Inadequate placement of osteochondral plugs may induce abnormal stress-strain distributions in articular cartilage - finite element simulations

Wu, John Z.; Herzog, Walter; Hasler, E.M.

doi:10.1016/s1350-4533(01)00122-9

Cited by 53 publications

(36 citation statements)

References 14 publications

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“…Stress-strain analyses for the tissue repaired with osteochondral plugs have also been conducted (Wu et al 2002). We believe that our tissue model with realistic collagen fibril organization in intact and repaired tissue (Kurkijarvi et al 2007) may highlight the risk locations in and around the repair area.…”

Section: Discussionmentioning

confidence: 99%

Alterations in structure and properties of collagen network of osteoarthritic and repaired cartilage modify knee joint stresses

Mononen

Julkunen

Töyräs

et al. 2010

Biomech Model Mechanobiol

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Organization of the collagen network is known to be different in healthy, osteoarthritic and repaired cartilage. The aim of the study was to investigate how the structure and properties of collagen network of cartilage modulate stresses in a knee joint with osteoarthritis or cartilage repair. Magnetic resonance imaging (MRI) at 1.5 T was conducted for a knee joint of a male subject. Articular cartilage and menisci in the knee joint were segmented, and a finite element mesh was constructed based on the two-dimensional section in sagittal projection. Then, the knee joint stresses were simulated under impact loads by implementing the structure and properties of healthy, osteoarthritic and repaired cartilage in the models. During the progression of osteoarthritis, characterized especially by the progressive increase in the collagen fibrillation from the superficial to the deeper layers, the stresses were reduced in the superficial zone of cartilage, while they were increased in and under menisci. Increased fibril network stiffness of repair tissue with randomly organized collagen fibril network reduced the peak stresses in the adjacent tissue and strains at the repair-adjacent cartilage interface. High collagen fibril strains were indicative of stress concentration areas in osteoarthritic and repaired cartilage. The collagen network orientation and stiffness controlled the stress distributions in healthy, osteoarthritic and repaired cartilage. The evaluation of articular cartilage function using clinical MRI and biomechanical modeling could enable noninvasive estimation of osteoarthritis progression and monitoring of cartilage repair. This study presents a step toward those goals.

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Section: Discussionmentioning

confidence: 99%

Alterations in structure and properties of collagen network of osteoarthritic and repaired cartilage modify knee joint stresses

Mononen

Julkunen

Töyräs

et al. 2010

Biomech Model Mechanobiol

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“…The effects of using improperly sized and shaped engineered tissues may resemble those produced by poorly inserted osteochondral grafts. Malpositioned osteochondral grafts may result in abnormal biomechanics including increased contact pressures (71) and cartilage strains (72). To minimize incongruity produced by osteochondral allograft transplantation, orthopedic surgeons frequently use orthotopic grafts from donor tissue matched to the recipient based on size (73,74).…”

Section: The Development Of Formmentioning

confidence: 99%

Bioengineering Cartilage Growth, Maturation, and Form

2008

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Cartilage of articular joints grows and matures to achieve characteristic sizes, forms, and functional properties. Through these processes, the tissue not only serves as a template for bone growth but also yields mature articular cartilage providing joints with a low-friction, wear-resistant bearing material. The study of cartilage growth and maturation is a focus of both cartilage biologists and bioengineers with one goal of trying to create biologic tissue substitutes for the repair of damaged joints. Experimental approaches both in vivo and in vitro are being used to better understand the mechanisms and regulation of growth and maturation processes. This knowledge may facilitate the controlled manipulation of cartilage size, shape, and maturity to meet the criteria needed for successful clinical applications. Mathematical models are also useful tools for quantitatively describing the dynamically changing composition, structure and function of cartilage during growth and maturation and may aid the development of tissue engineering solutions. Recent advances in methods of cartilage formation and culture which control the size, shape, and maturity of these tissues are numerous and provide contrast to the physiologic development of cartilage.

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“…Theoretical analysis indicates that malreduced plugs create abnormal joint stresses [23]. Using early postoperative MRI, Sanders et al found that incongruities were common after simple reconstructions but did not influence early clinical outcome [21].…”

Section: Introductionmentioning

confidence: 99%

The effect of surface incongruity of grafted plugs in osteochondral grafting: a report of five cases

Nakagawa

Suzuki

Kuroki

et al. 2007

Knee Surg Sports Traumatol Arthrosc

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Although grafted osteochondral plugs should ideally have a smooth surface for mosaicplasty, surface incongruity is sometimes evident at the time of surgery. There may be no problem if there is depression of the grafted plugs, but graft protuberance may have an adverse effect. We studied five knees in five patients who had incongruity (protuberance or depression) of grafted osteochondral plugs at the time of mosaicplasty. The mean age at surgery was 36.6 years (range, 15-65 years), and the mean follow-up period was 32.9 months (range, 24-49 months). All patients underwent second-look arthroscopy after a mean post-surgical period of 14.8 months (range, 3-18 months). We divided the cases so that there were two in the protuberant group (P) and three in the depressed group (D). In P, all patients had a catching sensation about 4 months after surgery, and sometimes pain in the knee joint. Second-look arthroscopy revealed fissuring of the plugs and fibrillation around the recipient site. In D, there were no symptoms due to the depressed plugs. Second-look arthroscopy showed that the depressed areas were covered with fibrocartilage-like tissue, and that the joint surface was smooth. In conclusion, our clinical results and second-look arthroscopic evaluation suggest that isolated osteochondral plug depressions of not greater than 1 mm could still promote acceptable cartilage healing leading to good clinical outcomes. However, plug protuberance at mosaicplasty should always be avoided.

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Inadequate placement of osteochondral plugs may induce abnormal stress-strain distributions in articular cartilage - finite element simulations

Cited by 53 publications

References 14 publications

Alterations in structure and properties of collagen network of osteoarthritic and repaired cartilage modify knee joint stresses

Alterations in structure and properties of collagen network of osteoarthritic and repaired cartilage modify knee joint stresses

Bioengineering Cartilage Growth, Maturation, and Form

The effect of surface incongruity of grafted plugs in osteochondral grafting: a report of five cases

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