How effective is proximal fibular osteotomy in redistributing joint pressures? Insights from an HTO comparative in-silico study

Background Knee osteoarthritis (KOA) represents a widespread degenerative condition among adults that significantly affects quality of life. This study aims to elucidate the biomechanical implications of proximal fibular osteotomy (PFO), a proposed cost-effective and straightforward intervention for...

Descripción completa

Detalles Bibliográficos
Autores: Morales Ávalos, Jorge Eduardo|||0000-0001-9551-1644, Morales-Avalos, Rodolfo, Martínez Guajardo, Karla V., Pacheco Garcia, Luis Miguel, Perelli, Simone, Monllau, Joan Carles, Sánchez Egea, Antonio José|||0000-0001-8085-6869, Serrancolí, Gil|||0000-0001-5034-2445
Tipo de recurso: artículo
Fecha de publicación:2024
País:España
Institución:Universitat Politècnica de Catalunya (UPC)
Repositorio:UPCommons. Portal del coneixement obert de la UPC
Idioma:inglés
OAI Identifier:oai:upcommons.upc.edu:2117/414035
Acceso en línea:https://hdl.handle.net/2117/414035
https://dx.doi.org/10.1186/s13018-024-04807-8
Access Level:acceso abierto
Palabra clave:Osteoarthritis
Knee -- Diseases
Biomechanics
Artrosi
Genolls -- Malalties
Biomecànica
Àrees temàtiques de la UPC::Enginyeria mecànica
Àrees temàtiques de la UPC::Enginyeria biomèdica::Biomecànica
Descripción
Sumario:Background Knee osteoarthritis (KOA) represents a widespread degenerative condition among adults that significantly affects quality of life. This study aims to elucidate the biomechanical implications of proximal fibular osteotomy (PFO), a proposed cost-effective and straightforward intervention for KOA, comparing its effects against traditional high tibial osteotomy (HTO) through in-silico analysis. Methods Using medical imaging and finite element analysis (FEA), this research quantitatively evaluates the biomechanical outcomes of a simulated PFO procedure in patients with severe medial compartment genu-varum, who have undergone surgical correction with HTO. The study focused on evaluating changes in knee joint contact pressures, stress distribution, and anatomical positioning of the center of pressure (CoP). Three models are generated for each of the five patients investigated in this study, a preoperative original condition model, an in-silico PFO based on the same original condition data, and a reversed-engineered HTO in-silico model. Results The novel contribution of this investigation is the quantitative analysis of the impact of PFO on the biomechanics of the knee joint. The results provide mechanical evidence that PFO can effectively redistribute and homogenize joint stresses, while also repositioning the CoP towards the center of the knee, similar to what is observed post HTO. The findings propose PFO as a potentially viable and simpler alternative to conventional surgical methods for managing severe KOA, specifically in patients with medial compartment genu-varum. Conclusion This research also marks the first application of FEA that may support one of the underlying biomechanical theories of PFO, providing a foundation for future clinical and in-silico studies.