TY - JOUR
T1 - Finite Element Analysis of Generalized Ligament Laxity on the Deterioration of Hallux Valgus Deformity (Bunion)
AU - Wong, Duo Wai Chi
AU - Wang, Yan
AU - Chen, Tony Lin Wei
AU - Yan, Fei
AU - Peng, Yinghu
AU - Tan, Qitao
AU - Ni, Ming
AU - Leung, Aaron Kam Lun
AU - Zhang, Ming
N1 - Funding Information:
This research was funded by the Key R&D Program granted by the Ministry of Science and Technology of China, grant number 2018YFB1107000; the National Natural Science Foundation of China, key program grant number 11732015, and general program grant number 11972315; and the General Research Fund granted by the Hong Kong Research Grants Council, grant number PolyU152065/17E and PolyU152002/15E.
Publisher Copyright:
© Copyright © 2020 Wong, Wang, Chen, Yan, Peng, Tan, Ni, Leung and Zhang.
Copyright:
Copyright 2020 Elsevier B.V., All rights reserved.
PY - 2020/9/8
Y1 - 2020/9/8
N2 - Hallux valgus is a common foot problem affecting nearly one in every four adults. Generalized ligament laxity was proposed as the intrinsic cause or risk factor toward the development of the deformity which was difficult to be investigated by cohort clinical trials. Herein, we aimed to evaluate the isolated influence of generalized ligament laxity on the deterioration using computer simulation (finite element analysis). We reconstructed a computational foot model from a mild hallux valgus participant and conducted a gait analysis to drive the simulation of walking. Through parametric analysis, the stiffness of the ligaments was impoverished at different degrees to resemble different levels of generalized ligament laxity. Our simulation study reported that generalized ligament laxity deteriorated hallux valgus by impairing the load-bearing capacity of the first metatarsal, inducing higher deforming force, moment and malalignment at the first metatarsophalangeal joint. Besides, the deforming moment formed a deteriorating vicious cycle between hallux valgus and forefoot abduction and may result in secondary foot problems, such as flatfoot. However, the metatarsocuneiform joint did not show a worsening trend possibly due to the overriding forefoot abduction. Controlling the deforming load shall be prioritized over the correction of angles to mitigate deterioration or recurrence after surgery.
AB - Hallux valgus is a common foot problem affecting nearly one in every four adults. Generalized ligament laxity was proposed as the intrinsic cause or risk factor toward the development of the deformity which was difficult to be investigated by cohort clinical trials. Herein, we aimed to evaluate the isolated influence of generalized ligament laxity on the deterioration using computer simulation (finite element analysis). We reconstructed a computational foot model from a mild hallux valgus participant and conducted a gait analysis to drive the simulation of walking. Through parametric analysis, the stiffness of the ligaments was impoverished at different degrees to resemble different levels of generalized ligament laxity. Our simulation study reported that generalized ligament laxity deteriorated hallux valgus by impairing the load-bearing capacity of the first metatarsal, inducing higher deforming force, moment and malalignment at the first metatarsophalangeal joint. Besides, the deforming moment formed a deteriorating vicious cycle between hallux valgus and forefoot abduction and may result in secondary foot problems, such as flatfoot. However, the metatarsocuneiform joint did not show a worsening trend possibly due to the overriding forefoot abduction. Controlling the deforming load shall be prioritized over the correction of angles to mitigate deterioration or recurrence after surgery.
KW - finite element method
KW - forefoot abduction
KW - hallux abducto valgus
KW - metatarsus primus varus
KW - pronation
UR - http://www.scopus.com/inward/record.url?scp=85091446009&partnerID=8YFLogxK
U2 - 10.3389/fbioe.2020.571192
DO - 10.3389/fbioe.2020.571192
M3 - Journal article
AN - SCOPUS:85091446009
SN - 2296-4185
VL - 8
JO - Frontiers in Bioengineering and Biotechnology
JF - Frontiers in Bioengineering and Biotechnology
M1 - 571192
ER -