Computational Models of the Foot and Ankle for Pathomechanics and Clinical Applications: A Review.

Complementary to experimental studies, computational biomechanics has become useful tool for the understanding of human foot biomechanics and pathomechanics. Its findings have been widely used for the evaluation of the effectiveness of surgical and conservative interventions. These models, however, were developed with a wide range of variations in terms of simplifications and assumptions on the representation of geometrical structures and material properties, as well as boundary and loading conditions. These variations may create differences in prediction accuracy, and restrict practical and clinical applications. This paper reviews the state-of-the-art technologies and challenges in computational model development, focusing on foot problem-specific models for the assessment of the effectiveness and accessibility of clinical treatments. The computational models have provided valuable biomechanical information for clinical applications but further investigations come with many challenges in terms of detailed and patient-specific models, accurate representations of tissue properties, and boundary and loading conditions. Multi-scale computational models are expected to be an efficient platform to fully address the biomechanical and biological concerns.