Journal article
Influence of custom dynamic orthoses on tibiotalar joint reaction force and contact Stress: A cadaveric study
Journal of biomechanics, Vol.177, 112420
12/2024
DOI: 10.1016/j.jbiomech.2024.112420
PMID: 39608184
Abstract
Post-traumatic osteoarthritis (PTOA) often develops following tibial pilon fractures. Evidence suggesting PTOA development is driven by elevated articular contact stress from residual malreduction has led surgeons to strive for precise articular reduction, typically at the cost of extended operative time. Post-operative bracing using carbon fiber custom dynamic orthoses (CDOs) offers another means to decrease tibiotalar joint reaction force (JRF) and contact stress. The purpose of this cadaveric study was to measure how CDO stiffness influences ankle JRF and contact stress over the stance phase of gait.
A servohydraulic load frame was used to test five cadaver ankles, with axial loading (240–330 N) and pneumatic actuation of the Achilles tendon (50–436 N) serving to quasi-statically model multiple points in the stance phase of gait. Three CDO rotational stiffness conditions were tested: (1) No CDO–0 Nm/deg, (2) low stiffness CDO–1.8 Nm/deg, and (3) moderate stiffness CDO–2.3 Nm/deg. JRF and contact stresses were measured using a piezoresistive pressure sensor inserted into the tibiotalar joint. An insole plantar pressure sensor placed between the cadaveric foot and CDO footplate measured limb/device interactions via the plantar center of pressure (COP).
As limb loading progressed through stance, the plantar COP progressed from hindfoot to forefoot, as it would in normal gait. Both CDOs demonstrated decreases in JRF, reaching as high as 32% for the low CDO and 26% for the moderate CDO, with associated decreases in contact stress. This suggests that post-operative bracing could lessen PTOA risk after pilon fractures.
Details
- Title: Subtitle
- Influence of custom dynamic orthoses on tibiotalar joint reaction force and contact Stress: A cadaveric study
- Creators
- Lucinda Williamson - Department of Orthopedics and Rehabilitation, University of Iowa, 200 Newton Road, Iowa City, IA 52242, United StatesMarc Brouillette - University of IowaTristan Miller - Department of Orthopedics and Rehabilitation, University of Iowa, 200 Newton Road, Iowa City, IA 52242, United StatesJessica Goetz - Department of Orthopedics and Rehabilitation, University of Iowa, 200 Newton Road, Iowa City, IA 52242, United StatesJason Wilken - Department of Physical Therapy and Rehabilitation Science, The University of Iowa, 1-152 Medical Education Building, Iowa City, IA 52242, United StatesDonald D. Anderson - Department of Orthopedics and Rehabilitation, University of Iowa, 200 Newton Road, Iowa City, IA 52242, United States
- Resource Type
- Journal article
- Publication Details
- Journal of biomechanics, Vol.177, 112420
- DOI
- 10.1016/j.jbiomech.2024.112420
- PMID
- 39608184
- NLM abbreviation
- J Biomech
- ISSN
- 0021-9290
- eISSN
- 1873-2380
- Publisher
- Elsevier Ltd
- Grant note
- Assistant Secretary of Defense for Health Affairs endorsed by the Department of Defense, through the Peer Reviewed Medical Research Program: W81XWH-17
Funding for this research was supported by the Assistant Secretary of Defense for Health Affairs endorsed by the Department of Defense, through the Peer Reviewed Medical Research Program under Award No. W81XWH-17. Opinions, interpretations, conclusions, and recommendations are those of the author and are not necessarily endorsed by the Department of Defense.
- Language
- English
- Electronic publication date
- 11/11/2024
- Date published
- 12/2024
- Academic Unit
- Roy J. Carver Department of Biomedical Engineering; Orthopedics and Rehabilitation; Industrial and Systems Engineering; Physical Therapy and Rehabilitation Science
- Record Identifier
- 9984747077802771
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