Subject-specific models of the hindfoot reveal a relationship between morphology and passive mechanical properties

Imhauser, Carl W.; Siegler, Sorin; Udupa, Jayaram K.; Toy, Jason

doi:10.1016/j.jbiomech.2007.12.017

Cited by 47 publications

(49 citation statements)

References 33 publications

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“…It is possible that hindfoot fusion modalities have the potential to produce different results in different individuals given the strong dependency of passive joint mechanics on morphologic features of the ankle complex [16]. However, our simplified model identified some predictable trends in ankle biomechanics during loading after hindfoot fusion.…”

Section: Discussionmentioning

confidence: 93%

How Do Hindfoot Fusions Affect Ankle Biomechanics: A Cadaver Model

Hutchinson

Baxter

Gilbert

et al. 2016

Clinical Orthopaedics &Amp; Related Research

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Background While successful subtalar joint arthrodesis provides pain relief, resultant alterations in ankle biomechanics need to be considered, as this procedure may predispose the remaining hindfoot and tibiotalar joint to accelerated degenerative changes. However, the biomechanical consequences of isolated subtalar joint arthrodesis and additive fusions of the Chopart's joints on tibiotalar joint biomechanics remain poorly understood. Questions/purposes We asked: What is the effect of isolated subtalar fusion and sequential Chopart's joint fusions of the talonavicular and calcaneocuboid joints on tibiotalar joint (1) mechanics and (2) kinematics during loading for neutral, inverted, and everted orientations of the foot? Methods We evaluated the total force, contact area, and the magnitude and distribution of the contact stress on the articular surface of the talar dome, while simultaneously tracking the position of the talus relative to the tibia during loading in seven fresh-frozen cadaver feet. Each foot was loaded in the unfused, intact control condition followed by three randomized simulated hindfoot arthrodesis modalities: subtalar, double (subtalar and talonavicular), and triple (subtalar, talonavicular, and calcaneocuboid) arthrodesis. The intact and arthrodesis conditions were tested in three alignments using a metallic wedge insert: neutral (flat), 10°i nverted, and 10°everted. Results Tibiotalar mechanics (total force and contact area) and kinematics (external rotation) differed owing to hindfoot arthrodeses. After subtalar arthrodesis, there were Each author certifies that he or she, or a member of their immediate family, has no commercial associations (eg, consultancies, stock ownership, equity interest, patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article. Clinical Orthopaedics and Related Research ®A Publication of The Association of Bone and Joint Surgeons® decreases in total force (445 ± 142 N, 95% CI, 340-550 N, versus 588 ± 118 N, 95% CI, 500-676 N; p \ 0.001) and contact area (282 mm 2 , 95% CI, 222-342 mm 2 , versus 336 ± 96 mm 2 , 95% CI, 265-407 mm 2 ; p \ 0.026) detected during loading in the neutral position; these changes also were seen in the everted foot position. Hindfoot arthrodesis also was associated with increased external rotation of the tibiotalar joint during loading: subtalar arthrodesis in the neutral loading position (3.3°± 1.6°; 95% CI, 2°-4.6°; p = 0.004) and everted loading position (4.8°± 2.6°; 95% CI, 2.7°-6.8°; p = 0.043); double arthrodesis in neutral (4.4°± 2°; 95% CI, 2.8°-6°; p = 0.003) and inverted positions (5.8°± 2.6°; 95% CI, 3.7°-7.9°; p = 0.002), and triple arthrodesis in all loaded orientations including neutral (4.5°±1.8°; 95% CI, 3.1°-5.9°; p = 0.002), inverted (6.4°± 3.5°; 95% CI, 3.6°-9.2°; p = 0.009), and everted (3.6°± 2°; 95% CI, 2°-5.2°; p = 0.053) positions. Finally, after subtalar arthrodesis, additive fusions at Chopart's joints did not appear to result in additional observe...

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Section: Discussionmentioning

confidence: 93%

How Do Hindfoot Fusions Affect Ankle Biomechanics: A Cadaver Model

Hutchinson

Baxter

Gilbert

et al. 2016

Clinical Orthopaedics &Amp; Related Research

View full text Add to dashboard Cite

show abstract

“…Alternatively, categorizing subjects into certain subtypes of hindfoot motion based on natural anatomical variation may be necessary to obtain accurate predictions. These recommendations are supported by previous studies that have suggested that the high variability in reported ankle kinematics may be caused by subject-specific differences in gender, talar tilt, bone morphology, and ligament laxity [29–31], and that anatomical variation in ligament location affects hindfoot motion, thereby creating ankle subtypes requiring careful distinction [32]. In the present study, we did not examine how modeling subject-specific factors influences predictive accuracy.…”

Section: Discussionmentioning

confidence: 49%

Predicting tibiotalar and subtalar joint angles from skin-marker data with dual-fluoroscopy as a reference standard

et al. 2016

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Evidence suggests that the tibiotalar and subtalar joints provide near six degree-of-freedom (DOF) motion. Yet, kinematic models frequently assume one DOF at each of these joints. In this study, we quantified the accuracy of kinematic models to predict joint angles at the tibiotalar and subtalar joints from skin-marker data. Models included 1 or 3 DOF at each joint. Ten asymptomatic subjects, screened for deformities, performed 1.0 m/s treadmill walking and a balanced, single-leg heel-rise. Tibiotalar and subtalar joint angles calculated by inverse kinematics for the 1 and 3 DOF models were compared to those measured directly in vivo using dual-fluoroscopy. Results demonstrated that, for each activity, the average error in tibiotalar joint angles predicted by the 1 DOF model were significantly smaller than those predicted by the DOF model for inversion/eversion and internal/external rotation. In contrast, neither model consistently demonstrated smaller errors when predicting subtalar joint angles. Additionally, neither model could accurately predict discrete angles for the tibiotalar and subtalar joints on a per-subject basis. Differences between model predictions and dual-fluoroscopy measurements were highly variable across subjects, with joint angle errors in at least one rotation direction surpassing 10° for 9 out of 10 subjects. Our results suggest that both the 1 and 3 DOF models can predict trends in tibiotalar joint angles on a limited basis. However, as currently implemented, neither model can predict discrete tibiotalar or subtalar joint angles for individual subjects. Inclusion of subject-specific attributes may improve the accuracy of these models.

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“…Therefore, additional PMHS tests of dorsiflexion and inversion performed at higher axial loads may help to understand the computational results obtained in this study. Since a recent study [43] showed that the variations in passive mechanical characteristics of ankle complex are mostly caused by morphological variations, it is believed that a better understanding of foot and ankle behavior under complex loading could be achieved using subject-specific models in parallel with testing.…”

Section: Discussionmentioning

confidence: 99%

Biomechanical and Injury Response of Human Foot and Ankle Under Complex Loading

Shin

Untaroiu

2013

Journal of Biomechanical Engineering

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Ankle and subtalar joint injuries of vehicle front seat occupants are frequently recorded during frontal and offset vehicle crashes. A few injury criteria for foot and ankle were proposed in the past; however, they addressed only certain injury mechanisms or impact loadings. The main goal of this study was to investigate numerically the tolerance of foot and ankle under complex loading which may appear during automotive crashes. A previously developed and preliminarily validated foot and leg finite element (FE) model of a 50th percentile male was employed in this study. The model was further validated against postmortem human subjects (PMHS) data in various loading conditions that generates the bony fractures and ligament failures in ankle and subtalar regions observed in traffic accidents. Then, the foot and leg model were subjected to complex loading simulated as combinations of axial, dorsiflexion, and inversion loadings. An injury surface was fitted through the points corresponding to the parameters recorded at the time of failure in the FE simulations. The compelling injury predictions of the injury surface in two crash simulations may recommend its application for interpreting the test data recorded by anthropometric test devices (ATD) during crash tests. It is believed that the methodology presented in this study may be appropriate for the development of injury criteria under complex loadings corresponding to other body regions as well.

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Subject-specific models of the hindfoot reveal a relationship between morphology and passive mechanical properties

Cited by 47 publications

References 33 publications

How Do Hindfoot Fusions Affect Ankle Biomechanics: A Cadaver Model

How Do Hindfoot Fusions Affect Ankle Biomechanics: A Cadaver Model

Predicting tibiotalar and subtalar joint angles from skin-marker data with dual-fluoroscopy as a reference standard

Biomechanical and Injury Response of Human Foot and Ankle Under Complex Loading

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