Description
Articular Contact Mechanics in Osteochondral Lesions of the Talus: A Discrete Element Analysis Study
Objectives
•Osteochondral Lesions of the Talus (OLT) may progress into a cascade of cartilage degeneration
•Previous studies have investigated articular contact mechanics in an ankle with artificial computer-made OLTs
•The present study aims to investigate whether the location of OLTs influences their loading characteristics during the range of motion of the ankle joint
Methods
•Retrospective case-control study
•Patients were included if they had a crater or cystic OLT and a weight-bearing CT (WBCT). Location was determined on a 4-grid zone (Figure 1)
•The study framework is presented in Figure 2 and was previously validated
•Range of motion was simulated, from 2° in dorsiflexion to 15° of plantarflexion
•Validation was performed using finite element analysis (FEA) in a point-to-point manner
•Primary outcome was the mean talar stress
Results
•36 patients with 39 ankles were included
•A point-to-point mean error between DEA and FEA was 0.48 MPa (SD 0.06) for OLT cases, and 0.42 MPa (SD 0.13) for the healthy twin
•Mean Talus Stress (MPa) changed during the ROM (Figure 3), and is visualized in Figure 4
Conclusion
•OLTs have effect on the whole-joint articular contact mechanics.
•Anterior lesions had the highest stresses in neutral and dorsiflexion
•Posterior lesions experienced higher stress during plantarflexion
•The findings should be further investigated to confirm these in clinical situations
