Biomaterial Database

Effects of Degree of Surgical Correction for Flatfoot Deformity in Patient-Specific Computational Models. 2015

E M Spratley, and E A Matheis, and C W Hayes, and R S Adelaar, and J S Wayne

Orthopaedic Research Laboratory, Departments of Biomedical Engineering and Orthopaedic Surgery, Virginia Commonwealth University, P.O. Box 843067, Richmond, VA, 23284-3067, USA.

A cohort of adult acquired flatfoot deformity rigid-body models was developed to investigate the effects of isolated tendon transfer with successive levels of medializing calcaneal osteotomy (MCO). Following IRB approval, six diagnosed flatfoot sufferers were subjected to magnetic resonance imaging (MRI) and their scans used to derive patient-specific models. Single-leg stance was modeled, constrained solely through physiologic joint contact, passive soft-tissue tension, extrinsic muscle force, body weight, and without assumptions of idealized mechanical joints. Surgical effect was quantified using simulated mediolateral (ML) and anteroposterior (AP) X-rays, pedobarography, soft-tissue strains, and joint contact force. Radiographic changes varied across states with the largest average improvements for the tendon transfer (TT) + 10 mm MCO state evidenced through ML and AP talo-1st metatarsal angles. Interestingly, 12 of 14 measures showed increased deformity following TT-only, though all increases disappeared with inclusion of MCO. Plantar force distributions showed medial forefoot offloading concomitant with increases laterally such that the most corrected state had 9.0% greater lateral load. Predicted alterations in spring, deltoid, and plantar fascia soft-tissue strain agreed with prior cadaveric and computational works suggesting decreased strain medially with successive surgical repair. Finally, joint contact force demonstrated consistent medial offloading concomitant with variable increases laterally. Rigid-body modeling thus offers novel advantages for the investigation of foot/ankle biomechanics not easily measured in vivo.

UI	MeSH Term	Description	Entries
D008297	Male		Males
D008954	Models, Biological	Theoretical representations that simulate the behavior or activity of biological processes or diseases. For disease models in living animals, DISEASE MODELS, ANIMAL is available. Biological models include the use of mathematical equations, computers, and other electronic equipment.	Biological Model,Biological Models,Model, Biological,Models, Biologic,Biologic Model,Biologic Models,Model, Biologic
D011859	Radiography	Examination of any part of the body for diagnostic purposes by means of X-RAYS or GAMMA RAYS, recording the image on a sensitized surface (such as photographic film).	Radiology, Diagnostic X-Ray,Roentgenography,X-Ray, Diagnostic,Diagnostic X-Ray,Diagnostic X-Ray Radiology,X-Ray Radiology, Diagnostic,Diagnostic X Ray,Diagnostic X Ray Radiology,Diagnostic X-Rays,Radiology, Diagnostic X Ray,X Ray Radiology, Diagnostic,X Ray, Diagnostic,X-Rays, Diagnostic
D003198	Computer Simulation	Computer-based representation of physical systems and phenomena such as chemical processes.	Computational Modeling,Computational Modelling,Computer Models,In silico Modeling,In silico Models,In silico Simulation,Models, Computer,Computerized Models,Computer Model,Computer Simulations,Computerized Model,In silico Model,Model, Computer,Model, Computerized,Model, In silico,Modeling, Computational,Modeling, In silico,Modelling, Computational,Simulation, Computer,Simulation, In silico,Simulations, Computer
D005260	Female		Females
D005413	Flatfoot	Anomaly in which one or more of the arches of the feet are flat.	Pes Planus,Acquired Adult Flatfoot Deformity,Convex Foot,Convex Pes Valgus,Flat Feet,Flat Foot,Flatfeet,Flexible Flatfoot,Pes Valgus, Congenital Convex,Rigid Flatfoot,Rocker-Bottom Foot,Splayfoot,Talipes Calcaneovalgus,Talipes Valgus,Vertical Talus,Vertical Talus, Congenital,Calcaneovalgus, Talipes,Congenital Vertical Talus,Feet, Flat,Flatfoot, Flexible,Flatfoot, Rigid,Foot, Convex,Foot, Flat,Foot, Rocker-Bottom,Pes Valgus, Convex,Rocker Bottom Foot,Talus, Congenital Vertical,Talus, Vertical,Valgus, Talipes
D005529	Foot Bones	The TARSAL BONES; METATARSAL BONES; and PHALANGES OF TOES. The tarsal bones consists of seven bones: CALCANEUS; TALUS; cuboid; navicular; internal; middle; and external cuneiform bones. The five metatarsal bones are numbered one through five, running medial to lateral. There are 14 phalanges in each foot, the great toe has two while the other toes have three each.	Bones of Foot,Bones of Feet,Bone, Foot,Bones, Foot,Feet Bone,Feet Bones,Foot Bone
D005531	Foot Deformities, Acquired	Distortion or disfigurement of the foot, or a part of the foot, acquired through disease or injury after birth.	Acquired Foot Deformities,Acquired Foot Deformity,Deformities, Acquired Foot,Deformity, Acquired Foot,Foot Deformity, Acquired
D006801	Humans	Members of the species Homo sapiens.	Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000328	Adult	A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available.	Adults