School of Engineering, University of Hull, Hull, UK.
University Hospitals of Leicester, Leicester, UK.
Clin Biomech (Bristol). 2023 Jun;106:106006. doi: 10.1016/j.clinbiomech.2023.106006. Epub 2023 May 20.
Biomechanical simulation of the foot and ankle complex is a growing research area but compared to simulation of joints such as hip and knee, it has been under investigated and lacks consistency in research methodology. The methodology is variable, data is heterogenous and there are no clear output criteria. Therefore, it is very difficult to correlate clinically and draw meaningful inferences.
The focus of this review is finite element simulation of the native ankle joint and we will explore: the different research questions asked, the model designs used, ways the model rigour has been ensured, the different output parameters of interest and the clinical impact and relevance of these studies.
The 72 published studies explored in this review demonstrate wide variability in approach. Many studies demonstrated a preference for simplicity when representing different tissues, with the majority using linear isotropic material properties to represent the bone, cartilage and ligaments; this allows the models to be complex in another way such as to include more bones or complex loading. Most studies were validated against experimental or in vivo data, but a large proportion (40%) of studies were not validated at all, which is an area of concern.
Finite element simulation of the ankle shows promise as a clinical tool for improving outcomes. Standardisation of model creation and standardisation of reporting would increase trust, and enable independent validation, through which successful clinical application of the research could be realised.
足部和踝关节复合体的生物力学模拟是一个不断发展的研究领域，但与髋关节和膝关节等关节的模拟相比，它的研究还不够充分，研究方法缺乏一致性。方法多种多样，数据存在异质性，没有明确的输出标准。因此，很难进行临床相关性分析并得出有意义的推论。
本综述的重点是对天然踝关节的有限元模拟，我们将探讨：提出的不同研究问题、使用的模型设计、确保模型严谨性的方法、感兴趣的不同输出参数以及这些研究的临床影响和相关性。
本综述中探讨的 72 项已发表研究表明方法存在很大差异。许多研究在表示不同组织时表现出对简单性的偏好，大多数研究使用线性各向同性材料特性来表示骨骼、软骨和韧带；这使得模型在其他方面变得复杂，例如包含更多的骨骼或复杂的加载。大多数研究都针对实验或体内数据进行了验证，但很大一部分（40%）的研究根本没有进行验证，这是一个令人关注的问题。
踝关节的有限元模拟有希望成为改善治疗效果的临床工具。通过标准化模型创建和报告标准，可以提高可信度，并通过独立验证来实现研究的成功临床应用。
