Patient-specific finite element analysis of chronic contact stress exposure after intraarticular fracture of the tibial plafond

Wendy Li; Donald D Anderson; Jane K Goldsworthy; J Lawrence Marsh; Thomas D Brown

doi:10.1002/jor.20642

$Patient-specific finite element analysis of chronic contact stress exposure after intraarticular fracture of the tibial plafond$

Journal article

Open access

Peer reviewed

Patient-specific finite element analysis of chronic contact stress exposure after intraarticular fracture of the tibial plafond

Wendy Li, Donald D Anderson, Jane K Goldsworthy, J Lawrence Marsh and Thomas D Brown

Journal of orthopaedic research, Vol.26(8), pp.1039-1045

08/2008

DOI: 10.1002/jor.20642

PMCID: PMC2562934

PMID: 18404662

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Abstract

The role of altered contact mechanics in the pathogenesis of posttraumatic osteoarthritis (PTOA) following intraarticular fracture remains poorly understood. One proposed etiology is that residual incongruities lead to altered joint contact stresses that, over time, predispose to PTOA. Prevailing joint contact stresses following surgical fracture reduction were quantified in this study using patient-specific contact finite element (FE) analysis. FE models were created for 11 ankle pairs from tibial plafond fracture patients. Both (reduced) fractured ankles and their intact contralaterals were modeled. A sequence of 13 loading instances was used to simulate the stance phase of gait. Contact stresses were summed across loadings in the simulation, weighted by resident time in the gait cycle. This chronic exposure measure, a metric of degeneration propensity, was then compared between intact and fractured ankle pairs. Intact ankles had lower peak contact stress exposures that were more uniform and centrally located. The series-average peak contact stress elevation for fractured ankles was 38% (p = 0.0015; peak elevation was 82%). Fractured ankles had less area with low contact stress exposure than intact ankles and a greater area with high exposure. Chronic contact stress overexposures (stresses exceeding a damage threshold) ranged from near zero to a high of 18 times the matched intact value. The patient-specific FE models represent substantial progress toward elucidating the relationship between altered contact stresses and the outcome of patients treated for intraarticular fractures.

Osteoarthritis - prevention & control

Humans

Middle Aged

Stress, Mechanical

Treatment Outcome

Osteoarthritis - physiopathology

Tibial Fractures - surgery

Tibial Fractures - physiopathology

Ankle Joint - physiopathology

Tibial Fractures - complications

Adult

Finite Element Analysis

Weight-Bearing

Chronic Disease

Osteoarthritis - etiology

Details

Title: Subtitle: Patient-specific finite element analysis of chronic contact stress exposure after intraarticular fracture of the tibial plafond
Creators: Wendy Li - Department of Biomedical Engineering, The University of Iowa, 2181 Westlawn Building, Iowa City, Iowa 52242, USA
Donald D Anderson
Jane K Goldsworthy
J Lawrence Marsh
Thomas D Brown
Resource Type: Journal article
Publication Details: Journal of orthopaedic research, Vol.26(8), pp.1039-1045
Publisher: United States
DOI: 10.1002/jor.20642
PMID: 18404662
PMCID: PMC2562934
ISSN: 0736-0266
eISSN: 1554-527X
Grant note: AR46601 / NIAMS NIH HHS P50 AR055533-019001 / NIAMS NIH HHS P50 AR048939-019002 / NIAMS NIH HHS P50 AR055533 / NIAMS NIH HHS P50 AR048939 / NIAMS NIH HHS P50 AR048939-010001 / NIAMS NIH HHS R24 AR046601 / NIAMS NIH HHS P50 AR048939-01 / NIAMS NIH HHS AR48939 / NIAMS NIH HHS R24 AR046601-01 / NIAMS NIH HHS AR55533 / NIAMS NIH HHS R01 AR046601 / NIAMS NIH HHS
Language: English
Date published: 08/2008
Academic Unit: Roy J. Carver Department of Biomedical Engineering; Orthopedics and Rehabilitation; Industrial and Systems Engineering
Record Identifier: 9984040254702771

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