Principal stresses obtained for the first metatarsal with both implants suggest that failure is induced in this bone because, values exceed (up to 136.84% for Swanson model) the tensile strength reported for phalange trabecular bone, which may be related to osteolysis. Stress and strain values obtained in this work suggest that arthroplasty surgery with Swanson implant is more likely to cause postoperative complications versus Tornier implant.
This work focuses on the biomechanical simulation of surgery for total replacement of the first metatarsophalangeal joint (MTPJ) allowed us to identify and analyze several key aspects for finite element simulation of hallux rigidus pathology. Predicting the optimal response of a finite element model (FEM) depends on proper characterization. At this part of the work, those conditions that have a direct or indirect influence on the model that can change its behavior should be considered.
For this purpose, we presented in this work a finite element model which include 26 bones: 14 phalanges, 5 metatarsals, 3 cuneiform bones, 1 cuboid, 1 navicular, 1 talus and 1 calcaneus, all of them include articular cartilage. In addition, the model also considers: thin ligaments, long ligaments, muscles and a joint implant.
Loads and boundary conditions included: a pretension in the flexor caused by position analysis, a distributed load in the talus in its normal and tangential component, a restriction of movement of some points in the phalanges and calcaneus and the contact conditions between flexor and extensor created from surfaces in the bone volumes.
Moreover, the selection of support and constrains regions in the phalanges and calcaneus area must be carefully selected to reproduce the conditions of real support and interaction with adjacent tissues not simulated. These conditions have influence in the structural biomechanical response of each tissue and in contact regions, leading to unexpected behavior if they are wrong selected. In addition, results showed that care must be taken in the mechanical characterization of each tissue, selecting the mechanical properties, pretension, geometry and critical position according to in vitro results or MRIs.
Biomechanical aspects reported in this work allow to take into account fundamental details to improve future simulations of this pathology as well as to improve the correlation with experimental results. These biomechanical aspects provide knowledge for finite element simulation of the arthroplasty for the first metatarsophalangeal joint, this allow us to generate a virtual model for arthroplasty of the hallux rigidus to predict, prevent and improve surgical techniques for implantation of prostheses in the first metatarsophalangeal joint.
Penetration and shared nodes between muscles, tendons and the plantar aponeurosis mesh elements in finite element models of the foot may cause inappropriate structural behavior of the tissues. Penetration between tissues caused using separate mesh without motion constraints or contacts can change the loading direction because of an inadequate mesh displacement. Shared nodes between mesh elements create bonded areas in the model, causing progressive or complete loss of load transmitted by tissue. This paper compares by the finite element method the structural behavior of the foot model in cases where a shared mesh has been used versus a separated mesh with sliding contacts between some important tissues. A very detailed finite element model of the foot and ankle that simulates the muscles, tendons and plantar aponeurosis with real geometry has been used for the research. The analysis showed that the use of a separate mesh with sliding contacts and a better characterization of the mechanical behavior of the soft tissues increased the mean of the absolute values of stress by 83.3% and displacement by 17.4% compared with a shared mesh. These increases mean an improvement of muscle and tendon behavior in the foot model. Additionally, a better quantitative and qualitative distribution of plantar pressure was also observed.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.