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Development of intraoperative plantar pressure measuring system considering weight bearing axis



Surgical reconstructions in three dimensions are needed for treatment of foot and ankle deformities. However, surgical results might be influenced by the skill and experience of doctors which complement the limited information for reconstructions in three dimensions. To solve these, studies were carried out to measure plantar pressure distribution during surgery. Though, it was impossible to accurately measure plantar pressure distribution accurately during operation. Therefore, we proposed an intraoperative plantar pressure measurement (IPPM) device that enables proper navigation in the push direction.


For this purpose, first, we investigated how the physiological load axis passes through the human body to identify the pushing direction of the pressure sensor of the device toward the patient’s foot. In particular, we hypothesized that the physiological load axis passes through the femoral head center and we evaluated this in a measurement experiment with nine healthy subjects. Second, based on these results, we developed the IPPM device that has two force sensors to identify the pushing direction toward the femoral head center and a conductive ink sensor to measure plantar pressure distribution. Finally, we conducted the experiments with nine healthy subjects and two users.


From the first experimental results, the physiological load axis was found to pass through the femoral head center in normal standing posture. From the evaluation experiment, there are no significant differences statistically in plantar pressure distributions between the conditions of using IPPM device and without using it for both a medical student and a surgeon. However, in some cases the plantar pressure distribution can be reproduced similarly to that of the standing posture, and also from the evaluation experiment concerning the relation between CoP position and NCC, the NCC tends to increase when the position of the CoP is closer to that at the standing posture.


The IPPM device has possibility to reproduce the plantar pressure distribution during surgery and prevent the recurrence of surgical complications.

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The study was funded by Terumo Foundation for Life sciences and the Arts.

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Correspondence to Izumu Hosoi.

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Hosoi, I., Kobayashi, E., Chang, S.H. et al. Development of intraoperative plantar pressure measuring system considering weight bearing axis. Int J CARS 14, 385–395 (2019).

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  • Foot deformation
  • Optical track
  • Measurement of the plantar pressure distribution
  • Physiological load axis