The Role of Footwear in the Pathogenesis of Hallux Valgus: A Proof-of-Concept Finite Element Analysis in Recent Humans and Homo naledi

Yu, Genyu; Fan, Yuzhou; Fan, Yuxuan; Li, Ruining; Liu, Yaming; Antonijevic, Djordje; Milovanović, Petar; Zhang, Bo; Li, Zhiyu; Djurić, Marija; Fan, Yifang

doi:10.3389/fbioe.2020.00648

Cited by 13 publications

(10 citation statements)

References 59 publications

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“… Shu et al (2015) found that habitual barefoot runners have more straight alignment of the first MTPJ than those who are habitually wearing shoes, which suggested that shoe-wearing might increase the risk of hallux valgus. Similarly, a recent study found that compared with the barefoot condition, the medial stress of the first MTPJ was significantly increased in the shod condition, which was related to the process of hallux valgus ( Yu et al, 2020 ). Meanwhile, the stress on the medial capsule of the first MTPJ produced by walking and running with shoes was believed to form a torque to tear the medial side of the joint capsule, which may accelerate the process of hallux valgus ( Yu et al, 2020 ).…”

Section: Introductionmentioning

confidence: 73%

“…Similarly, a recent study found that compared with the barefoot condition, the medial stress of the first MTPJ was significantly increased in the shod condition, which was related to the process of hallux valgus ( Yu et al, 2020 ). Meanwhile, the stress on the medial capsule of the first MTPJ produced by walking and running with shoes was believed to form a torque to tear the medial side of the joint capsule, which may accelerate the process of hallux valgus ( Yu et al, 2020 ). The aforementioned inconsistent findings might be partially due to the inaccurate kinematics of the first MTPJ obtained in the shod condition.…”

Section: Introductionmentioning

confidence: 73%

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Influence of Shod and Barefoot Running on the In Vivo Kinematics of the First Metatarsophalangeal Joint

Zhang

et al. 2022

Front. Bioeng. Biotechnol.

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The biomechanics of the first metatarsophalangeal joint (MTPJ) is affected by different shoe conditions. In the biomechanical research field, traditional skin marker motion capture cannot easily acquire the in vivo joint kinematics of the first MTPJ in shoes. Thus, the present study aims to investigate the differences of the first MTPJ’s six-degree-of-freedom (6DOF) kinematics between shod and barefoot running by using a high-speed dual fluoroscopic imaging system (DFIS). In total, 15 healthy male runners were recruited. Computed tomography scans were taken from each participant’s right foot for the construction of 3D models and local coordinate systems. Radiographic images were acquired at 100 Hz while the participants ran at a speed of 3 m/s ± 5% in shod and barefoot conditions along an elevated runway, and 6DOF kinematics of the first MTPJ were calculated by 3D–2D registration. Paired sample t-tests were used to compare the kinematic characteristics of the first MTPJ 6DOF kinematics during the stance phase between shod and barefoot conditions. Compared with barefoot, wearing shoes showed significant changes (p < 0.05): 1) the first MTPJ moved less inferior at 50% but moved less superior at 90 and 100% of the stance phase; 2) the peak medial, posterior, and superior translation of the first MTPJ significantly decreased in the shod condition; 3) the extension angle of the first MTPJ was larger at 30–60% but smaller at 90 and 100% of the stance phase; 4) the maximum extension angle and flexion/extension range of motion of the first MTPJ were reduced; and 5) the minimum extension and adduction angle of the first MTPJ was increased in the shod condition. On the basis of the high-speed DFIS, the aforementioned results indicated that wearing shoes limited the first MTPJ flexion and extension movement and increased the adduction angle, suggesting that shoes may affect the propulsion of the first MTPJ and increase the risk of hallux valgus.

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Section: Introductionmentioning

confidence: 73%

Section: Introductionmentioning

confidence: 73%

Influence of Shod and Barefoot Running on the In Vivo Kinematics of the First Metatarsophalangeal Joint

Zhang

et al. 2022

Front. Bioeng. Biotechnol.

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“…Computational method using finite element (FE) analysis provides a versatile platform to evaluate the internal biomechanical environment with controlled and pre-assigned sets of conditions ( Morales-Orcajo et al, 2016 ; Wang et al, 2016 ; Behforootan et al, 2017 ), which was commonly used to understand foot pathology ( Wong et al, 2016 , 2018 ), assess the outcome of surgery ( Wang et al, 2019 ; Wong et al, 2020a ), and design implant ( Ni et al, 2019 ; Wong et al, 2020b ), etc. The biomechanical consequences of hallux valgus were examined by partial foot models (first ray models) regarding the stress of the medial capsule and the tarsometatarsal and MPJ forces ( Wong et al, 2014b ; Yu et al, 2020 ). Moreover, Zhang et al (2018) predicted the metatarsal stress and pressure of a severe hallux valgus patient under a balanced standing condition using a comprehensive FE model of the foot and ankle complex.…”

Section: Introductionmentioning

confidence: 99%

Finite Element Analysis of Generalized Ligament Laxity on the Deterioration of Hallux Valgus Deformity (Bunion)

Wong

Yan

Chen

et al. 2020

Front. Bioeng. Biotechnol.

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Hallux valgus is a common foot problem affecting nearly one in every four adults. Generalized ligament laxity was proposed as the intrinsic cause or risk factor toward the development of the deformity which was difficult to be investigated by cohort clinical trials. Herein, we aimed to evaluate the isolated influence of generalized ligament laxity on the deterioration using computer simulation (finite element analysis). We reconstructed a computational foot model from a mild hallux valgus participant and conducted a gait analysis to drive the simulation of walking. Through parametric analysis, the stiffness of the ligaments was impoverished at different degrees to resemble different levels of generalized ligament laxity. Our simulation study reported that generalized ligament laxity deteriorated hallux valgus by impairing the loadbearing capacity of the first metatarsal, inducing higher deforming force, moment and malalignment at the first metatarsophalangeal joint. Besides, the deforming moment formed a deteriorating vicious cycle between hallux valgus and forefoot abduction and may result in secondary foot problems, such as flatfoot. However, the metatarsocuneiform joint did not show a worsening trend possibly due to the overriding forefoot abduction. Controlling the deforming load shall be prioritized over the correction of angles to mitigate deterioration or recurrence after surgery.

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“…The complete element mesh involves about 80,000 nodes and 40,000 elements. Table 2 shows the elements and material attributes [ 21 ]. The MTPJ structures of the three participants were used to simulate the stress impact experienced by the front sole of the trail foot during the lunge.…”

Section: Methodsmentioning

confidence: 99%

Asymptomatic foot and ankle structural injuries: a 3D imaging and finite element analysis of elite fencers

Fan

et al. 2022

BMC Sports Sci Med Rehabil

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Background Fencing is a highly asymmetrical combat sport, that imposes high mechanical demands over repeated exposures on the musculoskeletal structures, a primary cause of injuries in fencers. However, there are limited epidemiological studies on the structural injuries of the foot and ankle in fencers. This study aimed to investigate foot and ankle structural injuries, and explore how metatarsophalangeal joint structural changes may affect the mechanisms of foot and ankle injuries in asymptomatic fencers. Methods 3D images of foot and ankle morphology using computed tomography were obtained from ten elite fencers. We then constructed finite element models of the first metatarsophalangeal joint in the foot of their trail legs. The validated models were used to simulate stress distribution changes from different ankle joint angles during lunging. Results The findings showed that stress distribution changes at the medial and lateral sesamoid may have caused sesamoid fractures, and that habitual and concentrated stress on the metatarsal bones might have flattened the sesamoid groove. This process may damage the integrity of the first metatarsophalangeal joint, and consequently affect the efficiency of the windlass mechanism in fencers. During lunging, different ankle joint angles of the trail foot increased the total stress difference of the medial and lateral foot, and thus influenced the lunging quality and its stability. Conclusions Our findings revealed that the asymmetric nature of fencing might have caused asymptomatic foot and ankle structural injuries, and finite element analysis results indicated that this might increase the incidence of the serious injuries if unattended. Regular computed tomography examination should be introduced to monitor elite fencers’ lower limb alterations, permitting unique angle adjustments in the trail foot without sacrificing technical or physiologic properties based on the exam results and reduce the lower limb injury risk.

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The Role of Footwear in the Pathogenesis of Hallux Valgus: A Proof-of-Concept Finite Element Analysis in Recent Humans and Homo naledi

Cited by 13 publications

References 59 publications

Influence of Shod and Barefoot Running on the In Vivo Kinematics of the First Metatarsophalangeal Joint

Influence of Shod and Barefoot Running on the In Vivo Kinematics of the First Metatarsophalangeal Joint

Finite Element Analysis of Generalized Ligament Laxity on the Deterioration of Hallux Valgus Deformity (Bunion)

Asymptomatic foot and ankle structural injuries: a 3D imaging and finite element analysis of elite fencers

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