Total ankle arthroplasty and ankle arthrodesis affect the biomechanics of the inner foot differently

Abstract

Ankle arthrodesis and total ankle arthroplasty are the two primary surgeries for treatment of end-stage degenerative ankle arthritis. The biomechanical effects of them on the inner foot are insufficient to identify which is superior. This study compared biomechanical parameters among a foot treated by ankle arthrodesis, a foot treated by total ankle arthroplasty, and an intact foot using computational analysis. Validated finite element models of the three feet were developed and used to simulate the stance phase of gait. The results showed total ankle arthroplasty provides a more stable plantar pressure distribution than ankle arthrodesis. The highest contact pressure, 3.17 MPa, occurred in the medial cuneonavicular joint in the total ankle arthroplasty foot. Neither of the surgeries resulted in contact pressure increase in the subtalar joint. The peak stress in the metatarsal bones was increased in both surgical models, especially the second and third metatarsals. This study enables us to get visual to the biomechanics inside of an intact foot, and feet treated by total ankle arthroplasty and ankle arthrodesis during walking.

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

“…Implementing cohort studies with clearly defined and isolated exposure factors honed to an unspecific and long time is infeasible since the deterioration factors of hallux valgus could be multifactorial. 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 ).…”

Finite Element Approach Towards Selection of Appropriate Materials to Redistribute Peak Plantar Pressure in Diabetic Foot with Neuropathy

“…The plantar pressure in the current FEA model was found to be higher at the hind-foot from initial contact to mid-stance, and at the fore-foot from mid-stance to terminal stance of the gait cycle. 30 This would be more relevant in the case of diabetic feet that frequently face ulceration and re-ulceration at the hind-foot and fore-foot. 31 Both the hind-foot and fore-foot peak plantar pressure increased in diabetic neuropathic foot; however, the fore-foot and hind-foot ratio increased only in severe diabetic neuropathy.…”

Finite element stress analysis of the bearing component and bone resected surfaces for total ankle replacement with different implant material combinations

“…Due to the difficulties in measuring the stress on the implant and bones, finite element (FE) simulation had been widely used for the pre-clinical biomechanical evaluation of orthopedic implants [ 21 , 22 ] and a few FE studies tested the effect of implant material for TAR [ 12 , 23 – 30 ]. Kerschhofer et al [ 29 ] simulated contact stress and wear rate of PEEK and its composites on Wright State University (WSU) TAR devices.…”

“…Ozen et al [ 31 ] first developed a FE model of the whole foot and ankle implanted with the Bueshel-Pappas implant system at a balance standing position to simulate the stress at each bone. More recently, Wang et al [ 12 , 30 ] use a comprehensive FE foot model to compare the difference of the plantar pressure, joint contact pressure, the peak stress value among an intact foot, a foot with STAR ankle system, and a foot after ankle arthrodesis.…”