Biomechanical comparison of tenodesis reconstruction for subtalar instability: a finite element analysis
- PDF / 1,949,474 Bytes
- 12 Pages / 595.276 x 790.866 pts Page_size
- 86 Downloads / 163 Views
RESEARCH ARTICLE
Open Access
Biomechanical comparison of tenodesis reconstruction for subtalar instability: a finite element analysis Xu Can, Li Mingqing, Wang Chenggong and Liu Hua*
Abstract Background: There are several types of tenodesis reconstruction designed for subtalar instability. However, no comprehensive comparison has been conducted among these procedures in terms of their correcting power so far. The objective of this study is to evaluate the biomechanical behaviors of 5 representative procedures through finite element analysis. Methods: Finite element models were established and validated based on one of our previous studies. The Pisani interosseous talocalcaneal ligament (ITCL) reconstruction, Schon cervical ligament (CL) reconstruction and Choisne calcaneofibular ligament (CFL) reconstruction were compared on the model with the CFL, ITCL and CL sectioned. The Schon triligamentous reconstruction and Mann triligamentous reconstruction were compared on the model with the CFL, ITCL and CL, as well as the ATFL sectioned. The inversion and external/internal rotation were quantified at different ankle positions based on the rotational moment. Then, the stress in ligaments and reconstructed grafts and the contact characteristics of the subtalar joint under inversional stress test were calculated and compared accordingly. Results: For single ligament reconstruction, the Choisne CFL reconstruction provided the greatest degree of correction for subtalar instability, followed by the Schon CL reconstruction and then the Pisani ITCL reconstruction. For triligamentous reconstruction, the Mann procedure outperformed the Schon procedure in alleviating the subtalar instability. Conclusion: The finite element analysis showed that the Choisne CFL reconstruction and Mann triligamentous reconstruction provided the greatest degree of immediate postoperative subtalar stability. However, both procedures could not restore the biomechanical behaviors of the subtalar joint to normal. The long-term efficacy of these procedures warrants further investigation using a substantially larger sample of clinical cases. Keywords: Finite element, Subtalar instability, Tenodesis reconstruction, Biomechanical, Kinematic characteristics
Introduction Subtalar instability is a common functional talocalcaneal instability always coupled with lateral ankle instability. It was reported that about 10–25% of patients with lateral ankle instability suffered from subtalar instability [1, 2]. * Correspondence: [email protected] Department of Orthopaedics, Xiangya Hospital, Central South University, No. 87, Xiangya Road, Changsha 410008, China
Subtalar instability mainly results in varus tilt and anterior translation of the calcaneus. However, its clinical manifestation is often covered by the lateral ankle instability, for which, it is only recognized as a separate clinical condition that needs specific treatment in recent years [3]. The exact aetiology of subtalar instability is still unknown. Several cadaveric studies reported that the main
©
Data Loading...
