Qian Dong Yang, Le Chang, Xuting Bian, Lin Ma, Kang Lai Tang and Xu Tao*

The First Affiliated Hospital of Military Medical University of the Army, China

*Corresponding Author: Xu Tao, The First Affiliated Hospital of Military Medical University of the Army, China.

Received: July 12, 2022; Published: August 22, 2022

Abstract

As a new technology, three-dimensional (3D)-printed personalized talar prostheses are fixed via different methods, including fixing the subtalar joint and talonavicular joint with screws and fixing only the subtalar joint with screws and fixation without screws. No biomechanical study has been conducted yet. We aimed to build a 3D finite element model to compare the biomechanical effects of different fixation methods. With 3D CT and MRI data of a volunteer's foot, Mimics research 19.0 and Geomagic wrap 2017 software were used to complete the geometric reconstruction of bone and cartilage, and then the data were input into NX12.0 software to build finite element models. Finally, the models were imported into Abaqus 6.14 software for meshing and assigning material properties and for simulating the different biomechanical characteristics in three gait phases. The pressure changes in the articular surface around the talus or the prosthesis, the micromotion of the talus and the prosthesis and ankle motion were measured. The 3D finite element model created in this study has been verified to be consistent with those in previous studies. The results showed that screw fixation of the prosthesis in different gait phases mainly increased the pressure on the tibial-talus articular surface and decreased the pressure on the fused articular surface and joint micromotion, which may hinder ankle motion. The indicator values were nearly the same in the models of fixation without screws and the healthy state. Fixation of the prosthesis without screws yielded values most similar to healthy values.

Keywords: Talar prosthesis replacement; Biomechanical analysis; Finite element

References

1. Han Q., et al. “Measurement of talar morphology in northeast Chinese population based on three-dimensional computed tomography”. Medicine (Baltimore) 98 (2019): e17142.
2. Timothy G. “Talus fracture”. Treasure Island, FL: StatPearls Publishing (2020).
3. Flury A., et al. “Talar neck angle correlates with tibial torsion-Guidance for 3D and 2D measurements in total ankle replacement”. Journal of Orthopaedic Research 39 (2021): 788-796.
4. Parekh SG and Kadakia RJ. “Avascular necrosis of the talus”. Journal of the American Academy of Orthopaedic Surgeons 29 (2021): e267-278.
5. Oliva XM and Voegeli AV. “Aseptic (avascular) bone necrosis in the foot and ankle”. EFORT Open Reviews 5 (2020): 684-690.
6. Jovic TH., et al. “3D bioprinting and the future of surgery”. Frontiers in Surgery 7 (2020): 609836.
7. West TA and Rush SM. “Total talus replacement: case series and literature review”. The Journal of Foot and Ankle Surgery 60 (2021): 187-193.
8. Huang J., et al. “Treatment of osteosarcoma of the talus with a 3D-printed talar prosthesis”. The Journal of Foot and Ankle Surgery 60 (2021): 194-198.
9. Shnol H and LaPorta GA. “3D printed total talar replacement: a promising treatment option for advanced arthritis, avascular osteonecrosis, and osteomyelitis of the ankle”. Clinics in Podiatric Medicine and Surgery 35 (2018): 403-422.
10. Scott DJ., et al. “Early outcomes of 3D printed total talus arthroplasty”. Foot and Ankle Specialist 13 (2020): 372-377.
11. Kadakia RJ., et al. “3D printed total talus replacement for avascular necrosis of the talus”. Foot and Ankle International 41 (2020): 1529-1536.
12. Tracey J., et al. “Custom 3D-printed total talar prostheses restore normal joint anatomy throughout the hindfoot”. Foot and Ankle Specialist 12 (2019): 39-48.
13. Fang X., et al. “Total talar replacement with a novel 3D printed modular prosthesis for tumors”. Therapeutics and Clinical Risk Management 14 (2018): 1897-1905.
14. Mehta S., et al. “Understanding the basics of computational models in orthopaedics: a nonnumeric review for surgeons”. Journal of the American Academy of Orthopaedic Surgeons 25 (2017): 684-692.
15. Laz PJ and Browne M. “A review of probabilistic analysis in orthopaedic biomechanics”. Proceedings of the Institution of Mechanical Engineers, Part H 224 (2010): 927-943.
16. O'Sullivan R., et al. “Crouch gait or flexed-knee gait in cerebral palsy: is there a difference? A systematic review”. Gait Posture 82 (2020): 153-160.
17. Buckinx F., et al. “High intensity interval training combined with L-citrulline supplementation: effects on physical performance in healthy older adults”. Experimental Gerontology 140 (2020): 111036.
18. Li J., et al. “Finite element analysis of the effect of talar osteochondral defects of different depths on ankle joint stability”. Medical Science Monitor 26 (2020): e921823.
19. Lu CH., et al. “Establishment of a three-dimensional finite element model and stress analysis of the talus during normal gait”. Nan Fang Yi Ke Da Xue Xue Bao 30 (2019): 2273-2276.
20. Georgiannos D., et al. “Osteochondral transplantation of autologous graft for the treatment of osteochondral lesions of talus: 5- to 7-year follow-up”. Knee Surgery, Sports Traumatology, Arthroscopy 24 (2016): 3722-3729.
21. Horst F., et al. “Avascular necrosis of the talus: current treatment options”. Foot and Ankle Clinics 9 (2004): 757-773.
22. Nunley JA and Hamid KS. “Vascularized pedicle bone-grafting from the cuboid for talar osteonecrosis: results of a novel salvage procedure”. The Journal of Bone and Joint Surgery American 99 (2017): 848-854.
23. Sultan AA and Mont MA. “Core decompression and bone grafting for osteonecrosis of the talus: a critical analysis of the current evidence”. Foot and Ankle Clinics 24 (2019): 107-112.
24. Taniguchi A., et al. “The use of a ceramic talar body prosthesis in patients with aseptic necrosis of the talus”. The Journal of Bone and Joint Surgery 94 (2012): 1529-1533.
25. Valderrabano V., et al. “Kinematic changes after fusion and total replacement of the ankle: part 3: talar movement”. Foot and Ankle International 24 (2003): 897-900.
26. Harnroongroj T and Vanadurongwan V. “The talar body prosthesis”. The Journal of Bone and Joint Surgery American 79 (1997): 1313-1322.
27. Mu MD., et al. “Three-dimension printing talar prostheses for total replacement in talar necrosis and collapse”. International Orthopaedics 45 (2021): 2313-2321.
28. Yang QD., et al. “Three-dimensional printed talar prosthesis with biological function for giant cell tumor of the talus: a case report and review of the literature”. World Journal of Clinical Cases 9 (2021): 3147-3156.
29. Harnroongroj T and Harnroongroj T. “The talar body prosthesis: results at ten to thirty-six years of follow-up”. The Journal of Bone and Joint Surgery American 96 (2014): 1211-1218.
30. Assal M and Stern R. “Total extrusion of the talus. A case report”. The Journal of Bone and Joint Surgery American 86 (2004): 2726-2731.
31. Giddings VL., et al. “Calcaneal loading during walking and running”. Medicine and Science in Sports and Exercise 32 (2000): 627-634.

Citation

Citation: Kang Lai Tang and Xu Tao., et al. “Establishment of a Finite Element Model and Biomechanical Analysis of Different Fixation Methods for Total Talar Prosthesis Replacement". Acta Scientific Orthopaedics 5.5 (2022): 88-96.

Copyright

Copyright: © 2022 Kang Lai Tang and Xu Tao., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.