Effects of the posterior cruciate ligament reconstruction on the biomechanics of the knee joint: a finite element analysis

Abstract

Background. Previous experimental studies have been conducted to evaluate the biomechanical effects of posterior cruciate ligament reconstruction; but no consensus has been reached on the preferred method of reconstruction.Methods. The 3D finite element mesh of a knee joint was reconstructed from computed tomography and magnetic resonance images. The ligaments were considered as hyperelastic materials. The tibiofemoral and patellofemoral joints were modeled with large sliding contact elements. The 3D model was used to simulate knee flexion from 0°to 90°in four cases: a knee with a ''native'' posterior cruciate ligament, a resected posterior cruciate ligament, a reconstructed single graft posterior cruciate ligament, and a reconstructed double graft posterior cruciate ligament.Findings. A resected posterior cruciate ligament induced high compressive forces in the medial tibiofemoral and patellofemoral compartments. The pressures generated in the tibiofemoral and patellofemoral compartments were nearly the same for the two reconstruction techniques (single graft and double graft). The single graft resulted in lower tensile stresses inside the graft than for the double graft.Interpretation. Firstly, a resected posterior cruciate ligament should be replaced to avoid excessive compressive forces, which are a source of cartilage degeneration. Secondly, the two types of posterior cruciate ligament reconstruction techniques partially restored the biomechanics of the knee in flexion, e.g. contact pressures were restored for pure flexion of the knee. The reconstruction techniques therefore partially restore the biomechanics of the knee in flexion. A double graft reconstruction is subjected to the highest tensile stresses.

Biomechanical evaluation of intra-articular and extra-articular procedures in anterior cruciate ligament reconstruction: A finite element analysis

“…The 3D numerical reconstruction of the knee joint was developed in a previous study to evaluate the effects of posterior cruciate ligament (PCL) reconstruction on the biomechanics and kinematics of the knee (Ramaniraka et al, 2005). The obtained results were in agreement with clinical studies (Harner et al, 2001;Skyhar et al, 1993).…”

Finite-element simulation of flexor digitorum longus or flexor digitorum brevis tendon transfer for the treatment of claw toe deformity

“…It has been used specifically for preoperative planning and surgery assessment in many different applications (Peñ a et al, 2006;Raminaraka et al, 2005;Gó mezBenito et al, 2005). In the present work, we first evaluate the biomechanical performance of the foot after transferring the FDB and FDL tendons.…”

Three-dimensional fibril-reinforced finite element model of articular cartilage

“…These finite element models have great potential for providing information on normal and pathological joint contact mechanics [13]. They have been employed for studying bioengineering questions, including the effects of PCL reconstruction [38], the rate of progression of knee osteoarthritis after ACL injury [3], meniscal tear and meniscectomy [21,35,47], and stress alterations due to cartilage defects [36]. For simplicity, articular cartilage was considered homogenous, isotropic and linearly elastic in these 3D knee models; and interstitial fluid flow was neglected.…”