Total ankle replacement along with subtalar joint arthrodesis: In-vitro and in-silico biomechanical investigations,International Journal for Numerical Methods in Biomedical Engineering

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Total ankle replacement along with subtalar joint arthrodesis: In-vitro and in-silico biomechanical investigations
International Journal for Numerical Methods in Biomedical Engineering ( IF 2.2 ) Pub Date : 2021-07-27 , DOI: 10.1002/cnm.3514
Yousef Taghizadeh ₁ , Ahmad Chitsazan ₁ , Saeid Pezeshki ₂ , Hadi Taghizadeh ₃ , Gholamreza Rouhi ₁

Affiliation

Total ankle replacement (TAR) and subtalar joint (STJ) fusion, are popular treatments for ankle osteoarthritis (OA). Short endurance limits the former, and movement disability comes with the latter. It is hypothesized here that fusion of the STJ can improve the longevity of the TAR prosthesis. In this study, a fresh human cadaver's ankle joint underwent TAR surgery, and strain patterns in the vicinity of prosthesis were recorded after the application of axial compressive load on tibia, resembling stance phase of the gait. Then, STJ of the same sample fused (FTAR), and a similar test procedure was pursued. The obtained strains in the FTAR were smaller than those of the TAR (p < .01). Finite element models of the tested samples were also made, and validated by experimental strains. The validated FE models were then employed to find stress distribution on the tibial plateau and prosthesis compartments. FTAR demonstrated more regular stress profiles in bone-prosthesis interface. Also, maximum von Mises stress in the talar component of the FTAR is approximately half of that in the TAR (8 and 15 MPa, respectively). Based on the results of this study, having a more symmetric load distribution on the prosthesis after STJ fusion, longevity of the TAR may likely increase.

中文翻译：

全踝关节置换术和距下关节融合术：体外和硅片生物力学研究

全踝关节置换术 (TAR) 和距下关节 (STJ) 融合术是治疗踝关节骨关节炎 (OA) 的常用方法。短耐力限制了前者，而后者则伴随着运动障碍。这里假设 STJ 的融合可以提高 TAR 假体的寿命。在这项研究中，一个新鲜的人类尸体的踝关节接受了 TAR 手术，并在胫骨上施加轴向压缩载荷后记录了假体附近的应变模式，类似于步态的站立阶段。然后，将同一样品的 STJ 融合 (FTAR)，并进行类似的测试程序。FTAR 中获得的菌株小于 TAR 中的菌株（p < .01)。还制作了测试样品的有限元模型，并通过实验菌株进行了验证。然后使用经过验证的 FE 模型来寻找胫骨平台和假肢隔室上的应力分布。FTAR 在骨-假体界面中显示出更规律的应力分布。此外，FTAR 距骨组件中的最大 von Mises 应力约为 TAR 中的一半（分别为 8 和 15 MPa）。根据这项研究的结果，STJ 融合后假体上的载荷分布更加对称，TAR 的寿命可能会增加。

更新日期：2021-09-14

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