Finite element analysis of the amputated lower limb: A systematic review and recommendations

Highlights • Mobility following lower limb amputation depends on a stable, comfortable prosthesis. • Previous FEA work has evaluated limb-socket loading and soft tissue injury risk. • Several bony anatomy and soft tissue compliance factors are un-investigated. • Advances in sensors and imaging may b...

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Published inMedical engineering & physics Vol. 43; pp. 1 - 18
Main Authors Dickinson, A.S, Steer, J.W, Worsley, P.R
Format Journal Article
LanguageEnglish
Published England Elsevier Ltd 01.05.2017
Subjects
Amputation
Artificial Limbs
Deep tissue injury (DTI)
FEA
Finite Element Analysis
Humans
Mechanical Phenomena
Osseointegration
Pressure ulcers
Prosthesis Design
Prosthetics
Radiology
Residual limb
Soft tissue stress
Residual limb
Deep tissue injury (DTI)
FEA
Amputation
Pressure ulcers
Soft tissue stress
Prosthetics
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Abstract Highlights • Mobility following lower limb amputation depends on a stable, comfortable prosthesis. • Previous FEA work has evaluated limb-socket loading and soft tissue injury risk. • Several bony anatomy and soft tissue compliance factors are un-investigated. • Advances in sensors and imaging may benefit tissue characterization and validation. • Future work should consider fully dynamic loading and soft tissue responses. • Involving clinicians in development will promote receptiveness and safe translation.
AbstractList The care and rehabilitation of individuals after lower limb amputation presents a substantial and growing socioeconomic challenge. Clinical outcome is closely linked to successful functional rehabilitation with a prosthetic limb, which depends upon comfortable prosthetic limb - residual limb load transfer. Despite early interest in the 1980s, the amputated limb has received considerably less attention in computational biomechanical analysis than other subjects, such as arthroplasty. This systematic literature review investigates the state of the art in residual limb finite element analysis published since 2000. The identified studies were grouped into the following categories: (1) residuum-prosthesis interface mechanics; (2) residuum soft tissue internal mechanics; (3) identification of residuum tissue characteristics; (4) proposals for incorporating FEA into the prosthesis fitting process; (5) analysis of the influence of prosthetic componentry concepts to improve load transfer to the residuum, such as the monolimb and structural socket compliance; and (6) analysis of osseointegrated (OI) prostheses. The state of the art is critically appraised in order to form recommendations for future modeling studies in terms of geometry, material properties, boundary conditions, interface models, and relevant but un-investigated issues. Finally, the practical implementation of these approaches is discussed.
Highlights • Mobility following lower limb amputation depends on a stable, comfortable prosthesis. • Previous FEA work has evaluated limb-socket loading and soft tissue injury risk. • Several bony anatomy and soft tissue compliance factors are un-investigated. • Advances in sensors and imaging may benefit tissue characterization and validation. • Future work should consider fully dynamic loading and soft tissue responses. • Involving clinicians in development will promote receptiveness and safe translation.
•Mobility following lower limb amputation depends on a stable, comfortable prosthesis.•Previous FEA work has evaluated limb-socket loading and soft tissue injury risk.•Several bony anatomy and soft tissue compliance factors are un-investigated.•Advances in sensors and imaging may benefit tissue characterization and validation.•Future work should consider fully dynamic loading and soft tissue responses.•Involving clinicians in development will promote receptiveness and safe translation. The care and rehabilitation of individuals after lower limb amputation presents a substantial and growing socioeconomic challenge. Clinical outcome is closely linked to successful functional rehabilitation with a prosthetic limb, which depends upon comfortable prosthetic limb – residual limb load transfer. Despite early interest in the 1980s, the amputated limb has received considerably less attention in computational biomechanical analysis than other subjects, such as arthroplasty. This systematic literature review investigates the state of the art in residual limb finite element analysis published since 2000. The identified studies were grouped into the following categories: (1) residuum-prosthesis interface mechanics; (2) residuum soft tissue internal mechanics; (3) identification of residuum tissue characteristics; (4) proposals for incorporating FEA into the prosthesis fitting process; (5) analysis of the influence of prosthetic componentry concepts to improve load transfer to the residuum, such as the monolimb and structural socket compliance; and (6) analysis of osseointegrated (OI) prostheses. The state of the art is critically appraised in order to form recommendations for future modeling studies in terms of geometry, material properties, boundary conditions, interface models, and relevant but un-investigated issues. Finally, the practical implementation of these approaches is discussed.
Author Steer, J.W
Worsley, P.R
Dickinson, A.S
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Keywords Residual limb
Deep tissue injury (DTI)
FEA
Amputation
Pressure ulcers
Soft tissue stress
Prosthetics
Language English
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Snippet Highlights • Mobility following lower limb amputation depends on a stable, comfortable prosthesis. • Previous FEA work has evaluated limb-socket loading and...
•Mobility following lower limb amputation depends on a stable, comfortable prosthesis.•Previous FEA work has evaluated limb-socket loading and soft tissue...
The care and rehabilitation of individuals after lower limb amputation presents a substantial and growing socioeconomic challenge. Clinical outcome is closely...
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SubjectTerms Amputation
Artificial Limbs
Deep tissue injury (DTI)
FEA
Finite Element Analysis
Humans
Mechanical Phenomena
Osseointegration
Pressure ulcers
Prosthesis Design
Prosthetics
Radiology
Residual limb
Soft tissue stress
Title Finite element analysis of the amputated lower limb: A systematic review and recommendations
URI https://www.clinicalkey.es/playcontent/1-s2.0-S1350453317300607
https://dx.doi.org/10.1016/j.medengphy.2017.02.008
https://www.ncbi.nlm.nih.gov/pubmed/28285881
https://search.proquest.com/docview/1876819058
Volume 43
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