Expedited patient-specific assessment of contact stress exposure in the ankle joint following definitive articular fracture reduction

Andrew M Kern; Donald D Anderson

doi:10.1016/j.jbiomech.2015.05.030

$Expedited patient-specific assessment of contact stress exposure in the ankle joint following definitive articular fracture reduction$

Journal article

Open access

Peer reviewed

Expedited patient-specific assessment of contact stress exposure in the ankle joint following definitive articular fracture reduction

Andrew M Kern and Donald D Anderson

Journal of biomechanics, Vol.48(12), pp.3427-3432

09/18/2015

DOI: 10.1016/j.jbiomech.2015.05.030

PMCID: PMC4636344

PMID: 26105660

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http://doi.org/10.1016/j.jbiomech.2015.05.030View

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Abstract

Acute injury severity, altered joint kinematics, and joint incongruity are three important mechanical factors linked to post-traumatic osteoarthritis (PTOA). Finite element analysis (FEA) was previously used to assess the influence of increased contact stress due to joint incongruity on PTOA development. While promising agreement with PTOA development was seen, the inherent complexities of contact FEA limited the numbers of subjects that could be analyzed. Discrete element analysis (DEA) is a simplified methodology for contact stress computation, which idealizes contact surfaces as a bed of independent linear springs. In this study, DEA was explored as an expedited alternative to FEA contact stress exposure computation. DEA was compared to FEA using results from a previously completed validation study of two cadaveric human ankles, as well as a previous study of post-operative contact stress exposure in 11 patients with tibial plafond fracture. DEA-computed maximum contact stresses were within 19% of those experimentally measured, with 90% of the contact area having computed contact stress values within 1MPa of those measured. In the 11 fractured ankles, maximum contact stress and contact area differences between DEA and FEA were 0.85 ± 0.64 MPa and 22.5 ± 11.5mm(2). As a predictive measure for PTOA development, both DEA and FEA had 100% concordance with presence of OA (KL grade ≥ 2) and >95% concordance with KL grade at 2 years. These results support DEA as a reasonable alternative to FEA for computing contact stress exposures following surgical reduction of a tibial plafond fracture.

Ankle Joint - pathology

Osteoarthritis - prevention & control

Humans

Middle Aged

Stress, Physiological

Risk

Fracture Fixation

Young Adult

Tibial Fractures - surgery

Biomechanical Phenomena

Models, Biological

Ankle Joint - physiopathology

Talus - pathology

Tibial Fractures - complications

Adult

Female

Finite Element Analysis

Tibial Fractures - pathology

Osteoarthritis - etiology

Details

Title: Subtitle: Expedited patient-specific assessment of contact stress exposure in the ankle joint following definitive articular fracture reduction
Creators: Andrew M Kern - Departments of Orthopaedics and Rehabilitation and Biomedical Engineering, The University of Iowa, Orthopaedic Biomechanics Laboratory, 2181 Westlawn, Iowa City, IA 52242, United States. Electronic address: andrew-kern@uiowa.edu
Donald D Anderson - Departments of Orthopaedics and Rehabilitation and Biomedical Engineering, The University of Iowa, Orthopaedic Biomechanics Laboratory, 2181 Westlawn, Iowa City, IA 52242, United States
Resource Type: Journal article
Publication Details: Journal of biomechanics, Vol.48(12), pp.3427-3432
DOI: 10.1016/j.jbiomech.2015.05.030
PMID: 26105660
PMCID: PMC4636344
NLM abbreviation: J Biomech
ISSN: 0021-9290
eISSN: 1873-2380
Publisher: United States
Grant note: R01AR46601 / NIAMS NIH HHS\nP50AR48939 / NIAMS NIH HHS\nP50 AR055533 / NIAMS NIH HHS\nP50 AR048939 / NIAMS NIH HHS\nP50AR055533 / NIAMS NIH HHS\nR01 AR046601 / NIAMS NIH HHS
Language: English
Date published: 09/18/2015
Academic Unit: Roy J. Carver Department of Biomedical Engineering; Orthopedics and Rehabilitation; Industrial and Systems Engineering
Record Identifier: 9984040000902771

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