Upcoming Event

"Mechanobiology and Biomarkers of Thoracic Aortic Aneurysm and Dissection"
Christopher Koch
Ph.D. Candidate
Cleveland State University
Department of Chemistry
Apte Lab
Friday, March 9, 2018

"Protein TAILS Tell Remarkable Tales:  Probing the N-terminome for Mechanistic Insight into Proteolytic Pathways in vivo"
Christopher M. Overall, Ph.D.
Canada Research Chair in Protease Proteomics and Systems Biology
Life Sciences Institute
University of British Columbia
Wednesday, March 14, 2018

Assessment of the Effects of Diabetes on Midfoot Joint Pressures

Client: Brian Davis Ph.D. / Cleveland Clinic

Services provided: Experiment Design / Robotic Foot Joint Testing / Data Analysis / Manuscript Preparation

One of the more serious diabetic complications is Charcot neuroarthropathy (CN), a disease that results in arch collapse and permanent foot deformity. However, very little is known about the etiology of CN. From a mechanical standpoint, it is likely that there is a “vicious circle” in terms of (i) arch collapse causing increased midfoot joint pressures, and (ii) increased joint contact pressures exacerbating the collapse of midfoot bones. This study focused on assessment of peak joint pressure difference between diabetic and non-diabetic cadaver feet during simulated walking. We hypothesized that joint pressures are higher for diabetics than normal population. Materials and Methods: Sixteen cadaver foot specimens (eight control and eight diabetic specimens) were used in this study. Human gait at 25% of typical walking speed (averaged stance duration of 3.2s) was simulated by a custom-designed Universal Musculoskeletal Simulator. Four medial midfoot joint pressures (the first metatarsocuneiform, the medial naviculocuneiform, the middle naviculocuneiform, and the first intercuneiform) were measured dynamically during full stance. Results: The pressures in each of the four measured midfoot joints were significantly greater in the diabetic feet (p = 0.015, p = 0.025, p < 0.001, and p = 0.545, respectively). Conclusion: Across all four tested joints, the diabetic cadaver specimens had, on average, 46% higher peak pressures than the control cadaver feet during the simulated stance phase. Clinical Relevance: This finding suggests that diabetic patients could be predisposed to arch collapse even before there are visible signs of bone or joint abnormalities.

Publications: http://www.ncbi.nlm.nih.gov/pubmed/19735634