Pressure distribution in the knee joint

Bruns, J.; Volkmer, Marius; Luessenhop, S.

doi:10.1007/bf00441833

Cited by 23 publications

(17 citation statements)

References 27 publications

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“…12,16,22,28 In our goat model, pressures on the MFC in knees without defect were 10.7% greater at full extension than pressures on the LFC. This percentage increase was lesser in magnitude when compared with the results by Bruns et al 4 in their human cadaveric model, who noted that pressure in the MFC in a neutral position was 26.9% greater than that on the LFC. This difference can be attributed to a decrease in articular congruity between condyles in the goat model because of its fused fibula, convex lateral tibial plateau, and condylar and compartmental joint geometry and from the effects of dynamic loading.…”

Section: Discussioncontrasting

confidence: 63%

Consequences of Progressive Full-Thickness Focal Chondral Defects Involving the Medial and Lateral Femoral Condyles After Meniscectomy: A Biomechanical Study Using a Goat Model

Koh

Jacob

Kulkarni

et al. 2022

Orthopaedic Journal of Sports Medicine

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Background: Full-thickness chondral defects alter tibiofemoral joint homeostasis and, if left untreated, have the potential to progress to osteoarthritis. Purpose: To assess the effects of isolated and dual full-thickness chondral defect size and location on the biomechanical properties of the lateral femoral condyle (LFC) and medial femoral condyle (MFC) during dynamic knee flexion in goat knees without menisci. Methods: In 12 goat knees, we created progressively increasing full-thickness circular chondral defects (3-, 5-, and 7.5-mm diameter) in the weightbearing contact area of flexion and extension in the MFC, the LFC, or both. Each knee was fixed into a custom steel frame and attached to a motor with sensors inserted intra-articularly. For each testing condition, the knee was loaded to 100 N and underwent a dynamic range of motion between 90° of flexion and 30° of extension. The following parameters were collected: contact area, contact pressure, contact force, peak area, and peak pressure. Study Design: Controlled laboratory study. Results: The peak pressure at the defect rim of the MFC at full extension increased by 51.51% from no defect (1.887 MPa) to a 7.5-mm defect (2.859 MPa) ( P < .001), and the peak pressure at the defect rim of the LFC at full extension increased by 139.14% from no defect (1.704 MPa) to a 7.5-mm defect (4.075 MPa) ( P < .001). The peak pressures for LFC defects at all 3 diameters were significantly greater when compared with dual defects consisting of increasing LFC defect diameter and constant MFC defect diameter ( P < .001 for all). Conclusion: Extremely large increases in peak pressure were seen at the rim of articular cartilage defects when evaluated under dynamic loading conditions. Isolated LFC defects experienced a greater increase in defect rim stress concentrations when compared with isolated MFC defects for equivalent increases in defect size. Defect size played a significant role independent of location for peak pressures on the MFC and LFC. Clinical Relevance: Significant rim-loading effects increase with defect size under dynamic loading and may result in increasingly rapid progression of articular cartilage lesions. Within the context of this goat model, findings suggest that lateral compartment chondral lesions are more likely to progress than medial compartment lesions of equivalent size.

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Section: Discussioncontrasting

confidence: 63%

Consequences of Progressive Full-Thickness Focal Chondral Defects Involving the Medial and Lateral Femoral Condyles After Meniscectomy: A Biomechanical Study Using a Goat Model

Koh

Jacob

Kulkarni

et al. 2022

Orthopaedic Journal of Sports Medicine

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“…Thirdly, we tested the valgus laxity only in extension. Although the MCL is the primary static stabiliser against valgus rotation of the knee, in extension the posterior medial capsule seems to be an important structure and in flexion it is the superficial MCL [3, 14]. Nevertheless, in extension, we found a significant increase in valgus laxity after release of the superficial MCL, so, in flexion, the valgus laxity is expected to be more pronounced.…”

Section: Discussionmentioning

confidence: 71%

Relaxation of the MCL after an Open-Wedge High Tibial Osteotomy results in decreasing contact pressures of the knee over time

Egmond

Hannink

Janssen

et al. 2017

Knee Surg Sports Traumatol Arthrosc

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PurposeThe objective of this study was to investigate the effect of a medial open-wedge osteotomy (OWO) and the release of the superficial medial collateral ligament (MCL) on the tibiofemoral cartilage pressure, the MCL tension and the valgus laxity of the knee.MethodsSeven fresh-frozen, human cadaveric knees were used. Medial and lateral mean contact pressure (CP), peak contact pressure (peakCP), and contact area (CA) were measured using a pressure-sensitive film (I-Scan; Tekscan, Boston, MA). The MCL tension was measured using a custom-made device. These measurements were continuously recorded for 5 min after an OWO of 10°. After the osteotomy, the valgus laxity was measured with a handheld Newtonmeter. For one knee, the measurements were continued for 24 h. At the end, a complete release of the superficial MCL was performed and the measurements were repeated at 10°.ResultsThere was relaxation of the MCL after the osteotomy; the tension dropped in 5 min with 10.7% (mean difference 20.5 N (95% CI 16.1–24.9)), and in 24 h, the tension decreased by 24.2% (absolute difference 38.8 N) (one knee). After the osteotomy, the mean CP, peakCP and CA increased in the medial compartment (absolute difference 0.17 MPa (95% CI 0.14–0.20), 0.27 MPa (95% CI 0.24–0.30), 132.9mm2 (95% CI 67.7–198.2), respectively), and decreased in the lateral compartment (absolute difference 0.02 MPa (95% CI 0.03 –0.01), 0.08 MPa (95% CI 0.11 – 0.04), 47.0 mm2 (95% CI −105.8 to 11.8), respectively). Only after a release of the superficial MCL, the mean CP, peak CP and CA significantly decreased in the medial compartment (absolute difference 0.17, 0.27 MPa, 119.8 mm2, respectively), and increased in the lateral compartment (absolute difference 0.02, 0.11 MPa, 52.4 mm2, respectively). After the release of the superficial MCL, a mean increase of 7.9° [mean difference − 0.1° (95% CI −1.9 to 1.6)] of the valgus laxity was found.ConclusionsA release of the superficial MCL helps achieve the goal of reducing medial cartilage pressure in an OWO. There was considerable relaxation of the MCL after an OWO that resulted in a decrease of the mean CP in the medial and lateral compartments of the knee over time. However, cartilage pressure shifted from the medial to the lateral compartment only after release of the superficial MCL. The release of the superficial MCL caused a significant increase in the valgus laxity, which could influence stability after an OWO.Level of evidenceI.

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“…Joints were opened using aseptic technique, and one osteochondral explant was harvested from the anterior region of each distal femoral medial condyle [19]. This location was chosen for consistent harvest of samples from loadbearing regions of the joint [19][20][21], enabling the study of articular cartilage at locations more susceptible to accelerated wear in hemiarthroplasties. In addition, because this region of the stifle joint is characterized by high levels of SZP expression [19,22], it facilitates the quantification of protein loss due to mechanical wear.…”

Section: Methodsmentioning

confidence: 99%

Friction and Wear of Hemiarthroplasty Biomaterials in Reciprocating Sliding Contact With Articular Cartilage

Chan

Neu

Komvopoulos

et al. 2011

Journal of Tribology

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Friction and wear of four common orthopaedic biomaterials, alumina (Al2O3), cobalt-chromium (CoCr), stainless steel (SS), and crosslinked ultra-high-molecular-weight polyethylene (UHMWPE), sliding against bovine articular cartilage explants were investigated by reciprocating sliding, nanoscale friction and roughness measurements, protein wear assays, and histology. Under the experimental conditions of the present study, CoCr yielded the largest increase in cartilage friction coefficient, largest amount of protein loss, and greatest change in nanoscale friction after sliding against cartilage. UHMWPE showed the lowest cartilage friction coefficient, least amount of protein loss, and insignificant changes in nanoscale friction after sliding. Although the results are specific to the testing protocol and surface roughness of the examined biomaterials, they indicate that CoCr tends to accelerate wear of cartilage, whereas the UHMWPE shows the best performance against cartilage. This study also shows that the surface characteristics of all biomaterials must be further improved to achieve the low friction coefficient of the cartilage/cartilage interface.

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Pressure distribution in the knee joint

Cited by 23 publications

References 27 publications

Consequences of Progressive Full-Thickness Focal Chondral Defects Involving the Medial and Lateral Femoral Condyles After Meniscectomy: A Biomechanical Study Using a Goat Model

Consequences of Progressive Full-Thickness Focal Chondral Defects Involving the Medial and Lateral Femoral Condyles After Meniscectomy: A Biomechanical Study Using a Goat Model

Relaxation of the MCL after an Open-Wedge High Tibial Osteotomy results in decreasing contact pressures of the knee over time

Friction and Wear of Hemiarthroplasty Biomaterials in Reciprocating Sliding Contact With Articular Cartilage

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