Biomechanical effects of selective tarsometatarsal arthrodesis configurations: A finite element analysis

The biomechanical effects of different tarsometatarsal (TMT) arthrodesis configurations on adjacent joints remain unclear. This finite element study evaluated load transfer and pressure redistribution following selective TMT fusion.

Six TMT arthrodesis configurations, from isolated first TMT fusion to constructs including the third TMT joint, were analyzed. Joint reaction forces, plantar pressure, and tibiotalar contact pressure were assessed relative to an intact model across stance phases.

Arthrodesis altered midfoot joint reaction forces, while total tibiotalar forces remained largely unchanged. The medial - intermediate intercuneiform and calcaneocuboid joints showed the greatest increases, particularly with inclusion of the third TMT joint. Plantar pressure increased mainly in the first and second metatarsal regions, and tibiotalar contact pressure redistributed along an anterolateral - posteromedial axis.

TMT arthrodesis alters foot biomechanics in a configuration-dependent manner. Extension to the third TMT joint produced the greatest biomechanical alterations.

V, computational biomechanical study.