{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T01:35:07Z","timestamp":1760146507554,"version":"build-2065373602"},"reference-count":66,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2024,11,9]],"date-time":"2024-11-09T00:00:00Z","timestamp":1731110400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Engineering school at Universidad de Los Andes","award":["FAPA: PR.3.2020.7427"],"award-info":[{"award-number":["FAPA: PR.3.2020.7427"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JFB"],"abstract":"<jats:p>Adult-Acquired Flatfoot Deformity (AAFD) is a progressive orthopedic condition causing the collapse of the foot\u2019s medial longitudinal arch, often linked with injuries to the plantar arch\u2019s passive stabilizers, such as the spring ligament (SL) and plantar fascia. Conventional treatment typically involves replacing the SL with synthetic material grafts, which, while providing mechanical support, lack the biological compatibility of native ligaments. In response to this shortcoming, our study developed an electrospun, twisted polymeric graft made of polycaprolactone (PCL) and type B gelatin (GT), enhanced with graphene oxide (GO), a two-dimensional nanomaterial, to bolster biomechanical attributes. The addition of GO aimed to match the native ligamentous tissue\u2019s mechanical strength, with the PCL-GT-GO 2.0% blend demonstrating an optimal Young\u2019s modulus of 240.75 MPa. Furthermore, the graft showcased excellent biocompatibility, evidenced by non-hemolytic reactions, suitable wettability and favorable platelet aggregation\u2014essential features for promoting cell adhesion and proliferation. An MTT assay revealed cell viability exceeding 80% after 48 h of exposure, highlighting the potential of the graft as a regenerative scaffold for affected ligaments. Computational modeling of the human foot across various AAFD stages assessed the graft\u2019s in situ performance, with the PCL-GT-OG 2.0% graft efficiently preventing plantar arch collapse and offering hindfoot pronator support. Our study, based on in silico simulations, suggests that this bioengineered graft holds significant promise as an alternative treatment in AAFD surgery, marking a leap forward in the integration of advanced materials science for enhanced patient care.<\/jats:p>","DOI":"10.3390\/jfb15110335","type":"journal-article","created":{"date-parts":[[2024,11,11]],"date-time":"2024-11-11T08:46:54Z","timestamp":1731314814000},"page":"335","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Advancing Adult-Acquired Flatfoot Deformity Treatment: Enhanced Biomechanical Support Through Graphene Oxide-Integrated Bioengineered Grafts Tested In Silico"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0401-8449","authenticated-orcid":false,"given":"Sebasti\u00e1n","family":"Nieto","sequence":"first","affiliation":[{"name":"Department of Biomedical Engineering, Universidad de Los Andes, Bogot\u00e1 111711, Colombia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8435-2086","authenticated-orcid":false,"given":"M\u00f3nica","family":"Gantiva-D\u00edaz","sequence":"additional","affiliation":[{"name":"Department of Biomedical Engineering, Universidad de Los Andes, Bogot\u00e1 111711, Colombia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mar\u00eda A.","family":"Hoyos","sequence":"additional","affiliation":[{"name":"Department of Biomedical Engineering, Universidad de Los Andes, Bogot\u00e1 111711, Colombia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuliet","family":"Montoya","sequence":"additional","affiliation":[{"name":"Grupo de Din\u00e1mica Cardiovascular, L\u00ednea Ingenier\u00eda de Tejidos y Prot\u00e9sica Cardiovascular, Universidad Pontificia Bolivariana, Medell\u00edn 050031, Colombia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7790-7546","authenticated-orcid":false,"given":"Juan C.","family":"Cruz","sequence":"additional","affiliation":[{"name":"Department of Biomedical Engineering, Universidad de Los Andes, Bogot\u00e1 111711, Colombia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4785-8982","authenticated-orcid":false,"given":"Christian","family":"Cifuentes-De la Portilla","sequence":"additional","affiliation":[{"name":"Department of Biomedical Engineering, Universidad de Los Andes, Bogot\u00e1 111711, Colombia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2024,11,9]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1437","DOI":"10.1148\/rg.2019190046","article-title":"Adult Acquired Flatfoot Deformity: Anatomy, Biomechanics, Staging, and Imaging Findings","volume":"39","author":"Flores","year":"2019","journal-title":"RadioGraphics"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"507","DOI":"10.1039\/C8RA09073D","article-title":"Gelatin-assisted conglutination of aligned polycaprolactone nanofilms into a multilayered fibre-guiding scaffold for periodontal ligament regeneration","volume":"9","author":"Yang","year":"2019","journal-title":"RSC Adv."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"e7","DOI":"10.2106\/JBJS.RVW.16.00116","article-title":"Adult-Acquired Flatfoot Deformity","volume":"5","author":"Abousayed","year":"2017","journal-title":"JBJS Rev."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"818","DOI":"10.1177\/1071100713483099","article-title":"Isolated Spring Ligament Failure as a Cause of Adult-Acquired Flatfoot Deformity","volume":"34","author":"Orr","year":"2013","journal-title":"Foot Ankle Int."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1137","DOI":"10.2214\/ajr.176.5.1761137","article-title":"Association of Posterior Tibial Tendon Injury with Spring Ligament Injury, Sinus Tarsi Abnormality, and Plantar Fasciitis on MR Imaging","volume":"176","author":"Balen","year":"2001","journal-title":"Am. 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