{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,21]],"date-time":"2025-10-21T15:29:42Z","timestamp":1761060582435,"version":"3.37.3"},"reference-count":48,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2018,6,13]],"date-time":"2018-06-13T00:00:00Z","timestamp":1528848000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000738","name":"U.S. Department of Veterans Affairs","doi-asserted-by":"publisher","award":["A9243C"],"award-info":[{"award-number":["A9243C"]}],"id":[{"id":"10.13039\/100000738","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100007812","name":"University of Washington","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100007812","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal Orthopaedic Research"],"published-print":{"date-parts":[[2018,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:label\/><jats:p>Standard treatments of adult acquired flatfoot deformity (AAFD) fail to correct associated dysfunction of the posterior tibial tendon (PTT). This study aimed to determine if a novel passive engineering mechanism (PEM) enhanced flexor digitorum longus (FDL) tendon transfer procedure would better restore physiologic PTT function to improve AAFD gait parameters compared to standard treatment. We evaluated the kinetic, pedobarographic, and kinematic effects of a pulley\u2010based PEM\u2010enhancement system utilizing a cadaveric flatfoot model and robotic gait simulator. FDL tendon force, FDL tendon excursion, regional peak plantar pressures, center of pressure, and foot bone\/joint motions were quantified. Throughout the stance phase of gait, PEM\u2010enhancement significantly increased FDL tendon forces, resulting in gait cycle medial column unloading, lateral column loading, forefoot adduction, hindfoot inversion, and increased plantar flexion (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05). This proof\u2010of\u2010concept study demonstrated that an innovative PEM\u2010enhanced FDL tendon transfer procedure better restored physiologic PTT function, resulting in improved correction of the distinctive AAFD gait characteristics\u2014medial column collapse, hindfoot eversion, and forefoot abduction. Clinical significance: Novel PEM\u2010enhancement of a FDL tendon transfer procedure holds promise as a method for improved treatment of AAFD. \u00a9 2018 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 36:3033\u20133042, 2018.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jor.24051","type":"journal-article","created":{"date-parts":[[2018,5,18]],"date-time":"2018-05-18T09:45:27Z","timestamp":1526636727000},"page":"3033-3042","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Passive engineering mechanism enhancement of a flexor digitorum longus tendon transfer procedure"],"prefix":"10.1002","volume":"36","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2422-5824","authenticated-orcid":false,"given":"Connor M.","family":"Pihl","sequence":"first","affiliation":[{"name":"RR&amp;D Center for Limb Loss and MoBility VA Puget Sound Health Care System Seattle Washington"},{"name":"School of Medicine University of Washington Seattle Washington"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christina J.","family":"Stender","sequence":"additional","affiliation":[{"name":"RR&amp;D Center for Limb Loss and MoBility VA Puget Sound Health Care System Seattle Washington"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ravi","family":"Balasubramanian","sequence":"additional","affiliation":[{"name":"School of Mechanical Industrial and Manufacturing Engineering Oregon State University Corvallis Oregon"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kylie M.","family":"Edinger","sequence":"additional","affiliation":[{"name":"RR&amp;D Center for Limb Loss and MoBility VA Puget Sound Health Care System Seattle Washington"},{"name":"School of Medicine University of Washington Seattle Washington"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bruce J.","family":"Sangeorzan","sequence":"additional","affiliation":[{"name":"RR&amp;D Center for Limb Loss and MoBility VA Puget Sound Health Care System Seattle Washington"},{"name":"Department of Orthopedics &amp; Sports Medicine University of Washington Seattle Washington"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4982-7714","authenticated-orcid":false,"given":"William R.","family":"Ledoux","sequence":"additional","affiliation":[{"name":"RR&amp;D Center for Limb Loss and MoBility VA Puget Sound Health Care System Seattle Washington"},{"name":"Department of Orthopedics &amp; Sports Medicine University of Washington Seattle Washington"},{"name":"Department of Mechanical Engineering University of Washington Seattle Washington"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2018,6,13]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1177\/107110078000100104"},{"key":"e_1_2_7_3_1","first-page":"46","article-title":"Acquired flatfoot in adults","author":"Mann RA","year":"1983","journal-title":"Clin Orthop Relat Res"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.5435\/00124635-199509000-00005"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/00003086-198307000-00021"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.2106\/00004623-199605000-00020"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/00003086-198902000-00022"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1083-7515(03)00084-6"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.2106\/00004623-198567040-00009"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.2106\/00004623-198668010-00012"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1177\/107110079101100612"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1177\/107110079201300204"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.2106\/00004623-196951040-00014"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.fcl.2007.03.003"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1177\/107110070102200402"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12178-013-9173-z"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.E.00045"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1097\/00003086-199908000-00011"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1177\/107110070402500701"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.84B1.11847"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1177\/107110070102200802"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.97B3.34386"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.67B3.3997956"},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.1177\/107110070502600902"},{"key":"e_1_2_7_25_1","doi-asserted-by":"publisher","DOI":"10.1177\/107110070302400409"},{"key":"e_1_2_7_26_1","doi-asserted-by":"publisher","DOI":"10.1177\/107110070402500209"},{"key":"e_1_2_7_27_1","first-page":"321","article-title":"The management of complications following the treatment of flatfoot deformity","volume":"60","author":"Lin JS","year":"2011","journal-title":"Instr Course Lect"},{"key":"e_1_2_7_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.fcl.2012.03.007"},{"key":"e_1_2_7_29_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11552-014-9676-0"},{"key":"e_1_2_7_30_1","doi-asserted-by":"publisher","DOI":"10.1109\/TRO.2011.2164958"},{"key":"e_1_2_7_31_1","doi-asserted-by":"publisher","DOI":"10.1002\/jor.20930"},{"key":"e_1_2_7_32_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gaitpost.2011.02.011"},{"key":"e_1_2_7_33_1","doi-asserted-by":"publisher","DOI":"10.1115\/1.4003869"},{"key":"e_1_2_7_34_1","doi-asserted-by":"publisher","DOI":"10.1002\/jor.22488"},{"key":"e_1_2_7_35_1","doi-asserted-by":"publisher","DOI":"10.1177\/107110079301400305"},{"key":"e_1_2_7_36_1","doi-asserted-by":"publisher","DOI":"10.1177\/107110079401501206"},{"key":"e_1_2_7_37_1","doi-asserted-by":"publisher","DOI":"10.1177\/107110079501600911"},{"key":"e_1_2_7_38_1","doi-asserted-by":"publisher","DOI":"10.1093\/ptj\/80.9.864"},{"key":"e_1_2_7_39_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1748-1716.1989.tb08655.x"},{"key":"e_1_2_7_40_1","doi-asserted-by":"publisher","DOI":"10.1177\/107110079401500708"},{"key":"e_1_2_7_41_1","doi-asserted-by":"publisher","DOI":"10.1002\/bimj.200810425"},{"key":"e_1_2_7_42_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.2517-6161.1995.tb02031.x"},{"key":"e_1_2_7_43_1","first-page":"1","article-title":"Fitting linear mixed\u2010effects models using lme4","volume":"1","author":"Bates D","year":"2015","journal-title":"J Stat Software"},{"key":"e_1_2_7_44_1","doi-asserted-by":"publisher","DOI":"10.1177\/107110079701800208"},{"key":"e_1_2_7_45_1","doi-asserted-by":"publisher","DOI":"10.1177\/1071100714558512"},{"key":"e_1_2_7_46_1","doi-asserted-by":"publisher","DOI":"10.3113\/FAI.2007.0013"},{"key":"e_1_2_7_47_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinbiomech.2009.01.009"},{"key":"e_1_2_7_48_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinbiomech.2003.10.007"},{"key":"e_1_2_7_49_1","doi-asserted-by":"publisher","DOI":"10.1177\/107110070502600704"}],"container-title":["Journal of Orthopaedic Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fjor.24051","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jor.24051","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/jor.24051","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jor.24051","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,20]],"date-time":"2023-08-20T11:11:12Z","timestamp":1692529872000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/jor.24051"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,6,13]]},"references-count":48,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2018,11]]}},"alternative-id":["10.1002\/jor.24051"],"URL":"https:\/\/doi.org\/10.1002\/jor.24051","archive":["Portico"],"relation":{},"ISSN":["0736-0266","1554-527X"],"issn-type":[{"type":"print","value":"0736-0266"},{"type":"electronic","value":"1554-527X"}],"subject":[],"published":{"date-parts":[[2018,6,13]]},"assertion":[{"value":"2017-12-21","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-05-07","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-06-13","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}