Establishment of a Finite Element Model and Biomechanical Analysis of Different Fixation Methods for Total Talar Prosthesis Replacement

Back ground：A three-dimensional finite element model of the whole foot with high geometric similarity was established and used to simulate the conditions after whole talar prosthesis implantation with several fixation methods, including Screw fixation of subtalar+talus-navicular joint, fixation with screws at only the subtalar joint, and fixation without screws. The biomechanical characteristics of the talus prosthesis were assessed in different gait phases to guide the selection of surgical methods in clinical practice.Methods：With the three-dimensional CT data of a volunteer's foot, Mimics13.0 and Geomagic10.0 software were used to carry out geometric reconstruction of the ankle-related tissues, and Hypermesh10.0 software was used for grid division and material attribute selection. Finally, the data were imported into Abaqus 6.9, and the simulated screw data were applied to different models. Finite element models with different fixation methods were simulated, and the stresses exerted by the human body in three gait phases (heel-strike, midstance and push-off) were simulated. The pressure changes in the articular surface around the talus or the prosthesis, the micromotion of the talus and the prosthesis and ankle motion were measured. Results：Finite element analysis on the biomechanical mechanism showed that screw fixation of the prosthesis in different gait phases mainly increases the pressure on the tibialis articular surface as well as decreases the pressure on the fused articular surface and joint micromotion, which hinders ankle motion. The indicator values were nearly the same in the models of fixation without screws and the normal state.Conclusion：The 3D finite element model created in this study has been verified to be an accurate and reliable model. The biomechanical mechanism varies by fixation method according to finite element analysis. Fixation of the prosthesis without screws yields values most similar to normal values.