Ligament mechanics of ageing and osteoarthritic human knees

Peters, Abby E.; Geraghty, Brendan; Bates, Karl T.; Akhtar, Riaz; Readioff, Rosti; Comerford, Eithne

doi:10.3389/fbioe.2022.954837

Cited by 8 publications

(6 citation statements)

References 70 publications

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“…For example, stresses of the CCLs in the control group at 5% strain ranged between 0.5 and 0.75 MPa at strain rates up to 10%/min. However, stresses in human ACLs at 5% strain was approximately 0.05 MPa in an old osteoarthritic knee when mechanically tested at 1,400%/min (Peters et al, 2022), and it is lower than reported values in this study, possibly due to the joint degeneration effect on the ligaments.…”

Section: Figurecontrasting

confidence: 87%

Proteoglycans play a role in the viscoelastic behaviour of the canine cranial cruciate ligament

Readioff

Geraghty

Kharaz

et al. 2022

Front. Bioeng. Biotechnol.

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Proteoglycans (PGs) are minor extracellular matrix proteins, and their contributions to the mechanobiology of complex ligaments such as the cranial cruciate ligament (CCL) have not been determined to date. The CCLs are highly susceptible to injuries, and their extracellular matrix comprises higher PGs content than the other major knee ligaments. Hence these characteristics make CCLs an ideal specimen to use as a model in this study. This study addressed the hypothesis that PGs play a vital role in CCL mechanobiology by determining the biomechanical behaviour at low strain rates before and after altering PGs content. For the first time, this study qualitatively investigated the contribution of PGs to key viscoelastic characteristics, including strain rate dependency, hysteresis, creep and stress relaxation, in canine CCLs. Femur-CCL-tibia specimens (n = 6 pairs) were harvested from canine knee joints and categorised into a control group, where PGs were not depleted, and a treated group, where PGs were depleted. Specimens were preconditioned and cyclically loaded to 9.9 N at 0.1, 1 and 10%/min strain rates, followed by creep and stress relaxation tests. Low tensile loads were applied to focus on the toe-region of the stress-strain curves where the non-collagenous extracellular matrix components take significant effect. Biochemical assays were performed on the CCLs to determine PGs and water content. The PG content was ∼19% less in the treated group than in the control group. The qualitative study showed that the stress-strain curves in the treated group were strain rate dependent, similar to the control group. The CCLs in the treated group showed stiffer characteristics than the control group. Hysteresis, creep characteristics (creep strain, creep rate and creep compliance), and stress relaxation values were reduced in the treated group compared to the control group. This study suggests that altering PGs content changes the microstructural organisation of the CCLs, including water molecule contents which can lead to changes in CCL viscoelasticity. The change in mechanical properties of the CCLs may predispose to injury and lead to knee joint osteoarthritis. Future studies should focus on quantitatively identifying the effect of PG on the mechanics of intact knee ligaments across broader demography.

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Section: Figurecontrasting

confidence: 87%

Proteoglycans play a role in the viscoelastic behaviour of the canine cranial cruciate ligament

Readioff

Geraghty

Kharaz

et al. 2022

Front. Bioeng. Biotechnol.

Self Cite

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“…Peters et al concluded that age needed to be considered when performing biomechanical experiments on ligaments, and the failure load of ligaments would decrease with the age and progression of OA. 46 The total strain of an individual ligament is not the same as that of a bone-ligament-bone complex. The mechanical parameters obtained by treating the bone-ligament-bone complex as a functional unit are more suitable for FEMs.…”

Section: Ligamentsmentioning

confidence: 99%

Model Properties and Clinical Application in the Finite Element Analysis of Knee Joint: A Review

Yan,

Liang,

Zhao

et al. 2024

Orthopaedic Surgery

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The knee is the most complex joint in the human body, including bony structures like the femur, tibia, fibula, and patella, and soft tissues like menisci, ligaments, muscles, and tendons. Complex anatomical structures of the knee joint make it difficult to conduct precise biomechanical research and explore the mechanism of movement and injury. The finite element model (FEM), as an important engineering analysis technique, has been widely used in many fields of bioengineering research. The FEM has advantages in the biomechanical analysis of objects with complex structures. Researchers can use this technology to construct a human knee joint model and perform biomechanical analysis on it. At the same time, finite element analysis can effectively evaluate variables such as stress, strain, displacement, and rotation, helping to predict injury mechanisms and optimize surgical techniques, which make up for the shortcomings of traditional biomechanics experimental research. However, few papers introduce what material properties should be selected for each anatomic structure of knee FEM to meet different research purposes. Based on previous finite element studies of the knee joint, this paper summarizes various modeling strategies and applications, serving as a reference for constructing knee joint models and research design.

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“…In the knee joint, the anterior cruciate ligament (ACL), posterior cruciate ligament (PCL), medial collateral ligament (MCL), and lateral collateral ligament (LCL) were modeled with hyperelastic material models [20]. Peters et al [21] reported experimental stress-strain data of the knee ligaments for a range of ages in males and females. To age-match the material properties closely to the current model, the experimental data from a healthy 43-year-old female was utilized.…”

Section: Model Validationmentioning

confidence: 99%

Soft Tissue Mechanics in Hip Distraction after Total Knee Arthroplasty: A Finite Element Analysis

Soehnlen,

Sadeqi,

Kumaran

et al. 2024

Preprint

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INTRODUCTION: Improvement in diagnostic and surgical techniques in hip arthroscopy have led to a surge in hip distraction procedures over the recent years with the predicted annual frequency being four out of every 10,000 orthopedic procedures in 2017. Due to the large traction force required to achieve the appropriate joint spacing intra-operatively, an emergence of traction-related neurological and soft tissue injuries have surfaced. Pre-existing hip joint pathologies and surgical procedures disrupt the biomechanical stability of the joint and significantly increase the risk of iatrogenic damage. Furthermore, patients with total knee arthroplasties are often subject to intra-articular ligament releases, leading to reduced stability; however, it is not well understood how this may impact their outcomes of hip arthroscopic procedures. The current study aims to investigate the biomechanical behavior of various instrumented knee joints subjected to traction forces to aid clinical understanding and advancements of hip arthroscopy techniques. METHODS: A validated finite element (FE) model of the pelvis and lower extremity was developed from computed tomography (CT) scans of a healthy 45-year-old female. Three different models were assembled according to different TKA techniques performed: Bi-Cruciate Retaining (BCR) model, Posterior-Cruciate Retaining (PCR) model, and Posterior Stabilized (PS) model. The BCR model is noted by retaining all native ligaments of the knee joint (ACL, PCL, MCL, and LCL), whereas the PCR model was subject to ACL removal and the PS model required ACL and PCL removal (Figure 1). The pelvis was encastered to prevent translation under the traction forces as motion of the patients trunk is restrained, intraoperatively. To simulate the loading condition of hip distraction, an axial force was coupled to the distal fibula and tibia and incrementally increased from 100N to 500N. Joint spacing and ligament strain in the hip and knee joint were analyzed to assess the effects of traction forces. RESULTS: The medial and lateral compartment stiffness of the knee joint was analyzed under hip distraction for the three different TKA scenarios. The BCR model displayed the greatest average knee complex stiffness. Release of the ACL resulted in a larger decrease of stiffness compared to release of the PCL. There was no change in forces required for hip distraction as result of changes in the knee joint stiffness (Figure 3). The PCR and PS models were subject to excess knee joint distraction that exceeded 12 mm and ligament strain greater than 20% before adequate hip joint distraction of 10 mm was achieved. The BCR model remained below 10 mm of knee distraction and 15% ligament strain at 10 mm of hip joint distraction. DISCUSSION: Our study reveals patients undergoing hip distraction with a prior TKA may experience increased soft tissue damage or iatrogenic dislocation due to reduced knee joint stability. The PCR and PS models outline a trend suggesting patients who have undergone ligament sacrificing TKAs experience large reductions in knee joint stability, causing strain levels that are indicative of soft tissue injury. The BCR TKA was indicated to be the safest under the distraction conditions as joint spacing and strain levels were largely reduced comparatively; however, when surpassing 10 mm of knee joint distraction at forces greater than 350 N, the strain levels in the ACL suggest minor injury may occur.

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Ligament mechanics of ageing and osteoarthritic human knees

Cited by 8 publications

References 70 publications

Proteoglycans play a role in the viscoelastic behaviour of the canine cranial cruciate ligament

Proteoglycans play a role in the viscoelastic behaviour of the canine cranial cruciate ligament

Model Properties and Clinical Application in the Finite Element Analysis of Knee Joint: A Review

Soft Tissue Mechanics in Hip Distraction after Total Knee Arthroplasty: A Finite Element Analysis

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