Computational Models of the Foot and Ankle for Pathomechanics and Clinical Applications: A Review

Abstract

Complementary to experimental studies, computational biomechanics has become useful tool for the understanding of human foot biomechanics and pathomechanics. Its findings have been widely used for the evaluation of the effectiveness of surgical and conservative interventions. These models, however, were developed with a wide range of variations in terms of simplifications and assumptions on the representation of geometrical structures and material properties, as well as boundary and loading conditions. These variations may create differences in prediction accuracy, and restrict practical and clinical applications. This paper reviews the state-of-the-art technologies and challenges in computational model development, focusing on foot problem-specific models for the assessment of the effectiveness and accessibility of clinical treatments. The computational models have provided valuable biomechanical information for clinical applications but further investigations come with many challenges in terms of detailed and patient-specific models, accurate representations of tissue properties, and boundary and loading conditions. Multi-scale computational models are expected to be an efficient platform to fully address the biomechanical and biological concerns.

From Finite Element Meshes to Clouds of Points: A Review of Methods for Generation of Computational Biomechanics Models for Patient-Specific Applications

“…99,101,106,116 However, this review indicates that despite many years of research and development in academia and software industry, generation of patient-specific FE meshes using medical images as a source of information about organ geometry still requires input from an experienced analyst with expert knowledge of image processing and mesh generation. As discussed in sections ''Isogeometric Analysis and High Order Elements'' and ''Beyond Finite Element Meshes: Meshless Methods and Models as Clouds of Points'' methods combined with tissue classification eliminate key disadvantages associated with FE method's reliance on low-order polynomial interpolation and pave a way for automating computational grid generation.…”

Effect of pillow height on the biomechanics of the head-neck complex: investigation of the cranio-cervical pressure and cervical spine alignment

“…The recent advance in computer simulation technology has enabled non-invasive and more detailed investigations regarding the biomechanics of pathology, injury, surgery, and body-interface design (Cheung et al, 2009; Wong et al, 2016; Wong et al, 2015; Wong et al, 2014; Yu et al, 2013). Finite element analysis provide a versatile platform to examine the internal biomechanical characteristics of the human body in a controlled environment, using pre-defined parameters (Fagan, Julian & Mohsen, 2002; Wang, Wong & Zhang, 2016b). However, few attempts focused on the effect of the pillow or mattress design (Leilnahari et al, 2011), and some simulations employed a largely simplified geometry of the human body (Fagan, Julian & Mohsen, 2002; Haex, 2004).…”

Fixed and mobile-bearing total ankle prostheses: Effect on tibial bone strain

“…We might indeed observe other stress and strain patterns for more complex loading. However, very few models are using more complex loading (Arnold et al 2010;Leardini et al 2014;Wang et al 2016;DeMers et al 2017), and the comparison with our results remains difficult since bone strain is rarely analyzed (Reggiani et al 2006;Jay Elliot et al 2014). Besides, since we had no information about the donor, we applied the same loading to all tibias, which is certainly not fully consistent with real life.…”