This paper was produced for the 2019 NAFEMS World Congress in Quebec Canada

Resource Abstract

In current practice for foot surgery, surgeons start with the principle that a normal person has a “normal” geometry which results in painless motion and low stresses in the foot while a patient with foot pain has a “deviated” geometry that needs to be restored to provide relief. There are many cases where restoring the geometry does not result in improvements or even worsens the original situation. So instead of relying on the geometry-based, generic approach, the breakthrough idea of Digital Orthopaedics is to create personalized FE foot models for each patient starting from imaging and then determine via the use of realistic simulation the best possible treatment on the simulated 3D twin of that individual. This approach will assure better outcomes and allow prevention of errors that might otherwise be missed. Digital Orthopaedics is creating the framework necessary for developing a cloud-based CT- and MRI-scan based, patient-specific, 3D digital models to be used to diagnose injuries and abnormalities, identify optimum treatments for every patient, and simulate surgery in silico in your virtual 3D twin. We’ll provide this framework in the form of a three-part platform offering of Knowledge Base & Diagnosis Support, Personalized 3D Surgical Simulation, and Machine Learning and Clinical Cases. Our workflow that will be presented allows us to model the entire multibody systems from the segmented patient's DICOM CT data, which helps us understand the kinematics and global displacement of the patient’s foot. That reaction force and joint kinematics data can then be used as input for the detailed Abaqus FE model of the foot that includes the bones, ligaments, tendons, cartilage and soft tissues. We model the complex contact behavior between the foot and the ground, the internal foot quantities such as joint cartilage contact pressures and tissue stress levels. We also use a CAD workshop based on 3DEXPERIENCE platform to develop a library of virtual surgical interventions and Abaqus to analyze the results in silico that can help with right planning and orthopedic surgery. The workflow we are developing for foot & ankle surgery is applicable to any orthopedics surgery.