissue that lead to foot ulceration.
Collapse
Affiliation(s)
- M Moayedi
- Department of Mechanical Engineering, Amirkabir University of Technology, Iran.
| | - A R Arshi
- Biomechanics and Sports Engineering Groups, Biomedical Engineering Department, Amirkabir University of Technology, Iran.
| | - M Salehi
- Department of Mechanical Engineering, Amirkabir University of Technology, Iran.
| | - M Akrami
- Department of Engineering, College of Engineering, Mathematics, and Physical Sciences, University of Exeter, UK.
| | - R Naemi
- Centre for Biomechanics and Rehabilitation Technologies, Staffordshire University, UK.
| |
Collapse
|
18
|
The relationship between orthopedic clinical imaging and bone strength prediction. MEDICINE IN NOVEL TECHNOLOGY AND DEVICES 2021. [DOI: 10.1016/j.medntd.2021.100060] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
|
19
|
常 桐, 王 宽, 黄 尚, 王 乐, 张 胜, 牛 文, 张 明. [Biomechanical analysis of ankle-foot complex during a typical Tai Chi movement-Brush Knee and Twist Step]. SHENG WU YI XUE GONG CHENG XUE ZA ZHI = JOURNAL OF BIOMEDICAL ENGINEERING = SHENGWU YIXUE GONGCHENGXUE ZAZHI 2021; 38:97-104. [PMID: 33899433 PMCID: PMC10307576 DOI: 10.7507/1001-5515.202003003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 03/01/2020] [Revised: 10/18/2020] [Indexed: 11/03/2022]
Abstract
The purpose of this study is to analyze the biomechanics of ankle cartilage and ligaments during a typical Tai Chi movement-Brush Knee and Twist Step (BKTS). The kinematic and kinetic data were acquired in one experienced male Tai Chi practitioner while performing BKTS and in normal walking. The measured parameters were used as loading and boundary conditions for further finite element analysis. This study showed that the contact stress of the ankle joint during BKTS was generally less than that during walking. However, the maximum tensile force of the anterior talofibular ligament, the calcaneofibular ligament and the posterior talofibular ligament during BKTS was 130 N, 169 N and 89 N, respectively, while it was only 57 N, 119 N and 48 N during walking. Therefore, patients with arthritis of the ankle can properly practice Tai Chi. Practitioners with sprained lateral ligaments of the ankle joint were suggested to properly reduce the ankle movement range during BKTS.
Collapse
Affiliation(s)
- 桐博 常
- 甘肃中医药大学 体育健康学院(兰州 730101)School of Sport and Health, Gansu University of Chinese Medicine, Lanzhou 730101, P.R.China
- 上海体育学院 运动科学学院(上海 200438)School of Kinesiology, Shanghai University of Sports, Shanghai 200438, P.R.China
| | - 宽 王
- 同济大学附属养志康复医院 康复医学转化研究中心(上海 201619)Yangzhi Rehabilitation Hospital, Tongji University School of Medicine, Shanghai 201619, P.R.China
- 同济大学 医学院 康复工程与生物力学实验室(上海 200092)Laboratory of Rehabilitation Engineering & Biomechanics, Tongji University School of Medicine, Shanghai 200092, P.R.China
| | - 尚军 黄
- 同济大学 医学院 康复工程与生物力学实验室(上海 200092)Laboratory of Rehabilitation Engineering & Biomechanics, Tongji University School of Medicine, Shanghai 200092, P.R.China
| | - 乐军 王
- 同济大学 体育教学部 运动与健康研究中心(上海 200092)Sport and Health Research Center, Physical Education Department, Tongji University, Shanghai 200092, P.R.China
| | - 胜年 张
- 上海体育学院 运动科学学院(上海 200438)School of Kinesiology, Shanghai University of Sports, Shanghai 200438, P.R.China
| | - 文鑫 牛
- 同济大学附属养志康复医院 康复医学转化研究中心(上海 201619)Yangzhi Rehabilitation Hospital, Tongji University School of Medicine, Shanghai 201619, P.R.China
- 同济大学 医学院 康复工程与生物力学实验室(上海 200092)Laboratory of Rehabilitation Engineering & Biomechanics, Tongji University School of Medicine, Shanghai 200092, P.R.China
| | - 明 张
- 香港理工大学 生物医学工程系(香港 999077)Department of Biomedical Engineering, The Hong Kong Polytechnic University, Hong Kong 999077, P.R.China
| |
Collapse
|
20
|
Finite Element Analysis of a Novel Approach for Knee and Ankle Protection during Landing. APPLIED SCIENCES-BASEL 2021. [DOI: 10.3390/app11041912] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
There is a high risk of serious injury to the lower extremities during a human drop landing. Prophylactic knee and ankle braces are commonly used to reduce injury by restraining the motion of joints. However, braces that restrain joint range of motion (ROM) may have detrimental effects on the user’s kinematical performance and joint function. The present study aimed to propose a novel set of double-joint braces and to evaluate its protective performance in terms of the ankle and knee. Accordingly, the finite element method was performed to investigate the biomechanical responses of the ankle and knee in braced and unbraced conditions. The results showed that the semi-rigid support at the ankle joint can share the high impact force that would otherwise be inflicted on one’s lower extremity, thereby reducing the peak stress on the inferior articular surface of the tibia, menisci, and articular cartilages, as well as the horizontal force on the talus. Moreover, with knee bending, the elongated spring component at the knee joint can convert the impact kinetic energy into elastic potential energy of the spring; meanwhile, the retractive force generated by the spring also provides a more balanced interaction between the menisci and articular cartilages. This biomechanical analysis can accordingly provide inspiration for new approaches to place human lower extremities at lower risk during landings.
Collapse
|
21
|
Ni M, Lv ML, Sun W, Zhang Y, Mei J, Wong DWC, Zhang H, Jia Y, Zhang M. Fracture mapping of complex intra-articular calcaneal fractures. ANNALS OF TRANSLATIONAL MEDICINE 2021; 9:333. [PMID: 33708960 PMCID: PMC7944289 DOI: 10.21037/atm-20-7824] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Background Intra-articular calcaneal fracture remains challenging to manage. Computed tomography and fracture mapping are useful for the diagnosis and treatment of calcaneal fractures. The aim of the present study was to characterize calcaneal fracture patterns using fracture mapping. Methods Sixty-two calcaneal fractures were retrospectively included in the study. For each case, the fracture was simulated reduction manually. The fracture lines and zones of comminution were graphically superimposed onto an intact calcaneal template to identify fracture patterns. Major fracture lines and comminution were assessed by focusing on the posterior joint facet, medial wall, lateral wall, sustentaculum tali, and anterior process. Results The fracture lines were mostly concentrated on the area anterior to the posterior joint facet and extended medially. The longitudinal lines ran posteriorly from the angle of Gissane, and separated the sustentaculum tali and medial wall from the calcaneal tuberosity. In the lateral wall, the fracture lines extended posteriorly with some branches to the bottom of the calcaneus. No fracture lines passed through the sustentaculum tali. Fracture lines of the posterior tuberosity and anterior process were rare. Conclusions Calcaneal fracture lines follow characteristic patterns, which are closely related to the bone structure and fracture mechanism. These fracture patterns will aid clinicians choose surgical approach and fixations in the treatment of calcaneal fractures.
Collapse
Affiliation(s)
- Ming Ni
- Department of Orthopaedics, Pudong New Area People's Hospital Affiliated to Shanghai University of Medicine and Health Sciences, Shanghai, China
| | - Miko Lin Lv
- School of Medical Instrument and Food Engineering, University of Shanghai for Science and Technology, Shanghai, China
| | - Wanju Sun
- Department of Orthopaedics, Pudong New Area People's Hospital Affiliated to Shanghai University of Medicine and Health Sciences, Shanghai, China
| | - Yingqi Zhang
- Department of Orthopaedics, Tongji Hospital of Tongji University, Shanghai, China
| | - Jiong Mei
- Department of Orthopaedics, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University, Shanghai, China
| | - Duo Wai-Chi Wong
- Department of Biomedical Engineering, The Hong Kong Polytechnic University, Hong Kong, China.,The Hong Kong Polytechnic University Shenzhen Research Institute, Shenzhen, China
| | - Haowei Zhang
- School of Medical Instrument and Food Engineering, University of Shanghai for Science and Technology, Shanghai, China
| | - Yongwei Jia
- Department of Spine Surgery, Guanghua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Ming Zhang
- Department of Biomedical Engineering, The Hong Kong Polytechnic University, Hong Kong, China.,The Hong Kong Polytechnic University Shenzhen Research Institute, Shenzhen, China
| |
Collapse
|
22
|
Simonik MM, Pitarresi JM, Willing R. Development of customized finite element models of medial column fixation using an intramedullary beam: A computational sensitivity analysis. Med Eng Phys 2021; 88:32-40. [PMID: 33485511 DOI: 10.1016/j.medengphy.2020.12.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2020] [Revised: 11/11/2020] [Accepted: 12/11/2020] [Indexed: 11/26/2022]
Abstract
Intramedullary beaming is commonly used for medial column arthrodesis to prevent or correct rocker-bottom deformities; however, the biomechanics of these reconstructions have not been rigorously studied. Customized FE models of intramedullary beaming of the medial column were developed and compared to a previous cadaveric study, which resulted in a strong correlation in medial column stiffness (ρ = 0.83, p = .079) and implant failure locations. A design of experiments was performed to quantify the models' sensitivities to varying cortical shell and cartilage thicknesses, cancellous bone and cartilage elastic moduli, and surgical medial column compression distance. Cartilage thickness and cartilage elastic modulus had the largest impact on medial column stiffness and compression distance had the greatest effect on cartilage contact area. Cortical shell thickness and cancellous bone properties did not have a significant effect on the measured parameters for the values tested. Overall, the FE models exhibited behavior that is consistent with known mechanical principles related to bending and composite structures as well as the experimental results. This study elucidates the effects of varying commonly assumed model parameters that can aid future studies aimed at screening implant designs.
Collapse
Affiliation(s)
- Melissa M Simonik
- Mechanical Engineering Department, Binghamton University, Vestal, NY, USA.
| | - J M Pitarresi
- Mechanical Engineering Department, Binghamton University, Vestal, NY, USA
| | - R Willing
- Mechanical Engineering Department, Binghamton University, Vestal, NY, USA; Department of Mechanical and Materials Engineering, Western University, London, Canada
| |
Collapse
|
23
|
Lam WK, Wong DWC, Lee WCC. Biomechanics of lower limb in badminton lunge: a systematic scoping review. PeerJ 2020; 8:e10300. [PMID: 33194445 PMCID: PMC7648456 DOI: 10.7717/peerj.10300] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Accepted: 10/14/2020] [Indexed: 11/20/2022] Open
Abstract
Background Badminton is a popular sport activity in both recreational and elite levels. A lot of biomechanical studies have investigated badminton lunge, since good lunge performance may increase the chances to win the game. This review summarized the current trends, research methods, and parameters-of-interest concerning lower-extremity biomechanics in badminton lunges. Methodology Databases including Web of Science, Cochrane Library, Scopus, and PubMed were searched from the oldest available date to September 2020. Two independent authors screened all the articles and 20 articles were eligible for further review. The reviewed articles compared the differences among playing levels, footwear designs, and lunge directions/variations, using parameters including ground reaction forces, plantar pressure distribution, kinematics, and kinetics. Results Elite badminton players demonstrated higher impact attenuation capability, more aggressive knee and ankle strategy (higher mechanical moment), and higher medial plantar load than amateur players. Footwear modifications can influence comfort perception and movement mechanics, but it remains inconclusive regarding how these may link with lunging performance. Contradicting findings in kinematics is possibly due to the variations in lunge and instructions. Conclusions Playing levels and shoe designs have significant effects on biomechanics in badminton lunges. Future studies can consider to use an unanticipated testing protocol and realistic movement intensity. They can study the inter-limb coordination as well as the contributions and interactions of intrinsic and extrinsic factors to injury risk. Furthermore, current findings can stimulate further research studying whether some specific footwear materials with structural design could potentially compromise impact attenuation, proprioception, and performance.
Collapse
Affiliation(s)
- Wing-Kai Lam
- Guangdong Provincial Engineering Technology Research Center for Sports Assistive Devices, Guangzhou Sport University, Guangzhou, China.,Department of Kinesiology, Shenyang Sport University, Shenyang, China.,Li Ning Sports Science Research Center, Li Ning (China) Sports Goods Company, Beijing, China
| | - Duo Wai-Chi Wong
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong, China
| | - Winson Chiu-Chun Lee
- School of Mechanical, Materials, Mechatronic & Biomedical Engineering, University of Wollongong, Wollongong, New South Wales, Australia
| |
Collapse
|
24
|
Wong DWC, Wang Y, Chen TLW, Yan F, Peng Y, Tan Q, Ni M, Leung AKL, Zhang M. Finite Element Analysis of Generalized Ligament Laxity on the Deterioration of Hallux Valgus Deformity (Bunion). Front Bioeng Biotechnol 2020; 8:571192. [PMID: 33015022 PMCID: PMC7505935 DOI: 10.3389/fbioe.2020.571192] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Accepted: 08/18/2020] [Indexed: 12/12/2022] Open
Abstract
Hallux valgus is a common foot problem affecting nearly one in every four adults. Generalized ligament laxity was proposed as the intrinsic cause or risk factor toward the development of the deformity which was difficult to be investigated by cohort clinical trials. Herein, we aimed to evaluate the isolated influence of generalized ligament laxity on the deterioration using computer simulation (finite element analysis). We reconstructed a computational foot model from a mild hallux valgus participant and conducted a gait analysis to drive the simulation of walking. Through parametric analysis, the stiffness of the ligaments was impoverished at different degrees to resemble different levels of generalized ligament laxity. Our simulation study reported that generalized ligament laxity deteriorated hallux valgus by impairing the load-bearing capacity of the first metatarsal, inducing higher deforming force, moment and malalignment at the first metatarsophalangeal joint. Besides, the deforming moment formed a deteriorating vicious cycle between hallux valgus and forefoot abduction and may result in secondary foot problems, such as flatfoot. However, the metatarsocuneiform joint did not show a worsening trend possibly due to the overriding forefoot abduction. Controlling the deforming load shall be prioritized over the correction of angles to mitigate deterioration or recurrence after surgery.
Collapse
Affiliation(s)
- Duo Wai-Chi Wong
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong, China
- The Hong Kong Polytechnic University Shenzhen Research Institute, Shenzhen, China
| | - Yan Wang
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong, China
- The Hong Kong Polytechnic University Shenzhen Research Institute, Shenzhen, China
| | - Tony Lin-Wei Chen
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong, China
| | - Fei Yan
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong, China
| | - Yinghu Peng
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong, China
| | - Qitao Tan
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong, China
| | - Ming Ni
- Department of Orthopaedics, Pudong New Area Peoples’ Hospital Affiliated to Shanghai University of Medicine & Health Sciences, Shanghai, China
| | - Aaron Kam-Lun Leung
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong, China
| | - Ming Zhang
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong, China
- The Hong Kong Polytechnic University Shenzhen Research Institute, Shenzhen, China
| |
Collapse
|
25
|
Meng Z, Wong DWC, Zhang M, Leung AKL. Analysis of compression/release stabilized transfemoral prosthetic socket by finite element modelling method. Med Eng Phys 2020; 83:123-129. [PMID: 32527518 DOI: 10.1016/j.medengphy.2020.05.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Revised: 05/09/2020] [Accepted: 05/13/2020] [Indexed: 11/26/2022]
Abstract
The aim of this study was to investigate the residual limb stress of a transfemoral amputee's Compression/Release Stabilized (CRS) socket by finite elemental modelling. The model was constructed from magnetic resonance images of the left residual limb of a 48-year-old male transfemoral amputee. Two conditions were simulated. In the donning condition, the prosthetic socket under the residual limb moved proximally until it reached the required donned position. The weight-bearing condition was subsequently simulated by applying body weight (800N) at the femoral head while keeping the distal end of the socket fixed. The maximum contact pressure was concentrated at the proximal anterior-medial regions of the residual limb surfaces in both conditions. In the donning condition, the maximum von Mises stress and the maximum contact pressure were 277.7 kPa and 254 kPa respectively. The respective values were 191.9 kPa and 218.5 kPa when body weight was applied. The stress and contact pressure did not exceed the suggested threshold value of pain. Our findings provide important biomechanical information on the CRS socket that may help future design optimization.
Collapse
Affiliation(s)
- Zhaojian Meng
- Rehabilitation Research Institute, Guangdong Provincial Work Injury Rehabilitation Center, Guangzhou, China; Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong, China
| | - Duo Wai-Chi Wong
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong, China
| | - Ming Zhang
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong, China
| | - Aaron Kam-Lun Leung
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong, China.
| |
Collapse
|
26
|
Li SJ, Tang L, Zhao L, Liu CL, Liu YB. Effect of Achilles tendon on kinematic coupling relationship between tarsal bones: a pilot finite element study. J Orthop Surg Res 2020; 15:210. [PMID: 32513196 PMCID: PMC7278193 DOI: 10.1186/s13018-020-01728-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Accepted: 05/25/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The procedure of percutaneous Achilles tenotomy (PAT) is an important component of the Ponseti method. However, few studies reported the influence of Achilles tendon on kinematic coupling relationship between tarsal bones. The purpose of present study was to demonstrate the effect of Achilles tendon on the kinematic coupling relationship between tarsal bones, and to illustrate how kinematic coupling relationship between tarsal bones works in term of finite element analysis. METHODS A three-dimensional finite element model of foot and ankle was constructed based on the Chinese digital human girl No.1 (CDH-G1) image database using the software of mimics, Geomagic studio, HyperMesh, and Abaqus. The last manipulation of the Ponseti method before the procedure of PAT was simulated. The talus head and the proximal tibia and fibula bone were fixed in all six degrees of freedom, and the outward pressure was added on the first metatarsal head to investigate the kinematic coupling relationship between tarsal bones. RESULTS The least relationship of kinematic coupling between tarsal bones was found in calcaneus. Stress concentration was mainly observed at the navicular, talus and the medial malleolus. The difference in displacement of the navicular was only found with the Achilles tendon stiffness of 0 N/mm and others. No difference in the navicular displacement was found in the stiffness of Achilles tendon between 40, 80, 200, 400, and 1000 N/mm. The maximum displacement of navicular was observed at the ankle position of PF-20° (plantar flexion-20°). The difference in displacement of the navicular was greater at the ankle position of PF-20° with the Achilles tendon stiffness of 0 N/mm than that at the ankle position of PF-40° with the Achilles tendon stiffness of 40 N/mm. CONCLUSIONS Based on the findings from this study, it was demonstrated that the Achilles tendon existence or not and ankle position had great influence, while increased stiffness of Achilles tendon had no influence on kinematic coupling relationship between tarsal bones. For the cases with severe equinus, earlier implementation of PAT procedure (with the purpose of release the Achilles tendon and reduce the degree of ankle plantar flexion) may be beneficial to the deformity correction.
Collapse
Affiliation(s)
- Song-Jian Li
- Department of Orthopaedics, Zhujiang Hospital of Southern Medical University, Guangzhou, 510280, China
| | - Lei Tang
- Department of Anatomy, Southern Medical University, Guangzhou, 510280, China
| | - Li Zhao
- Ying-Hua Medical Group of Bone and Joint Healthcare in Children, Shanghai, 200092, China
| | - Cheng-Long Liu
- Department of Orthopaedics, Zhujiang Hospital of Southern Medical University, Guangzhou, 510280, China
| | - Yu-Bin Liu
- Department of Orthopaedics, Zhujiang Hospital of Southern Medical University, Guangzhou, 510280, China. .,Ying-Hua Medical Group of Bone and Joint Healthcare in Children, Shanghai, 200092, China.
| |
Collapse
|
27
|
Finite element analysis of subtalar joint arthroereisis on adult-acquired flexible flatfoot deformity using customised sinus tarsi implant. J Orthop Translat 2020; 27:139-145. [PMID: 33981572 PMCID: PMC8071640 DOI: 10.1016/j.jot.2020.02.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2019] [Revised: 02/05/2020] [Accepted: 02/10/2020] [Indexed: 11/21/2022] Open
Abstract
Background Subtalar arthroereisis may cause sinus tarsi pain complications. In this study, we aimed to introduce a customised implant that facilitated treatment effect and less impingement. The biomechanical outcome between the intact and implant conditions was compared using finite element analysis. Methods A female patient with flatfoot (age: 36 years, height: 156 cm, body mass: 51 kg) was recruited as the model patient. The customised implant was designed from the extracted geometry. Boundary and loading conditions were assumed from the data of a normal participant. Four gait instants, including the ground reaction force first peak (25% stance), valley (45%), initial push-off (60%) and second peak (75%) were analyzed. Results The navicular height was elevated by 4.2% at 25% stance, whereas the strain of the spring, plantar cuneonavicular and plantar cuboideonavicular ligaments were reduced. The talonavicular joint force decreased and the calcaneocuboid joint increased by half and 67%, respectively, representing a lateralised load pathway. There was a stress concentration at the sulcus tali reaching 15.29 MPa Conclusion Subtalar arthroereisis using a customised implant may produce some positive treatment effects in terms of navicular height elevation, ligament strain relief and lateralised joint loading pathway. Although the concentrated stress at the sulcus tali did not exceed the threshold of bone breakdown, we could not rule out the potential of vascular disturbance owing to the remarkable elevation of stress. Future study may enlarge the contact area of the bone–implant interface by considering customisation based on the dynamic change of the sinus tarsi during walking gait. The translational potential of this article Geometry mismatch of prefabricated implants could be the reason for complications. With the advancement of 3D printing, customising implant becomes possible and may improve treatment outcome. This study implemented a theoretical model approach to explore its potential under a simulation of walking.
Collapse
|
28
|
Mo F, Li J, Yang Z, Zhou S, Behr M. In Vivo Measurement of Plantar Tissue Characteristics and Its Indication for Foot Modeling. Ann Biomed Eng 2019; 47:2356-2371. [PMID: 31264043 DOI: 10.1007/s10439-019-02314-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2019] [Accepted: 06/24/2019] [Indexed: 11/30/2022]
Abstract
Plantar heel pain is one of the most common musculoskeletal disorders and generally causing long term discomfort of the patients. The objective of the present study is to combine in vivo experimental measurements and finite element modelling of the foot to investigate the influences of stiffness and thickness variation of individual plantar tissues especially the heel pad on deformation behaviours of the human foot. The stiffness and thickness variance of individuals were measured through supersonic shear wave elastography considering detailed heel pad layers refered to in literature as: dermis, stiffer micro-chamber layer, softer macro-chamber layer. A corresponding foot model with separated heel pad layers was established and used to a sensitivity analysis related to the variance of above-mentioned tissue characteristics. The experimental results show that the average stiffness of the micro-chamber layer ranged from 24.7 (SD 2.4) kPa to 18.8 (SD 3.5) kPa with the age group increasing from 20-29 years old to 60-69 years old, while the average macro-chamber stiffness is 10.6 (SD 1.5) kPa that appears to slightly decrease with the increasing age. Both plantar soft tissue stiffness and thickness of male were generally larger than that of female. The numerical simulation results show that the variance of heel pad strain level can reach 27.5% due to the effects of stiffness and thickness change of the plantar tissues. Their influences on the calcaneus stress and plantar pressure were also significant. This indicates that the most appreciate way to establish a personalized foot model needs to consider the difference of both individual foot anatomic geometry and plantar soft tissue material properties.
Collapse
Affiliation(s)
- Fuhao Mo
- State Key Laboratory of Advanced Design and Manufacture for Vehicle Body, Hunan University, Changsha, 410082, Hunan, China.,Aix-Marseille University, IFSTTAR, LBA UMRT24, Marseille, France
| | - Junjie Li
- State Key Laboratory of Advanced Design and Manufacture for Vehicle Body, Hunan University, Changsha, 410082, Hunan, China
| | - Zurong Yang
- Department of Ultrasound, The Second Xiangya Hospital, Central South University, 139 Renmin Road, Changsha, 410011, Hunan, China.
| | - Shuangyuan Zhou
- Department of Radiology, Xiangya Hospital, Central South University, 87 XiangYa Road, Changsha, 410011, Hunan, China
| | - Michel Behr
- Aix-Marseille University, IFSTTAR, LBA UMRT24, Marseille, France
| |
Collapse
|
29
|
Talar-sided osteochondral lesion of the subtalar joint following the intra-articular calcaneal fracture: study via a modified computed tomography mapping analysis. EUROPEAN JOURNAL OF ORTHOPAEDIC SURGERY AND TRAUMATOLOGY 2019; 29:1331-1336. [PMID: 31037405 DOI: 10.1007/s00590-019-02445-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Accepted: 04/23/2019] [Indexed: 10/26/2022]
Abstract
INTRODUCTION This study is to report the prevalence of osteochondral lesions in subtalar joint following intra-articular calcaneal fracture, including the relationship between fracture severity and lesion characteristics, using modified computed tomography (CT) mapping analysis. METHODS Thirty patients with intra-articular calcaneal fracture who were preoperatively imaged with modified CT mapping analysis were recruited. The presence of talar-sided osteochondral lesions (OLTS) of subtalar joint was noted with lesion area defined by Akiyama's mapping classification. Lesion severity was assessed via Ferkel's classification, and fracture severity via Sanders' classification. RESULTS Lesions were found in 28 patients (93.3%), mostly at anterior [16 (57.1%) lesions] or central [13 (46.4%) lesions] areas of posterior talar facet. Most common grade of lesion severity was grade I (mild) seen in 24 (80%) patients. Most fractures were classified as Sanders' grade III and IV with 12 (40%) and 12 (40%) patients noted, respectively. High severity of fracture denoted by Sanders' grade IV showed a trend of higher prevalence of OLTS at anterior and central sites of posterior talar facet (P = 0.181). Lesion severity was significantly higher in patients with double lesions than patients with single lesions (P = 0.005). However, OLTS were not significantly related with osteoarthritic changes in follow-up radiographs (P > 0.05). CONCLUSIONS The prevalence of OLTS is very high following intra-articular calcaneal fractures. Most lesions occur at anterior or central area of posterior talar facet and are more likely to occur in patients with higher fracture severity. Lesion severity was significantly higher in patients with double lesions than patients with single lesions.
Collapse
|
30
|
Yuan CS, Sun JJ, Wu SY, Jing GQ, Xie MM, Tang KL. Analysis of the stress distribution of the subtalar joint and fusion efficacy after double-screw insertion. J Orthop Surg Res 2019; 14:20. [PMID: 30642345 PMCID: PMC6332584 DOI: 10.1186/s13018-018-1034-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2018] [Accepted: 12/06/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Screw fixation is a typical technique for the isolated subtalar joint. However, no consensus has been reached on how to select the most suitable insertion position and direction. This study aims to find the ideal screw insertion and then explore its influence on the clinical efficacy of subtalar fusion by analyzing the effects of different cannulated screw insertions on the stress distribution, anti-rotary strength, and anti-inversion/eversion strength of the subtalar joint. METHODS In this study, we investigated three cannulated screw insertions for subtalar fusion: screw insertion with the most uniform stress distribution (group A), lateral-medial parallel screw insertion (group B), and traditional longitudinally parallel screw insertion (group C). The effects of these three insertions on the loading stress of the subtalar joint (including stress distribution, anti-inversion/eversion strength, and anti-rotary strength) were comparatively analyzed with the three-dimensional finite element method to screen the ideal screw insertion. Moreover, a prospective study was conducted to analyze the influence of the ideal screw insertion on subtalar fusion, including the fusion rate, fusion time, and clinical efficacy (VAS score, AOFAS score, and complications). RESULTS Group B was worse than group A with respect to the stress distribution uniformity, but slightly better than group C, and better than both groups A and C in terms of the anti-rotary strength and anti-inversion/eversion strength. The screw insertion based on the most uniform stress distribution is not feasible in surgery. Therefore, the lateral-medial antiparallel screw insertion is the ideal insertion. From January 2012 to June 2016, 48 cases were treated by subtalar fusion with the ideal screw insertion, and then followed up for 30.6 months (12-48 months). The fusion was proved in all 48 cases with a fusion rate of 100% by X-ray or CT scan. The mean time of fusion was 12.8 weeks (12-16 weeks). The VAS score decreased from 6.00 before operation to 1.03 on the last visit (P < 0.05), and the AOFAS score increased from 57.0 to 85.6 (P < 0.05), with a good and excellent rate of 95.8%. CONCLUSIONS The lateral-medial parallel screw insertion not only demonstrates a good stress distribution profile of the subtalar joint but also has advantages such as easy localization and operation during surgery, as well as a high fusion rate and few complications after surgery. Therefore, it is a safe, accurate, and effective fixation mode that is worthy of being popularized clinically.
Collapse
Affiliation(s)
- Cheng-Song Yuan
- Department of Orthopaedic Surgery, Southwest Hospital, the Third Military Medical University, No. 30, Gaotanyan Street, Chongqing, 400038, China
| | - Jing-Jing Sun
- Department of Orthopaedic Surgery, Southwest Hospital, the Third Military Medical University, No. 30, Gaotanyan Street, Chongqing, 400038, China
| | - Si-Ya Wu
- Department of Orthopaedic Surgery, Southwest Hospital, the Third Military Medical University, No. 30, Gaotanyan Street, Chongqing, 400038, China
| | - Guo-Qing Jing
- Department of Orthopaedic Surgery, Southwest Hospital, the Third Military Medical University, No. 30, Gaotanyan Street, Chongqing, 400038, China
| | - Mei-Ming Xie
- Department of Orthopaedic Surgery, Southwest Hospital, the Third Military Medical University, No. 30, Gaotanyan Street, Chongqing, 400038, China
| | - Kang-Lai Tang
- Department of Orthopaedic Surgery, Southwest Hospital, the Third Military Medical University, No. 30, Gaotanyan Street, Chongqing, 400038, China.
| |
Collapse
|
31
|
Chen TLW, Wong DWC, Wang Y, Lin J, Zhang M. Foot arch deformation and plantar fascia loading during running with rearfoot strike and forefoot strike: A dynamic finite element analysis. J Biomech 2019; 83:260-272. [DOI: 10.1016/j.jbiomech.2018.12.007] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2018] [Revised: 10/24/2018] [Accepted: 12/03/2018] [Indexed: 01/22/2023]
|
32
|
Gozar H, Chira A, Nagy Ö, Derzsi Z. Medical Use of Finite Element Modeling of the Ankle and Foot. JOURNAL OF INTERDISCIPLINARY MEDICINE 2018. [DOI: 10.1515/jim-2018-0001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Finite element modeling is a field of medicine with great potential future in experimental studies and in daily clinical practice as well. Computational modeling is currently used in several medical applications including orthopedics, cardiovascular surgery, and dentistry. In orthopedics, this method allows a proper understanding of joint behavior, as well as of more complex articular biomechanics that are encountered in several conditions such as ankle fractures or congenital clubfoot. Currently, there is little data on the development of a 3D finite element-defined model for congenital clubfoot. This paper aims to summarize the current status of knowledge and applications of finite element modeling of the foot and ankle.
Collapse
Affiliation(s)
- Horea Gozar
- Discipline of Pediatric Surgery and Orthopedics , University of Medicine and Pharmacy , Tîrgu Mureş , Romania
| | - Alexandru Chira
- Department of Structural Mechanics, Faculty of Civil Engineering , Technical University of Cluj-Napoca , Romania
| | - Örs Nagy
- Discipline of Orthopedics I , University of Medicine and Pharmacy , Tîrgu Mureş , Romania
| | - Zoltán Derzsi
- Discipline of Pediatric Surgery and Orthopedics , University of Medicine and Pharmacy , Tîrgu Mureş , Romania
| |
Collapse
|
33
|
Effect of Dropping Height on the Forces of Lower Extremity Joints and Muscles during Landing: A Musculoskeletal Modeling. JOURNAL OF HEALTHCARE ENGINEERING 2018; 2018:2632603. [PMID: 30079173 PMCID: PMC6051254 DOI: 10.1155/2018/2632603] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/26/2017] [Revised: 03/18/2018] [Accepted: 05/10/2018] [Indexed: 11/24/2022]
Abstract
The objective of this study was to investigate the effect of dropping height on the forces of joints and muscles in lower extremities during landing. A total of 10 adult subjects were required to landing from three different heights (32 cm, 52 cm, and 72 cm), and the ground reaction force and kinematics of lower extremities were measured. Then, the experimental data were input into the AnyBody Modeling System, in which software the musculoskeletal system of each subject was modeled. The reverse dynamic analysis was done to calculate the joint and muscle forces for each landing trial, and the effect of dropping-landing on the results was evaluated. The computational simulation showed that, with increasing of dropping height, the vertical forces of all the hip, knee, and ankle joints, and the forces of rectus femoris, gluteus maximus, gluteus medius, vastii, biceps femoris and adductor magnus were all significantly increased. The increased dropping height also resulted in earlier activation of the iliopsoas, rectus femoris, gluteus medius, gluteus minimus, and soleus, but latter activation of the tibialis anterior. The quantitative joint and muscle forces can be used as loading conditions in finite element analysis to calculate stress and strain and energy absorption processes in various tissues of the lower limbs.
Collapse
|
34
|
Li H, Chen Y, Qiang M, Zhang K, Jiang Y, Zhang Y, Jia X. Computational biomechanical analysis of postoperative inferior tibiofibular syndesmosis: a modified modeling method. Comput Methods Biomech Biomed Engin 2018; 21:427-435. [PMID: 30010400 DOI: 10.1080/10255842.2018.1472770] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Haobo Li
- Department of Orthopedic Trauma, East Hospital, Tongji University School of Medicine, Shanghai, China
| | - Yanxi Chen
- Department of Orthopedic Trauma, East Hospital, Tongji University School of Medicine, Shanghai, China
| | - Minfei Qiang
- Department of Orthopedic Trauma, East Hospital, Tongji University School of Medicine, Shanghai, China
| | - Kun Zhang
- Department of Orthopedic Trauma, East Hospital, Tongji University School of Medicine, Shanghai, China
| | - Yuchen Jiang
- Department of Orthopedic Trauma, East Hospital, Tongji University School of Medicine, Shanghai, China
| | - Yijie Zhang
- Department of Orthopedic Trauma, East Hospital, Tongji University School of Medicine, Shanghai, China
| | - Xiaoyang Jia
- Department of Orthopedic Trauma, East Hospital, Tongji University School of Medicine, Shanghai, China
| |
Collapse
|
35
|
Franco PS, Moro CF, Figueiredo MM, Azevedo RR, Ceccon FG, Carpes FP. Within and between-days repeatability and variability of plantar pressure measurement during walking in children, adults and older adults. Adv Rheumatol 2018; 58:15. [PMID: 30657062 DOI: 10.1186/s42358-018-0014-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2018] [Accepted: 06/15/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Previous studies discussed the repeatability and variability in plantar pressure measurement, but a few considered different age groups. Here we determine within and between-days repeatability and variability of plantar pressure measurement during gait in participants from different age groups. METHOD Plantar pressure was recorded in children, young adults and older adults walking at preferred speed in four non-consecutive days within one week. Data from 10 steps from each foot in each day were analyzed considering the different regions of the foot. Mean and peak plantar pressure and data variability were compared between the steps, foot regions and days. RESULTS To describe mean and peak pressure during gait in children and adults a single measurement can be enough, but elderly will requires more attention especially concerning peak values. Variability in mean pressure did not differ between age groups, but peak pressure variability differed across foot regions and age groups. CONCLUSION One single observation can be used to describe plantar pressure during gait in children and adults. When the interest concerns older people, it might be pertinent to consider more than one day of assessment, especially when looking at peak pressure.
Collapse
Affiliation(s)
- Pedro S Franco
- Applied Neuromechanics Research Group, Federal University of Pampa,Uruguaiana, BR 472 km 592, Po box 118, Uruguaiana, RS, ZIP 97500-970, Brazil.,Graduated Program in Physical Education, Federal University of Santa Maria, Santa Maria, Brazil
| | - Cristiane F Moro
- Applied Neuromechanics Research Group, Federal University of Pampa,Uruguaiana, BR 472 km 592, Po box 118, Uruguaiana, RS, ZIP 97500-970, Brazil
| | - Mariane M Figueiredo
- Applied Neuromechanics Research Group, Federal University of Pampa,Uruguaiana, BR 472 km 592, Po box 118, Uruguaiana, RS, ZIP 97500-970, Brazil
| | - Renato R Azevedo
- Applied Neuromechanics Research Group, Federal University of Pampa,Uruguaiana, BR 472 km 592, Po box 118, Uruguaiana, RS, ZIP 97500-970, Brazil.,Graduated Program in Physical Education, Federal University of Santa Maria, Santa Maria, Brazil
| | - Fernando G Ceccon
- Applied Neuromechanics Research Group, Federal University of Pampa,Uruguaiana, BR 472 km 592, Po box 118, Uruguaiana, RS, ZIP 97500-970, Brazil.,Graduated Program in Physical Education, Federal University of Santa Maria, Santa Maria, Brazil
| | - Felipe P Carpes
- Applied Neuromechanics Research Group, Federal University of Pampa,Uruguaiana, BR 472 km 592, Po box 118, Uruguaiana, RS, ZIP 97500-970, Brazil. .,Graduated Program in Physical Education, Federal University of Santa Maria, Santa Maria, Brazil.
| |
Collapse
|
36
|
Chen TLW, Wong DWC, Xu Z, Tan Q, Wang Y, Luximon A, Zhang M. Lower limb muscle co-contraction and joint loading of flip-flops walking in male wearers. PLoS One 2018; 13:e0193653. [PMID: 29561862 PMCID: PMC5862437 DOI: 10.1371/journal.pone.0193653] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2017] [Accepted: 02/15/2018] [Indexed: 11/18/2022] Open
Abstract
Flip-flops may change walking gait pattern, increase muscle activity and joint loading, and predispose wearers to foot problems, despite that quantitative evidence is scarce. The purpose of this study was to examine the lower limb muscle co-contraction and joint contact force in flip-flops gait, and compare with those of barefoot and sports shoes walking. Ten healthy males were instructed to perform over-ground walking at self-selected speed under three footwear conditions: 1) barefoot, 2) sports shoes, and 3) thong-type flip-flops. Kinematic, kinetic and EMG data were collected and input to a musculoskeletal model to estimate muscle force and joint force. One-way repeated measures ANOVA was conducted to compare footwear conditions. It was hypothesized that flip-flops would induce muscle co-contraction and produce different gait kinematics and kinetics. Our results demonstrated that the musculoskeletal model estimation had a good temporal consistency with the measured EMG. Flip-flops produced significantly lower walking speed, higher ankle and subtalar joint range of motion, and higher shear ankle joint contact force than sports shoes (p < 0.05). There were no significant differences between flip-flops and barefoot conditions in terms of muscle co-contraction index, joint kinematics, and joint loading of the knee and ankle complex (p > 0.05). The variance in walking speed and footwear design may be the two major factors that resulted in the comparable joint biomechanics in flip-flops and barefoot walking. From this point of view, whether flip-flops gait is potentially harmful to foot health remains unclear. Given that shod walking is more common than barefoot walking on a daily basis, sports shoes with close-toe design may be a better footwear option than flip-flops for injury prevention due to its constraint on joint motion and loading.
Collapse
Affiliation(s)
- Tony Lin-Wei Chen
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Duo Wai-Chi Wong
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong SAR, China
- The Hong Kong Polytechnic University Shenzhen Research Institute, Shenzhen, Guangdong, China
| | - Zhi Xu
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong SAR, China
- Laboratory of Biomechanical Engineering, Department of Applied Mechanics, Sichuan University, Chengdu, Sichuan, China
| | - Qitao Tan
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Yan Wang
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong SAR, China
- The Hong Kong Polytechnic University Shenzhen Research Institute, Shenzhen, Guangdong, China
| | - Ameersing Luximon
- Institute of Textiles and Clothing, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Ming Zhang
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong SAR, China
- The Hong Kong Polytechnic University Shenzhen Research Institute, Shenzhen, Guangdong, China
- * E-mail:
| |
Collapse
|
37
|
Sylvester AD, Kramer PA. Young's Modulus and Load Complexity: Modeling Their Effects on Proximal Femur Strain. Anat Rec (Hoboken) 2018; 301:1189-1202. [PMID: 29451371 DOI: 10.1002/ar.23796] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2017] [Revised: 10/23/2017] [Accepted: 11/27/2017] [Indexed: 01/22/2023]
Abstract
Finite element analysis (FEA) is a powerful tool for evaluating questions of functional morphology, but the application of FEA to extant or extinct creatures is a non-trivial task. Three categories of input data are needed to appropriately implement FEA: geometry, material properties, and boundary conditions. Geometric data are relatively easily obtained from imaging techniques, but often material properties and boundary conditions must be estimated. Here we conduct sensitivity analyses of the effect of the choice of Young's Modulus for elements representing trabecular bone and muscle loading complexity on the proximal femur using a finite element mesh of a modern human femur. We found that finite element meshes that used a Young's Modulus between 500 and 1,500 MPa best matched experimental strains. Loading scenarios that approximated the insertion sites of hip musculature produced strain patterns in the region of the greater trochanter that were different from scenarios that grouped muscle forces to the superior greater trochanter, with changes in strain values of 40% or more for 20% of elements. The femoral head, neck, and proximal shaft were less affected (e.g. approximately 50% of elements changed by 10% or less) by changes in the location of application of muscle forces. From our sensitivity analysis, we recommend the use of a Young's Modulus for the trabecular elements of 1,000 MPa for the proximal femur (range 500-1,500 MPa) and that the muscular loading complexity be dependent on whether or not strains in the greater trochanter are the focus of the analytical question. Anat Rec, 301:1189-1202, 2018. © 2018 Wiley Periodicals, Inc.
Collapse
Affiliation(s)
- Adam D Sylvester
- The John Hopkins University School of Medicine, Center for Functional Anatomy and Evolution, 1830 E. Monument Street, Baltimore, Maryland
| | - Patricia A Kramer
- Department of Anthropology, University of Washington, 314 Denny Hall, Seattle, Washington
| |
Collapse
|
38
|
Finite element analysis of the wrist in stroke patients: the effects of hand grip. Med Biol Eng Comput 2017; 56:1161-1171. [DOI: 10.1007/s11517-017-1762-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2017] [Accepted: 11/25/2017] [Indexed: 11/26/2022]
|
39
|
Oken OF, Yildirim AO, Asilturk M. Finite element analysis of the stability of AO/OTA 43-C1 type distal tibial fractures treated with distal tibia medial anatomic plate versus anterolateral anatomic plate. ACTA ORTHOPAEDICA ET TRAUMATOLOGICA TURCICA 2017; 51:404-408. [PMID: 28986074 PMCID: PMC6197470 DOI: 10.1016/j.aott.2017.09.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/18/2016] [Revised: 09/13/2017] [Accepted: 09/19/2017] [Indexed: 11/06/2022]
Abstract
Background The treatment of a pilon fracture type is possible from a medial, an anterolateral approach or both medial and lateral. The aim of study was compare the stability of two different plate fixation of a tibia pilon AO-43C1 type fractures. Material and methods In this study, three-dimensional finite element stress analysis was applied using isotropic materials and static linear analysis. Loading of 400 N force was applied to the model of a patient fixed in a standing position. In the model, first the fibula was treated by plating and then in one group the pilon fracture was treated by medial plating, and in the other by anterolateral plating. The displacement and stress values of the fragments of the fracture line were compared of the same points in each model. Results The magnitude of the displacement of fragments in the total displacement magnitudes of X, Y, Z axis were measured in the medial plate and anterolateral plate. The anterolateral plate results were similar to those of the medial plate and the displacement values in the Y axis were determined to be lower than in the medial plate. Conclusion In AO 43 C1 distal tibia fractures, medial or anterolateral plates can be used, and the results of this study showed similar biomechanical stiffness in the two plates.
Collapse
|
40
|
Wong DWC, Wang Y, Chen TLW, Leung AKL, Zhang M. Biomechanical consequences of subtalar joint arthroereisis in treating posterior tibial tendon dysfunction: a theoretical analysis using finite element analysis. Comput Methods Biomech Biomed Engin 2017; 20:1525-1532. [DOI: 10.1080/10255842.2017.1382484] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Duo Wai-Chi Wong
- Interdisciplinary Division of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong, China
- Shenzhen Research Institute, The Hong Kong Polytechnic University, Shenzhen, China
| | - Yan Wang
- Interdisciplinary Division of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong, China
- Shenzhen Research Institute, The Hong Kong Polytechnic University, Shenzhen, China
| | - Tony Lin-Wei Chen
- Interdisciplinary Division of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong, China
| | - Aaron Kam-Lun Leung
- Interdisciplinary Division of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong, China
- Shenzhen Research Institute, The Hong Kong Polytechnic University, Shenzhen, China
| | - Ming Zhang
- Interdisciplinary Division of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong, China
- Shenzhen Research Institute, The Hong Kong Polytechnic University, Shenzhen, China
| |
Collapse
|
41
|
Yu X, Li WL, Pang QJ, Zhou RL. Finite element analysis of locking plate and 1/4 tubular plate for first tarsometatarsal joint fracture-dislocation. J Int Med Res 2017; 45:1528-1534. [PMID: 28760086 PMCID: PMC5718719 DOI: 10.1177/0300060517707114] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Objective The optimal plate for fixation of tarsometatarsal joint injuries is controversial. The objective of this study was to compare the biomechanical characteristics between a locking plate and 1/4 tubular plate for first tarsometatarsal joint fracture-dislocation. Method Finite element analysis was used after establishment of a first tarsometatarsal joint fracture-dislocation model. Two implant simulations using a locking plate and five-hole 1/4 tubular plate were designed to simulate fixation of the fracture-dislocation. The displacement of the first tarsometatarsal articular surface and the stress distribution in the implants were calculated. Results A 700-N load was applied to both models. The minimum displacement of the articular surface in the locking plate and 1/4 tubular plate model was 0.6471 mm and 0.3833 mm, respectively. The maximum principal stress in the locking plate and 1/4 tubular plate was 1.212 × 103 MPa and 1.107 × 103 MPa, respectively. Conclusion Use of a 1/4 tubular plate is recommended for fixation of first tarsometatarsal joint fracture-dislocation after consideration of other factors such as economical issues.
Collapse
Affiliation(s)
- Xiao Yu
- 1 Department of Orthopedics, Ningbo No. 2 Hospital, Ningbo, China
| | - Wei-Long Li
- 2 Ningbo University, School of Medicine, Ningbo, China
| | - Qing-Jiang Pang
- 1 Department of Orthopedics, Ningbo No. 2 Hospital, Ningbo, China
| | - Rong-Li Zhou
- 1 Department of Orthopedics, Ningbo No. 2 Hospital, Ningbo, China
| |
Collapse
|
42
|
Alonso-Rasgado T, Jimenez-Cruz D, Karski M. 3-D computer modelling of malunited posterior malleolar fractures: effect of fragment size and offset on ankle stability, contact pressure and pattern. J Foot Ankle Res 2017; 10:13. [PMID: 28293302 PMCID: PMC5346225 DOI: 10.1186/s13047-017-0194-5] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2016] [Accepted: 03/01/2017] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND The positioning of the fracture fragment of a posterior malleolus fracture is critical to healing and a successful outcome as malunion of a posterior malleolar fracture, a condition seen in clinical practice, can affect the dynamics of the ankle joint, cause posterolateral rotational subluxation of the talus and ultimately lead to destruction of the joint. Current consensus is to employ anatomic reduction with internal fixation when the fragment size is larger than 25 to 33% of the tibial plafond. METHODS A 3-dimensional finite element (FE) model of ankle was developed in order to investigate the effect of fragment size (6-15 mm) and offset (1-4 mm) of a malunited posterior malleolus on tibiotalar joint contact area, pressure, motion of joint and ligament forces. Three positions of the joint were simulated; neutral position, 20° dorsiflexion and 30° plantarflexion. RESULTS Compared to the intact joint our model predicted that contact area was greater in all malunion scenarios considered. In general, the joint contact area was affected more by section length than section offset. In addition fibula contact area played a role in all the malunion cases. CONCLUSIONS We found no evidence to support the current consensus of fixing posterior malleolus fractures of greater than 25% of the tibial plafond. Our model predicted joint instability only with the highest level of fracture in a loaded limb at an extreme position of dorsiflexion. No increase of peak contact pressure as a result of malunion was predicted but contact pattern was modified. The results of our study support the view that in cases of posterior malleolar fracture, posttraumatic osteoarthritis occurs as a result of load on areas of cartilage not used to loading rather than an increase in contact pressure. Ankle repositioning resulted in increased force in two ankle ligaments. Our finding could explain commonly reported clinical observations.
Collapse
Affiliation(s)
- Teresa Alonso-Rasgado
- Bioengineering Research Group, School of Materials, The University of Manchester, Oxford Road, Manchester, M13 9PL UK
| | - David Jimenez-Cruz
- Bioengineering Research Group, School of Materials, The University of Manchester, Oxford Road, Manchester, M13 9PL UK
| | - Michael Karski
- Wrightington Hospital, Wigan and Leigh NHS Foundation Trust, Lancashire, UK
| |
Collapse
|
43
|
Xie MM, Xia K, Zhang HX, Cao HH, Yang ZJ, Cui HF, Gao S, Tang KL. Individual headless compression screws fixed with three-dimensional image processing technology improves fusion rates of isolated talonavicular arthrodesis. J Orthop Surg Res 2017; 12:17. [PMID: 28114949 PMCID: PMC5259994 DOI: 10.1186/s13018-017-0516-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2017] [Accepted: 01/09/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Screw fixation is a typical technique for isolated talonavicular arthrodesis (TNA), however, no consensus has been reached on how to select most suitable inserted position and direction. The study aimed to present a new fixation technique and to evaluate the clinical outcome of individual headless compression screws (HCSs) applied with three-dimensional (3D) image processing technology to isolated TNA. METHODS From 2007 to 2014, 69 patients underwent isolated TNA by using double Acutrak HCSs. The preoperative three-dimensional (3D) insertion model of double HCSs was applied by Mimics, Catia, and SolidWorks reconstruction software. One HCS oriented antegradely from the edge of dorsal navicular tail where intersected interspace between the first and the second cuneiform into the talus body along the talus axis, and the other one paralleled the first screw oriented from the dorsal-medial navicular where intersected at the medial plane of the first cuneiform. The anteroposterior and lateral X-ray examinations certified that the double HCSs were placed along the longitudinal axis of the talus. Postoperative assessment included the American Orthopaedic Foot & Ankle Society hindfoot (AOFAS), the visual analogue scale (VAS) score, satisfaction score, imaging assessments, and complications. RESULTS At the mean 44-months follow-up, all patients exhibited good articular congruity and solid bone fusion at an average of 11.26 ± 0.85 weeks (range, 10 ~ 13 weeks) without screw loosening, shifting, or breakage. The overall fusion rates were 100%. The average AOFAS score increased from 46.62 ± 4.6 (range, 37 ~ 56) preoperatively to 74.77 ± 5.4 (range, 64-88) at the final follow-up (95% CI: -30.86 ~ -27.34; p < 0.001). The mean VAS score decreased from 7.01 ± 1.2 (range, 4 ~ 9) to 1.93 ± 1.3 (range, 0 ~ 4) (95% CI: 4.69 ~ 5.48; p < 0.001). One cases (1.45%) and three cases (4.35%) experienced wound infection and adjacent arthritis respectively. The postoperative satisfaction score including pain relief, activities of daily living, and return to recreational activities were good to excellent in 62 (89.9%) cases. CONCLUSIONS Individual 3D reconstruction of HCSs insertion model can be designed with three-dimensional image processing technology in TNA. The technology is safe, effective, and reliable to isolated TNA method with high bone fusion rates, low incidences of complications.
Collapse
Affiliation(s)
- Mei-Ming Xie
- Department of Orthopaedic Surgery, Southwest Hospital, The Third Military Medical University, Gaotanyan Str. 30, Chongqing city, 400038, People's Republic of China
| | - Kang Xia
- Department of Orthopaedic Surgery, Southwest Hospital, The Third Military Medical University, Gaotanyan Str. 30, Chongqing city, 400038, People's Republic of China
| | - Hong-Xin Zhang
- Department of Orthopaedic Surgery, Southwest Hospital, The Third Military Medical University, Gaotanyan Str. 30, Chongqing city, 400038, People's Republic of China
| | - Hong-Hui Cao
- Department of Orthopaedic Surgery, Southwest Hospital, The Third Military Medical University, Gaotanyan Str. 30, Chongqing city, 400038, People's Republic of China
| | - Zhi-Jin Yang
- Department of Orthopaedic Surgery, Southwest Hospital, The Third Military Medical University, Gaotanyan Str. 30, Chongqing city, 400038, People's Republic of China
| | - Hai-Feng Cui
- Department of Orthopaedic Surgery, Southwest Hospital, The Third Military Medical University, Gaotanyan Str. 30, Chongqing city, 400038, People's Republic of China
| | - Shang Gao
- Department of Orthopaedic Surgery, Southwest Hospital, The Third Military Medical University, Gaotanyan Str. 30, Chongqing city, 400038, People's Republic of China
| | - Kang-Lai Tang
- Department of Orthopaedic Surgery, Southwest Hospital, The Third Military Medical University, Gaotanyan Str. 30, Chongqing city, 400038, People's Republic of China.
| |
Collapse
|
44
|
Sun J, Yan S, Jiang Y, Wong DWC, Zhang M, Zeng J, Zhang K. Finite element analysis of the valgus knee joint of an obese child. Biomed Eng Online 2016; 15:158. [PMID: 28155677 PMCID: PMC5260062 DOI: 10.1186/s12938-016-0253-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
Background Knee valgus and varus morbidity is at the second top place in children lower limb deformity diseases. It may cause abnormal stress distribution. The magnitude and location of contact forces on tibia plateau during gait cycle have been indicated as markers for risk of osteoarthritis. So far, few studies reported the contact stress and force distribution on tibial plateau of valgus knee of children. Methods To estimate the contact stresses and forces on tibial plateau of an 8-year old obese boy with valgus knee and a 7-year old healthy boy, three-dimensional (3D) finite element (FE) models of their left knee joints were developed. The valgus knee model has 36,897 nodes and 1,65,106 elements, and the normal knee model has 78,278 nodes and 1,18,756 elements. Paired t test was used for the comparison between the results from the 3D FE analysis method and the results from traditional kinematic measurement methods. Results The p value of paired t test is 0.12. Maximum stresses shifted to lateral plateau in knee valgus children while maximum stresses were on medial plateau in normal knee child at the first peak of vertical GRF of stance phase. The locations of contact centers on medial plateau changed 3.38 mm more than that on lateral plateau, while the locations of contact centers on medial plateau changed 1.22 mm less than that on lateral plateau for healthy child from the first peak to second peak of vertical GRF of stance phase. Conclusions The paired t test result shows that there is no significant difference between the two methods. The results of FE analysis method suggest that knee valgus malalignment could be the reason for abnormal knee load that may cause knee problems in obese children with valgus knee in the long-term. This study may help to understand biomechanical mechanism of valgus knees of obese children.
Collapse
Affiliation(s)
- Jun Sun
- School of Biomedical Engineering, Capital Medical University, Beijing, 100069, China.,Beijing Key Laboratory of Fundamental Research on Biomechanics in Clinical Application, Capital Medical University, Beijing, 100069, China
| | - Songhua Yan
- School of Biomedical Engineering, Capital Medical University, Beijing, 100069, China.,Beijing Key Laboratory of Fundamental Research on Biomechanics in Clinical Application, Capital Medical University, Beijing, 100069, China
| | - Yan Jiang
- School of Biomedical Engineering, Capital Medical University, Beijing, 100069, China
| | - Duo Wai-Chi Wong
- Interdisciplinary Division of Biomedical Engineering, The Hong Kong Polytechnic University, Hong Kong, 999077, China
| | - Ming Zhang
- Interdisciplinary Division of Biomedical Engineering, The Hong Kong Polytechnic University, Hong Kong, 999077, China
| | - Jizhou Zeng
- Department of Orthopedics, Beijing Luhe Hospital, Capital Medical University, Beijing, 101149, China
| | - Kuan Zhang
- School of Biomedical Engineering, Capital Medical University, Beijing, 100069, China. .,Beijing Key Laboratory of Fundamental Research on Biomechanics in Clinical Application, Capital Medical University, Beijing, 100069, China.
| |
Collapse
|
45
|
Ren S, Wong DWC, Yang H, Zhou Y, Lin J, Zhang M. Effect of pillow height on the biomechanics of the head-neck complex: investigation of the cranio-cervical pressure and cervical spine alignment. PeerJ 2016; 4:e2397. [PMID: 27635354 PMCID: PMC5012320 DOI: 10.7717/peerj.2397] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2016] [Accepted: 08/02/2016] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND While appropriate pillow height is crucial to maintaining the quality of sleep and overall health, there are no universal, evidence-based guidelines for pillow design or selection. We aimed to evaluate the effect of pillow height on cranio-cervical pressure and cervical spine alignment. METHODS Ten healthy subjects (five males) aged 26 ± 3.6 years were recruited. The average height, weight, and neck length were 167 ± 9.3 cm, 59.6 ± 11.9 kg, and 12.9 ± 1.2 cm respectively. The subjects lay on pillows of four different heights (H0, 110 mm; H1, 130 mm; H2, 150 mm; and H3, 170 mm). The cranio-cervical pressure distribution over the pillow was recorded; the peak and average pressures for each pillow height were compared by one-way ANOVA with repeated measures. Cervical spine alignment was studied using a finite element model constructed based on data from the Visible Human Project. The coordinate of the center of each cervical vertebra were predicted for each pillow height. Three spine alignment parameters (cervical angle, lordosis distance and kyphosis distance) were identified. RESULTS The average cranial pressure at pillow height H3 was approximately 30% higher than that at H0, and significantly different from those at H1 and H2 (p < 0.05). The average cervical pressure at pillow height H0 was 65% lower than that at H3, and significantly different from those at H1 and H2 (p < 0.05). The peak cervical pressures at pillow heights H2 and H3 were significantly different from that at H0 (p < 0.05). With respect to cervical spine alignment, raising pillow height from H0 to H3 caused an increase of 66.4% and 25.1% in cervical angle and lordosis distance, respectively, and a reduction of 43.4% in kyphosis distance. DISCUSSION Pillow height elevation significantly increased the average and peak pressures of the cranial and cervical regions, and increased the extension and lordosis of the cervical spine. The cranio-cervical pressures and cervical spine alignment were height-specific, and they were believed to reflect quality of sleep. Our results provide a quantitative and objective evaluation of the effect of pillow height on the biomechanics of the head-neck complex, and have application in pillow design and selection.
Collapse
Affiliation(s)
- Sicong Ren
- Interdisciplinary Division of Biomedical Engineering, The Hong Kong Polytechnic University, Hong Kong, China
| | - Duo Wai-Chi Wong
- Interdisciplinary Division of Biomedical Engineering, The Hong Kong Polytechnic University, Hong Kong, China.,The Hong Kong Polytechnic University Shenzhen Research Institute, Shenzhen, China
| | - Hui Yang
- Infinitus (China) Company Ltd., China
| | - Yan Zhou
- Infinitus (China) Company Ltd., China
| | - Jin Lin
- Infinitus (China) Company Ltd., China
| | - Ming Zhang
- Interdisciplinary Division of Biomedical Engineering, The Hong Kong Polytechnic University, Hong Kong, China.,The Hong Kong Polytechnic University Shenzhen Research Institute, Shenzhen, China
| |
Collapse
|