Hao Li , Haitao Xie , Yuanqiang Li , Wan Chen , Haiqiong Xie , Xu Cai , Kai Wei
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引用次数: 0
Abstract
Background
Total talar replacement (TTR) using a personalized customized total talar prosthesis (TTP) is an emerging and promising surgical option for the treatment of ankle problems. However, how to solve ankle instability after total talar replacement, and the influence of related solutions on foot biomechanics has not been investigated.
Methods
Our preliminary studies have found that enlarging a personalized total talar prosthesis (TTP0) by 1.5 % along the coronal axis (TTP-FP1.5) and reconstructing the anterior talofibular ligament (ATFL) significantly can enhance ankle stability. However, there is a lack of insight into the effect of the two options on biomechanics. Consequently, this work constructed anatomically detailed finite element models of the foot, including an intact model and four surgical models, including replacement of TTP0, replacement of TTP-FP1.5, and two models of TTP-coupled ATFL reconstruction. Biomechanical differences were evaluated by numerical simulation of a balanced-standing and three characteristic instants of the stand phase.
Results
Changes in plantar pressure distribution, joint contact pressure and force transmission, von Mises stress on bone, and prosthesis stress were predicted and analyzed. It was found that significant changes in foot biomechanics occurred after TTP-FP1.5 replacement compared to TTP0 replacement. In contrast, no ligament reconstruction versus ATFL reconstruction exerts a minor effect on biomechanics.
Conclusion
The findings indicate that the shape of the prosthesis is the primary factor affecting foot biomechanics after total talar replacement. In contrast, reconstruction of the ATFL has only a minimal effect on the biomechanics of the foot. The above findings will provide a solid basis for the improvement of TTR surgical plans in clinical.
期刊介绍：
Foot and Ankle Surgery is essential reading for everyone interested in the foot and ankle and its disorders. The approach is broad and includes all aspects of the subject from basic science to clinical management. Problems of both children and adults are included, as is trauma and chronic disease. Foot and Ankle Surgery is the official journal of European Foot and Ankle Society.
The aims of this journal are to promote the art and science of ankle and foot surgery, to publish peer-reviewed research articles, to provide regular reviews by acknowledged experts on common problems, and to provide a forum for discussion with letters to the Editors. Reviews of books are also published. Papers are invited for possible publication in Foot and Ankle Surgery on the understanding that the material has not been published elsewhere or accepted for publication in another journal and does not infringe prior copyright.
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