A numerical investigation of stress, strain, and bone density changes due to bone remodelling in the talus bone following total ankle arthroplasty

Subrata Mondal, David B. MacManus, Rajesh Ghosh, Abhishek Banagunde, Nicholas Dunne

Research output: Contribution to journalArticlepeer-review


Total ankle arthroplasty is the gold standard surgical treatment for severe ankle arthritis and fracture. However, revision surgeries due to the in vivo failure of the ankle implant are a serious concern. Extreme bone density loss due to bone remodelling is one of the main reasons for in situ implant loosening, with aseptic loosening of the talar component being one of the primary reasons for total ankle arthroplasty revisions. This study is aimed at determining the performance and potential causes of failure of the talar component. Herein, we investigated the stress, strain, and bone density changes that take place in the talus bone during the first 6 months of bone remodelling due to the total ankle arthroplasty procedure. Computed tomography scans were used to generate the 3D geometry used in the finite element (FE) model of the Intact and implanted ankle. The Scandinavian Total Ankle Replacement (STAR™) CAD files were generated, and virtual placement within bone models was done following surgical guidelines. The dorsiflexion physiological loading condition was investigated. The cortical region of the talus bone was found to demonstrate the highest values of stress (5.02 MPa). Next, the adaptive bone remodelling theory was used to predict bone density changes over the initial 6-month post-surgery. A significant change in bone density was observed in the talus bone due to bone remodelling. The observed quantitative changes in talus bone density over 6-month period underscore potential implications for implant stability and fracture susceptibility. These findings emphasise the importance of considering such biomechanical factors in ankle implant design and clinical management.

Original languageEnglish
Pages (from-to)1-11
JournalJournal of Medical Engineering and Technology
Issue number1
Early online date12 Jun 2024
Publication statusE-pub ahead of print - 12 Jun 2024

Data Availability Statement

The authors will provide the raw data used to support the results in this article upon reasonable request.


  • aseptic loosening
  • bone remodelling
  • finite element analysis
  • orthopaedic surgery
  • Total ankle arthroplasty

ASJC Scopus subject areas

  • Biomedical Engineering

Cite this