In Silico Modeling of Stress Distribution in the Diseased Ankle Joint

<b>Background/Objectives:</b> Osteoarthritis is a feature of the aging process. Here, we adopted in silico 2D finite element modeling (FEM) for the simulation of diseased ankle joints. We delved into the influence of body weight intensity on the stress distribution caused by subchondral cysts imitating degenerative age-related arthritic changes. <b>Methods:</b> FEM was performed using virtually generated pictorial schemes of the ankle joint skeletal contour. It included a constellation of scenarios with solitary or multiple cysts, or the lack thereof, located centrally, peripherally, or both in the talus and tibia at increased fixed levels of body weight. <b>Results:</b> The modeling showed that the highest stress was in the presence of a solitary central cyst in the talus and two centrally located cysts in the talus and the tibia, with the averaged values of 1.81 ± 0.52 MPa and 1.92 ± 0.55 MPa, respectively; there was a significant increase compared with the 1.24 ± 0.35 MPa in the control condition without cysts. An increase in body weight consistently increased the strain on the ankle joint. In contrast, peripherally located cysts failed to affect the stress distribution significantly. <b>Conclusions:</b> We conclude that subchondral central cysts substantially enhance the stress exerted on the ankle joint and its vicinity with body weight dependence. FEM's ability to predict the location and magnitude of subchondral stress changes when confirmed in clinical trials might help to optimize the management of age-related degenerative joint changes.