The effect of meniscal tears and resultant partial meniscectomies on the knee contact stresses: a finite element analysis

Abstract

Knee osteoarthritis (OA) is believed to result from high levels of contact stresses on the articular cartilage and meniscus after meniscal damage. This study investigated the effect of meniscal tears and partial meniscectomies on the peak compressive and shear stresses in the human knee joint. An elaborate three-dimensional finite element model of knee joint including bones, articular cartilages, menisci and main ligaments was developed from computed tomography and magnetic resonance imaging images. This model was used to model four types of meniscal tears and their resultant partial meniscectomies and analysed under an axial 1150 N load at 0° flexion. Three different conditions were compared: a healthy knee joint, a knee joint with medial meniscal tears and a knee joint following partial meniscectomies. The numerical results showed that each meniscal tear and its resultant partial meniscectomy led to an increase in the peak compressive and shear stresses on the articular cartilages and meniscus in the medial knee compartment, especially for partial meniscectomy. Among the four types of meniscal tears, the oblique tear resulted in the highest values of the peak compressive and shear stresses. For the four partial meniscectomies, longitudinal meniscectomy led to the largest increase in these two stresses. The lateral compartment was minimally affected by all the simulations. The results of this study demonstrate meniscal tear and its resultant partial meniscectomy has a positive impact on the maintenance of high levels of contact stresses, which may improve the progression of knee OA, especially for partial meniscectomy. Surgeons should adopt a prudent strategy to preserve the greatest amount of meniscus possible.

Regional and depth variability of porcine meniscal mechanical properties through biaxial testing

“…The results of these previous studies suggest the mechanical response in meniscal tissue is non-homogenous. However, current finite element models (FEM) of the meniscus have modeled the meniscus as transversely isotropic without accommodating regional variation in properties (Haut Donahue et al, 2003;Bao et al, 2013;Dong et al, 2014;Mononen et al, 2013). Moreover, while little has been reported on the mechanical response of the two scaffolds currently commercially available (Spencer et al, 2012), there may be benefits to gain from synthesizing scaffolds of nonhomogenous properties.…”

Analysis of Force Transmission by a Knee Loading Device from Skin and Soft Tissue to Knee Joint Elements

“…Bendjaballah et al [20] found that the compressive stress on the menisci varied between 1 MPa in the external periphery to 4 MPa in the internal periphery, under a compressive force of 1300 N. Dong et al [21] obtained a compressive stress on the medial and lateral meniscus of 3.00 and 2.83 MPa, respectively. Pena et al [22] found that the compressive stress on the medial meniscus was 3.31 MPa.…”

Mechanisms underpinning the peak knee flexion moment increase over 2-years following arthroscopic partial meniscectomy

“…Third, the absence of information regarding the amount and location of meniscus removed is a limitation as these have been shown to alter joint contact force (Atmaca et al, 2013;Dong et al, 2014), and possibly the peak KFM. Finally, as in any correlation study, the observed associations do not necessarily indicate causation.…”