Initial stability and stress distribution of ankle arthroscopic arthrodesis with three kinds of 2-screw configuration fixation: a finite element analysis
Abstract Background Arthroscopic ankle arthrodesis (AAA) is recognized as the standard treatment for the end-stage ankle arthritis. Two-screw configuration fixation is a typical technique for AAA; however, no consensus has been reached on how to select most suitable inserted position and direction....
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2018-10-01
|
| Series: | Journal of Orthopaedic Surgery and Research |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s13018-018-0972-1 |
| _version_ | 1798025369988628480 |
|---|---|
| author | Min Zhu Cheng-song Yuan Zhong-min Jin Yun-jiao Wang You-xing Shi Zhi-jin Yang Kanglai Tang |
| author_facet | Min Zhu Cheng-song Yuan Zhong-min Jin Yun-jiao Wang You-xing Shi Zhi-jin Yang Kanglai Tang |
| author_sort | Min Zhu |
| collection | DOAJ |
| description | Abstract Background Arthroscopic ankle arthrodesis (AAA) is recognized as the standard treatment for the end-stage ankle arthritis. Two-screw configuration fixation is a typical technique for AAA; however, no consensus has been reached on how to select most suitable inserted position and direction. For better joint reduction, we developed a new configuration (2 home run-screw configuration: 2 screws are inserted from the lateral-posterior and medial-posterior malleolus into the talar neck) and investigated whether it turned out to be better than the other commonly used 2-screw configurations. Methods In this study, we investigated three kinds of 2-screw configurations: 2 “home run”-screw configuration (group A), crossed transverse configuration (the screw is inserted from the medial malleolus into the anterior talus and the other from the lateral tibia maintains posterior talus, group B), and 2 parallel screw configuration (2 parallel screws are inserted from the posteromedial side of the tibia into talus, group C). The effects of the above three insertions on the loading stress of the tibio-talar joint were comparatively analyzed with a three-dimensional finite element model. Results Group A was better than groups B and C in respect of stress distribution uniformity and superior to both groups B and C in anti-flexion strength and anti-internal rotation strength. Group A was slightly worse than group C but better than group B in anti-dorsiflexion and anti-valgus and varus strength. Conclusions Two “home run”-screw configuration facilitates the reduction of anterior talus dislocation of end-stage ankle arthritis. Our finite element analysis demonstrates the configuration is superior to crossed transverse and parallel configuration for arthroscopic ankle arthrodesis in terms of stress distribution and initial stability. |
| first_indexed | 2024-04-11T18:17:43Z |
| format | Article |
| id | doaj.art-838d928639f845b797204e17a12d447d |
| institution | Directory Open Access Journal |
| issn | 1749-799X |
| language | English |
| last_indexed | 2024-04-11T18:17:43Z |
| publishDate | 2018-10-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Orthopaedic Surgery and Research |
| spelling | doaj.art-838d928639f845b797204e17a12d447d2022-12-22T04:09:50ZengBMCJournal of Orthopaedic Surgery and Research1749-799X2018-10-011311710.1186/s13018-018-0972-1Initial stability and stress distribution of ankle arthroscopic arthrodesis with three kinds of 2-screw configuration fixation: a finite element analysisMin Zhu0Cheng-song Yuan1Zhong-min Jin2Yun-jiao Wang3You-xing Shi4Zhi-jin Yang5Kanglai Tang6Department of Orthopaedic Surgery, Southwest Hospital, The Third Military Medical UniversityDepartment of Orthopaedic Surgery, Southwest Hospital, The Third Military Medical UniversitySchool of Mechanical Engineering, Southwest Jiaotong UniversityDepartment of Orthopaedic Surgery, Southwest Hospital, The Third Military Medical UniversityDepartment of Orthopaedic Surgery, Southwest Hospital, The Third Military Medical UniversityDepartment of Orthopaedic Surgery, Southwest Hospital, The Third Military Medical UniversityDepartment of Orthopaedic Surgery, Southwest Hospital, The Third Military Medical UniversityAbstract Background Arthroscopic ankle arthrodesis (AAA) is recognized as the standard treatment for the end-stage ankle arthritis. Two-screw configuration fixation is a typical technique for AAA; however, no consensus has been reached on how to select most suitable inserted position and direction. For better joint reduction, we developed a new configuration (2 home run-screw configuration: 2 screws are inserted from the lateral-posterior and medial-posterior malleolus into the talar neck) and investigated whether it turned out to be better than the other commonly used 2-screw configurations. Methods In this study, we investigated three kinds of 2-screw configurations: 2 “home run”-screw configuration (group A), crossed transverse configuration (the screw is inserted from the medial malleolus into the anterior talus and the other from the lateral tibia maintains posterior talus, group B), and 2 parallel screw configuration (2 parallel screws are inserted from the posteromedial side of the tibia into talus, group C). The effects of the above three insertions on the loading stress of the tibio-talar joint were comparatively analyzed with a three-dimensional finite element model. Results Group A was better than groups B and C in respect of stress distribution uniformity and superior to both groups B and C in anti-flexion strength and anti-internal rotation strength. Group A was slightly worse than group C but better than group B in anti-dorsiflexion and anti-valgus and varus strength. Conclusions Two “home run”-screw configuration facilitates the reduction of anterior talus dislocation of end-stage ankle arthritis. Our finite element analysis demonstrates the configuration is superior to crossed transverse and parallel configuration for arthroscopic ankle arthrodesis in terms of stress distribution and initial stability.http://link.springer.com/article/10.1186/s13018-018-0972-1ArthrodesisArthritisAnkleArthroscopyFinite element analysis |
| spellingShingle | Min Zhu Cheng-song Yuan Zhong-min Jin Yun-jiao Wang You-xing Shi Zhi-jin Yang Kanglai Tang Initial stability and stress distribution of ankle arthroscopic arthrodesis with three kinds of 2-screw configuration fixation: a finite element analysis Journal of Orthopaedic Surgery and Research Arthrodesis Arthritis Ankle Arthroscopy Finite element analysis |
| title | Initial stability and stress distribution of ankle arthroscopic arthrodesis with three kinds of 2-screw configuration fixation: a finite element analysis |
| title_full | Initial stability and stress distribution of ankle arthroscopic arthrodesis with three kinds of 2-screw configuration fixation: a finite element analysis |
| title_fullStr | Initial stability and stress distribution of ankle arthroscopic arthrodesis with three kinds of 2-screw configuration fixation: a finite element analysis |
| title_full_unstemmed | Initial stability and stress distribution of ankle arthroscopic arthrodesis with three kinds of 2-screw configuration fixation: a finite element analysis |
| title_short | Initial stability and stress distribution of ankle arthroscopic arthrodesis with three kinds of 2-screw configuration fixation: a finite element analysis |
| title_sort | initial stability and stress distribution of ankle arthroscopic arthrodesis with three kinds of 2 screw configuration fixation a finite element analysis |
| topic | Arthrodesis Arthritis Ankle Arthroscopy Finite element analysis |
| url | http://link.springer.com/article/10.1186/s13018-018-0972-1 |
| work_keys_str_mv | AT minzhu initialstabilityandstressdistributionofanklearthroscopicarthrodesiswiththreekindsof2screwconfigurationfixationafiniteelementanalysis AT chengsongyuan initialstabilityandstressdistributionofanklearthroscopicarthrodesiswiththreekindsof2screwconfigurationfixationafiniteelementanalysis AT zhongminjin initialstabilityandstressdistributionofanklearthroscopicarthrodesiswiththreekindsof2screwconfigurationfixationafiniteelementanalysis AT yunjiaowang initialstabilityandstressdistributionofanklearthroscopicarthrodesiswiththreekindsof2screwconfigurationfixationafiniteelementanalysis AT youxingshi initialstabilityandstressdistributionofanklearthroscopicarthrodesiswiththreekindsof2screwconfigurationfixationafiniteelementanalysis AT zhijinyang initialstabilityandstressdistributionofanklearthroscopicarthrodesiswiththreekindsof2screwconfigurationfixationafiniteelementanalysis AT kanglaitang initialstabilityandstressdistributionofanklearthroscopicarthrodesiswiththreekindsof2screwconfigurationfixationafiniteelementanalysis |