The Effects of Proximal Fibular Osteotomy on the Knee and Ankle Joints: a Finite Element Analysis

Abstract

PURPOSE OF THE STUDYIn this study, our aim is to examine the effect of proximal fibular osteotomy on knee and ankle kinematics with finite element analysis method. MATERIAL AND METHODSOne 62-year-old, female volunteer's radiologic images were used for creating lower limb model. Osteotomized model (OM) which was created according to definition of PFO and non-osteotomized model (NOM) were created. To obtain a stress distribution comparison between the two models, 350 N of axial force was applied to the femoral heads of the models. RESULTSAfter PFO, the average contact pressure decreased 26.1% at the medial tibial cartilage and increased 42.4% at the lateral tibial cartilage. The Von Mises stresses decreased 57.1% at the femoral cartilage and decreased 79.1% at tibial cartilage. The stress on the tibial cartilage increased 44.6%, and stress on the talar cartilage increased 7.1% at the ankle joint. CONCLUSIONSFEA revealed that main loading at the knee joint shifted from medial tibial cartilage to the lateral tibial cartilage after PFO. Additionally, the stresses on each cartilage were redistributed across a wider and more peripheral area. FEA also demonstrated that the Von Mises stresses of the tibial and talar cartilages of the ankle joint increased after PFO.

How effective is proximal fibular osteotomy in redistributing joint pressures? Insights from an HTO comparative in-silico study

“…This study is the first to compare these parameters in a preoperative original state model, a postoperative HTO model, and a simulated PFO model. Compared to the few studies [ 22 , 23 , 56 , 57 ] that have utilized FEA to describe the effects of PFO on stress changes for KOA with varus deformity, this is the first to investigate the influence on CoP anatomical location after an in-silico PFO. Furthermore, such effects have never been compared to clinically intervened patients using HTO as a treatment.…”

“…All bones were assumed to be 3D rigid bodies, homogeneous, isotropic, and linearly elastic [ 50 , 54 ]. In addition, ligaments were modeled as 1D linear elements [ 56 , 57 ] to represent their anisotropy [ 49 , 59 ].…”

“…Distal ends of both the tibia and fibula were fixed in all studied models [ 22 , 56 , 60 ], mimicking contact interactions with the ankle joint.…”

“…Ligaments were modeled to ensure proper contact conditions with the other structures, based on the literature [49][50][51][52][53][54][55]. In addition, the proximal and distal anterior and posterior tibiofibular ligaments were constructed as 1D linear elements [56,57].…”

“…Distal ends of both the tibia and fibula were fixed in all studied models [22,56,60], mimicking contact interactions with the ankle joint. A total force of 750 N was exerted vertically on the proximal head of the femur to replicate the complete weight of an average adult weighing 75 kg [39,48,54,55,[61][62][63][64][65][66].…”