TY - JOUR
T1 - The impact of ligament tears on joint contact mechanics in progressive collapsing foot deformity
T2 - A finite element study
AU - Malakoutikhah, Hamed
AU - Madenci, Erdogan
AU - Latt, Leonard Daniel
N1 - Publisher Copyright:
© 2022 Elsevier Ltd
PY - 2022/4
Y1 - 2022/4
N2 - Background: Patients with longstanding progressive collapsing foot deformity often develop osteoarthritis of the ankle, midfoot, or hindfoot joints, which can be symptomatic or lead to fixed deformities that complicate treatment. The development of deformity is likely caused by ligament degeneration and tears. However, the effect of individual ligament tears on changes in joint contact mechanics has not been investigated. Methods: A validated finite element model of the foot was used to compare joint contact areas, forces, and pressures between the intact and collapsed foot, and to evaluate the effect of individual ligament tears on joint contact mechanics. Findings: Collapsing the foot resulted in an increase in contact pressure in the subtalar, calcaneocuboid, tibiotalar, medial naviculocuneiform, and first tarsometatarsal joints but a decrease in contact pressure in the talonavicular joint. Rupture of the spring ligament was the main contributor to increased calcaneocuboid and subtalar joint contact pressures and decreased medial naviculocuneiform and first tarsometatarsal joint contact pressures, as well as talonavicular subluxation. Deltoid ligament rupture was the primary source of increased contact pressure in the medial naviculocuneiform, first tarsometatarsal, and tibiotalar joints. Interpretation: Degenerative tearing of the ligaments in flatfoot deformity leads to increased joint contact pressures, primarily in the calcaneocuboid, subtalar, and tibiotalar joints, which has been implicated in the development of osteoarthritis in these joints. An improved understanding of the relationship between ligament tears and joint contact pressures could provide support for the use of ligament reconstructions to prevent the development of arthrosis.
AB - Background: Patients with longstanding progressive collapsing foot deformity often develop osteoarthritis of the ankle, midfoot, or hindfoot joints, which can be symptomatic or lead to fixed deformities that complicate treatment. The development of deformity is likely caused by ligament degeneration and tears. However, the effect of individual ligament tears on changes in joint contact mechanics has not been investigated. Methods: A validated finite element model of the foot was used to compare joint contact areas, forces, and pressures between the intact and collapsed foot, and to evaluate the effect of individual ligament tears on joint contact mechanics. Findings: Collapsing the foot resulted in an increase in contact pressure in the subtalar, calcaneocuboid, tibiotalar, medial naviculocuneiform, and first tarsometatarsal joints but a decrease in contact pressure in the talonavicular joint. Rupture of the spring ligament was the main contributor to increased calcaneocuboid and subtalar joint contact pressures and decreased medial naviculocuneiform and first tarsometatarsal joint contact pressures, as well as talonavicular subluxation. Deltoid ligament rupture was the primary source of increased contact pressure in the medial naviculocuneiform, first tarsometatarsal, and tibiotalar joints. Interpretation: Degenerative tearing of the ligaments in flatfoot deformity leads to increased joint contact pressures, primarily in the calcaneocuboid, subtalar, and tibiotalar joints, which has been implicated in the development of osteoarthritis in these joints. An improved understanding of the relationship between ligament tears and joint contact pressures could provide support for the use of ligament reconstructions to prevent the development of arthrosis.
KW - Adult acquired flatfoot deformity
KW - Joint contact area
KW - Joint contact pressure
KW - Joint degeneration
KW - Osteoarthritis
KW - Pes planus
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U2 - 10.1016/j.clinbiomech.2022.105630
DO - 10.1016/j.clinbiomech.2022.105630
M3 - Article
C2 - 35334403
AN - SCOPUS:85126903180
SN - 0268-0033
VL - 94
JO - Clinical Biomechanics
JF - Clinical Biomechanics
M1 - 105630
ER -