Validation of a personalized ligament-constraining discrete element framework for computing ankle joint contact mechanics

Peiffer, Matthias; Duquesne, Kate; Oevelen, Aline Van; Burssens, Arne; Mits, Sophie De; Maas, Steve A.; Atkins, Penny R.; Anderson, Andrew E.; Audenaert, Emmanuel

doi:10.1016/j.cmpb.2023.107366

Cited by 8 publications

(6 citation statements)

References 37 publications

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“…19 Mesh densities were based on a previously published sensitivity analysis, determining the number of tetrahedral elements needed for mesh convergence. 24…”

Section: Input Data and Sensitivity Studiesmentioning

confidence: 99%

“…Furthermore, novel imaging modalities such as weightbearing CT (WBCT) enable a bilateral 3D assessment of the ankle while standing, opening the door for noninvasive "in silico" investigation of contact mechanics during the stance position. 7,23,24 The purpose of this study was therefore to examine multiple uniplanar mortise malalignment and its effects on articular contact interactions using computational ankle models derived from WBCT and to compare our results with those of Ramsey and Hamilton. We hypothesized that (1) analysis using modern techniques may result in different loading characteristics than previously reported and (2) lateral translation may influence tibiotalar contact mechanics to a lesser degree as compared to other directions of displacement including anterior and posterior translation, valgus-varus angulation, and external rotation.…”

Section: Introductionmentioning

confidence: 99%

“…Furthermore, novel imaging modalities such as weightbearing CT (WBCT) enable a bilateral 3D assessment of the ankle while standing, opening the door for noninvasive “in silico” investigation of contact mechanics during the stance position. 7,23,24…”

Section: Introductionmentioning

confidence: 99%

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The Influence of Talar Displacement on Articular Contact Mechanics: A 3D Finite Element Analysis Study Using Weightbearing Computed Tomography

Peiffer,

Lewis,

Xie

et al. 2024

Foot Ankle Int.

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Background: Talar displacement is considered the main predictive factor for poor outcomes and the development of post-traumatic osteoarthritis after ankle fractures. Isolated lateral talar translation, as previously studied by Ramsey and Hamilton using carbon powder imprinting, does not fully replicate the multidirectional joint subluxations seen in ankle fractures. The purpose of this study was to analyze the influence of multiple uniplanar talar displacements on tibiotalar contact mechanics utilizing weightbearing computed tomography (WBCT) and finite element analysis (FEA). Methods: Nineteen subjects (mean age = 37.6 years) with no history of ankle surgery or injury having undergone WBCT arthrogram (n = 1) and WBCT without arthrogram (n = 18) were included. Segmentation of the WBCT images into 3D simulated models of bone and cartilage was performed. Three-dimensional (3D) multiple uniplanar talar displacements were simulated to investigate the respective influence of various uniaxial displacements (including lateral translation, anteroposterior translation, varus-valgus angulation, and external rotation) on the tibiotalar contact mechanics using FEA. Tibiotalar peak contact stress and contact area were modeled for each displacement and its gradations. Results: Our modeling demonstrated that peak contact stress of the talus and tibia increased, whereas contact area decreased, with incremental displacement in all tested directions. Contact stress maps of the talus and tibia were computed for each displacement demonstrating unique patterns of pressure derangement. One millimeter of lateral translation resulted in 14% increase of peak talar contact pressure and a 3% decrease in contact area. Conclusion: Our model predicted that with lateral talar translation, there is less noticeable change in tibiotalar contact area compared with prior studies whereas external rotation greater than 12 degrees had the largest effect on peak contact stress predictions. Level of Evidence: Level V, computational simulation study.

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“…19 Mesh densities were based on a previously published sensitivity analysis, determining the number of tetrahedral elements needed for mesh convergence. 24…”

Section: Input Data and Sensitivity Studiesmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The Influence of Talar Displacement on Articular Contact Mechanics: A 3D Finite Element Analysis Study Using Weightbearing Computed Tomography

Peiffer,

Lewis,

Xie

et al. 2024

Foot Ankle Int.

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“…( Althoff et al, 2017 ; Paluch et al, 2022 ; Tison et al, 2022 ). Therefore, any discrepancy between the joint’s load-bearing capacity and the actual load it experiences often precipitates pathological changes within the ankle joint ( Peiffer et al, 2023 ). Given the diversity in individual gait patterns, it is plausible that certain patterns may be associated with specific pathologies, such as ankle osteoarthrosis ( Jarchi et al, 2018 ; Horst et al, 2021 ).…”

Section: Introductionmentioning

confidence: 99%

Quantifying walking speeds in relation to ankle biomechanics on a real-time interactive gait platform: a musculoskeletal modeling approach in healthy adults

Peiffer,

Duquesne,

Delanghe

et al. 2024

Front. Bioeng. Biotechnol.

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Background: Given the inherent variability in walking speeds encountered in day-to-day activities, understanding the corresponding alterations in ankle biomechanics would provide valuable clinical insights. Therefore, the objective of this study was to examine the influence of different walking speeds on biomechanical parameters, utilizing gait analysis and musculoskeletal modelling.Methods: Twenty healthy volunteers without any lower limb medical history were included in this study. Treadmill-assisted gait-analysis with walking speeds of 0.8 m/s and 1.1 m/s was performed using the Gait Real-time Analysis Interactive Lab (GRAIL®). Collected kinematic data and ground reaction forces were processed via the AnyBody® modeling system to determine ankle kinetics and muscle forces of the lower leg. Data were statistically analyzed using statistical parametric mapping to reveal both spatiotemporal and magnitude significant differences.Results: Significant differences were found for both magnitude and spatiotemporal curves between 0.8 m/s and 1.1 m/s for the ankle flexion (p < 0.001), subtalar force (p < 0.001), ankle joint reaction force and muscles forces of the M. gastrocnemius, M. soleus and M. peroneus longus (α = 0.05). No significant spatiotemporal differences were found between 0.8 m/s and 1.1 m/s for the M. tibialis anterior and posterior.Discussion: A significant impact on ankle joint kinematics and kinetics was observed when comparing walking speeds of 0.8 m/s and 1.1 m/s. The findings of this study underscore the influence of walking speed on the biomechanics of the ankle. Such insights may provide a biomechanical rationale for several therapeutic and preventative strategies for ankle conditions.

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“…Syndesmotic ankle injuries are present in one‐fourth of all ankle trauma and may lead to syndesmotic instability or posttraumatic ankle osteoarthritis on the long term [15, 16, 29, 36]. Stability of the injury mainly depends on the severity of the lesion and ability of the ligaments to heal [35].…”

Section: Introductionmentioning

confidence: 99%

Application of external torque enhances the detection of subtle syndesmotic ankle instability in a weight‐bearing CT

Peiffer,

Dhont,

Cuigniez

et al. 2023

Knee surg. sports traumatol. arthrosc.

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Purpose Acute syndesmotic ankle injuries continue to impose a diagnostic dilemma and it remains unclear whether weightbearing and/or external rotation should be added during the imaging process. Therefore, the aim of this study was to assess if combined weightbearing and external rotation increases the diagnostic sensitivity of syndesmotic ankle instability using weightbearing CT (WBCT) imaging, compared to isolated weightbearing. Methods In this retrospective study, patients with an acute syndesmotic ankle injury were analysed using a WBCT (N = 21; Age = 31.6 ± 14.1 years old). Inclusion criteria were an MRI conirmed syndesmotic ligament injury imaged by a WBCT of the ankle during weightbearing and combined weightbearing-external rotation. Exclusion criteria consisted of fracture associated syndesmotic injuries. Three-dimensional (3D) models were generated from the CT slices. Tibioibular displacement and talar rotation were quantiied using automated 3D measurements (anterior tibioibular distance (ATFD), Alpha angle, posterior Tibioibular distance (PTFD) and Talar rotation (TR) angle in comparison to the contralateral non-injured ankle. ResultsThe diference in neutral-stressed Alpha angle and ATFD showed a signiicant diference between patients with a syndesmotic ankle lesion and contralateral control (P = 0.046 and P = 0.039, respectively). The diference in neutral-stressed PTFD and TR angle did not show a signiicant diference between patients with a syndesmotic ankle lesion and healthy ankles (n.s.). Conclusion Application of combined weightbearing-external rotation reveals an increased ATFD in patients with syndesmotic ligament injuries. This study provides the irst insights based on 3D measurements to support the potential relevance of applying external rotation during WBCT imaging. In clinical practice, this could enhance the current diagnostic accuracy of subtle syndesmotic instability in a non-invasive manner. However, to what extent certain displacement patterns require operative treatment strategies has yet to be determined in future studies. Level of evidence Level III.

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Validation of a personalized ligament-constraining discrete element framework for computing ankle joint contact mechanics

Cited by 8 publications

References 37 publications

The Influence of Talar Displacement on Articular Contact Mechanics: A 3D Finite Element Analysis Study Using Weightbearing Computed Tomography

The Influence of Talar Displacement on Articular Contact Mechanics: A 3D Finite Element Analysis Study Using Weightbearing Computed Tomography

Quantifying walking speeds in relation to ankle biomechanics on a real-time interactive gait platform: a musculoskeletal modeling approach in healthy adults

Application of external torque enhances the detection of subtle syndesmotic ankle instability in a weight‐bearing CT

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