Biomechanical comparison among five mid/hindfoot arthrodeses procedures in treating flatfoot using a musculoskeletal multibody driven finite element model

Peng, Yonghan; Niu, Wen; Wong, Duo Wai-Chi; Wang, Yan; Chen, Tony Lin-Wei; Zhang, Guoxin; Tan, Qitao; Zhang, Ming

doi:10.1016/j.cmpb.2021.106408

Cited by 14 publications

(15 citation statements)

References 48 publications

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“…In the authors' view, this difference confirms both procedures presented in the study as adequate treatments. However, the authors' experience is consistent with the prevailing opinion in the literature that talonavicular arthrodesis is the standard of surgical treatment for AAFD [27][28][29][30]. Therefore, radiological results should not be considered in isolation from the clinical outcome.…”

Section: Discussionsupporting

confidence: 84%

Adult-Acquired Flatfoot Deformity: Combined Talonavicular Arthrodesis and Calcaneal Displacement Osteotomy versus Double Arthrodesis

Fischer

Oepping

Altmeppen

et al. 2022

JCM

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Background: Adult-acquired flatfoot deformity due to posterior tibial tendon dysfunction (PTTD) is one of the most common foot deformities among adults. Hypothesis: Our study aimed to confirm that the combined procedures of calcaneal displacement osteotomy and talonavicular arthrodesis are equivalent to double arthrodesis. Methods: Between 2016 and 2020, 41 patients (13 male and 28 females, mean age of 63 years) were retrospectively enrolled in the comparative study. All deformities were classified into Stages II and III of PTTD, according to Johnson and Strom. All patients underwent isolated bony realignment of the deformity: group A (n = 19) underwent calcaneal displacement osteotomy and talonavicular arthrodesis, and group B (n = 23) underwent double arthrodesis. Measurements from the Foot Function Index-D (FFI-D) and the SF-12 questionnaire were collected, with a comparison of pre- and post-operative radiographs conducted. The mean follow-up period for patients was 3.4 years. Results: The mean FFI-D was 33.9 (group A: 34.5; group B: 33.5), the mean SF-12 physical component summary was 43.13 (group A: 40.9; group B: 44.9), and the mean SF-12 mental component summary was 43.13 (group A: 40.9; group B: 44.9). The clinical data and corrected angles showed no significant intergroup differences. Conclusion: Based on the available data, our study confirmed that the combined procedures of talonavicular arthrodesis and calcaneal shift, with preservation of the subtalar joint, can be considered equivalent to the established double arthrodesis, with no significant differences in terms of clinical and radiological outcomes.

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Section: Discussionsupporting

confidence: 84%

Adult-Acquired Flatfoot Deformity: Combined Talonavicular Arthrodesis and Calcaneal Displacement Osteotomy versus Double Arthrodesis

Fischer

Oepping

Altmeppen

et al. 2022

JCM

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“…The construction of the flatfoot FE model has been reported in our previous studies ( Peng et al, 2021a ). A young male adult (27 years old, 175 cm height, and 64 kg weight) was recruited for the FE modeling.…”

Section: Methodsmentioning

confidence: 99%

“…In addition, the foot muscles forces for the tibialis anterior (38 N), tibialis posterior (200 N), peroneus brevis (1 N), peroneus longus (0 N), Achilles tendon (gastrocnemius and soleus) (774 N), flexor hallucis longus (95 N), and flexor digitorum longus (26 N) were used as inputs to drive the FE model. The musculoskeletal model was adopted to estimate these muscle forces based on the experimental gait data ( Peng et al, 2021a ). These simulations were conducted with Abaqus 6.14 (Dassault Systèmes, Vélizy-Villacoublay, France) using the standard static solver.…”

Section: Methodsmentioning

confidence: 99%

“…The muscle-driven flatfoot FE has been validated by comparing the predicted foot pressure with the measurements in our previous studies under barefoot and shod-walking conditions ( Peng et al, 2021a ; Peng et al, 2021c ). The correlation analysis showed that the measurement and prediction were highly associated under barefoot walking ( r = 0.95, p < 0.001) and shod-walking ( r = 0.8, p < 0.001) conditions ( Peng et al, 2021a ; Peng et al, 2021c ).…”

Section: Methodsmentioning

confidence: 99%

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Different Design Feature Combinations of Flatfoot Orthosis on Plantar Fascia Strain and Plantar Pressure: A Muscle-Driven Finite Element Analysis With Taguchi Method

Peng

Wang

Wong

et al. 2022

Front. Bioeng. Biotechnol.

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Customized foot orthosis is commonly used to modify foot posture and relieve foot pain for adult acquired flexible flatfoot. However, systematic investigation of the influence of foot orthotic design parameter combination on the internal foot mechanics remains scarce. This study aimed to investigate the biomechanical effects of different combinations of foot orthoses design features through a muscle-driven flatfoot finite element model. A flatfoot-orthosis finite element model was constructed by considering the three-dimensional geometry of plantar fascia. The plantar fascia model accounted for the interaction with the bulk soft tissue. The Taguchi approach was adopted to analyze the significance of four design factors combination (arch support height, medial posting inclination, heel cup height, and material stiffness). Predicted plantar pressure and plantar fascia strains in different design combinations at the midstance instant were reported. The results indicated that the foot orthosis with higher arch support (45.7%) and medial inclination angle (25.5%) effectively reduced peak plantar pressure. For the proximal plantar fascia strain, arch support (41.8%) and material stiffness (37%) were strong influencing factors. Specifically, higher arch support and softer material decreased the peak plantar fascia strain. The plantar pressure and plantar fascia loading were sensitive to the arch support feature. The proposed statistics-based finite element flatfoot model could assist the insole optimization and evaluation for individuals with flatfoot.

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“…A sensitivity analysis may be conducted to address the variance of model assumption ( Wong et al, 2018 ), while the patient-specific muscle force profile could be obtained by a musculoskeletal model to drive the FE model ( Peng et al, 2021a ). A sensitivity test on the coefficient of friction between bone fragments could enable the quantification of the biomechanical role of the plate.…”

Section: Discussionmentioning

confidence: 99%

Biomechanical Analysis of a Novel Double-Point Fixation Method for Displaced Intra-Articular Calcaneal Fractures

Sun

et al. 2022

Front. Bioeng. Biotechnol.

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The development of minimally invasive procedures and implant materials has improved the fixation strength of implants and is less traumatic in surgery. The purpose of this study was to propose a novel “double-point fixation” for calcaneal fractures and compare its biomechanical stability with the traditional “three-point fixation.” A three-dimensional finite element foot model with a Sanders type IIIAB calcaneal fracture was developed based on clinical images comprising bones, plantar fascia, ligaments, and encapsulated soft tissue. Double-point and three-point fixation resembled the surgical procedure with a volar distal radius plate and calcaneal locking plate, respectively. The stress distribution, fracture displacement, and change of the Böhler angle and Gissane’s angle were estimated by a walking simulation using the model, and the predictions between the double-point and three-point fixation were compared at heel-strike, midstance, and push-off instants. Double-point fixation demonstrated lower bone stress (103.3 vs. 199.4 MPa), but higher implant stress (1,084.0 vs. 577.9 MPa). The model displacement of double-point fixation was higher than that of three-point fixation (3.68 vs. 2.53 mm). The displacement of the posterior joint facet (0.127 vs. 0.150 mm) and the changes of the Böhler angle (0.9° vs. 1.4°) and Gissane’s angle (0.7° vs. 0.9°) in double-point fixation were comparably lower. Double-point fixation by volar distal radius plates demonstrated sufficient and favorable fixation stability and a lower risk of postoperative stress fracture, which may potentially serve as a new fixation modality for the treatment of displaced intra-articular calcaneal fractures.

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Biomechanical comparison among five mid/hindfoot arthrodeses procedures in treating flatfoot using a musculoskeletal multibody driven finite element model

Cited by 14 publications

References 48 publications

Adult-Acquired Flatfoot Deformity: Combined Talonavicular Arthrodesis and Calcaneal Displacement Osteotomy versus Double Arthrodesis

Adult-Acquired Flatfoot Deformity: Combined Talonavicular Arthrodesis and Calcaneal Displacement Osteotomy versus Double Arthrodesis

Different Design Feature Combinations of Flatfoot Orthosis on Plantar Fascia Strain and Plantar Pressure: A Muscle-Driven Finite Element Analysis With Taguchi Method

Biomechanical Analysis of a Novel Double-Point Fixation Method for Displaced Intra-Articular Calcaneal Fractures

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