The contribution of the ligaments in progressive collapsing foot deformity: A comprehensive computational study
AffiliationDepartment of Aerospace and Mechanical Engineering, University of Arizona
Department of Orthopaedic Surgery, University of Arizona
Keywordsadult-acquired flatfoot deformity
finite element modeling
posterior tibial tendon dysfunction
progressive collapsing foot deformity
MetadataShow full item record
CitationMalakoutikhah, H., Madenci, E., & Latt, L. D. (2022). The contribution of the ligaments in progressive collapsing foot deformity: A comprehensive computational study. Journal of Orthopaedic Research.
JournalJournal of Orthopaedic Research
Rights© 2022 Orthopaedic Research Society. Published by Wiley Periodicals LLC.
Collection InformationThis item from the UA Faculty Publications collection is made available by the University of Arizona with support from the University of Arizona Libraries. If you have questions, please contact us at firstname.lastname@example.org.
AbstractThe contribution of each of the ligaments in preventing the arch loss, hindfoot valgus, and forefoot abduction seen in progressive collapsing foot deformity (PCFD) has not been well characterized. An improved understanding of the individual ligament contributions to the deformity would aid in selecting among available treatments, optimizing current surgical techniques, and developing new ones. In this study, we evaluated the contribution of each ligament to the maintenance of foot alignment using a finite element model of the foot reconstructed from computed tomography scan images. The collapsed foot was modeled by simulating the failure of all the ligaments involved in PCFD. The ligaments were removed one at a time to determine the impact of each ligament on foot alignment, and then restored one at a time to simulate isolated reconstruction. Our findings show that the failure of any one ligament did not immediately lead to deformity, but that combined failure of only a few (the plantar fascia, long plantar, short plantar, deltoid, and spring ligaments) could lead to significant deformity. The plantar fascia, deltoid, and spring ligaments were primarily responsible for the prevention of arch collapse, hindfoot valgus, and forefoot abduction, respectively. Moreover, to produce deformity, a considerable amount of attenuation in the spring, tibiocalcaneal, interosseous talocalcaneal, plantar naviculocuneiform, and first plantar tarsometatarsal ligaments, but only a small amount in the plantar fascia, long plantar, and short plantar ligaments was needed. The results of this study suggest that the ability of a ligament to prevent deformity may not correlate with its attenuation in a collapsed foot.
Note12 month embargo; first published: 03 January 2022
VersionFinal accepted manuscript